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How to Choose an Asthma Diary

Rating Scale for Asthma Diaries Based on Peak Flow Scores

Printer Friendly Rating Scale and Instructions (PDF)

Each category in this rating scale is scored based on completeness, accuracy and ease of use and can achieve a score of fifteen only if items five and ten are fulfilled.

Gives Instructions
The diary should have clear, user-friendly instructions that explain each component to be filled out by the patient or parent. Instructions should be on the same sheet as the diary itself.
5 instructions provided.
10 instructions cover at least three diary components (described below).
15 instructions include example of how to fill out the diary.

Based on Peak Flow
Peak flow monitoring is an essential component of asthma education and management. Peak flow readings provide an early, objective indicator of asthma status. A diary should emphasize the recording and comparison of peak flow scores, before and after treatment with a quick relief medicine, and over the course of time. A graphic layout enhances the ability of the diary user to assess asthma status and identify trends. The zones (green, yellow, red) serve as a guide for treatment decisions by the patient or parent. Asthma signs can be substituted in diaries designed for patients under five years of age.
5 space for recording peak flow scores.
10 graph layout for recording scores.
15 graph organized into peak flow zones.

Includes Signs and Symptoms
A diary should have a separate space to record asthma signs (cough, wheeze, increased respirations and retractions) and symptoms. It should also provide a way for patients to quantify signs to help with assessing asthma status.
5 separate space to record signs or symptoms.
10 three signs and/or symptoms listed on diary with some method to assess severity of each.
15 four signs and/or symptoms listed on diary with a score assigned to frequency or intensity of each.

Lists Medicines
Medicine names should be printed on the diary with space for brand names, dosage and frequency. The patient can then record daily treatment and observe efficacy, onset and duration of action. The patient will be able to see that a change in dose has an effect on peak flow scores and asthma signs.
5 separate space to list each medicine type.
10 adequate space for brand name, dose and frequency.
15 space for patient to check off each medicine dose taken each day.

Comments / Triggers
Space for the patient to record asthma triggers and other comments. Each day should stand in clear relationship to other items in the diary. This design assists with overall evaluation of treatment and status. The diary often demonstrates that triggers are additive.
5 designated space for comments and/or triggers observed by patient.
10 adequate space to log trigger or comment of at least 8 words.
15 comment space linked clearly with entries of peak flow, signs, symptoms and medicine on the same day.

An asthma diary is most useful to the patient and physician when it shows the relationship between the many pieces of the asthma puzzle. For example, peak flow often drops before the appearance of signs or symptoms. Triggers cause a change in peak flow scores, signs and symptoms. Information should be recorded in such a way that the patient can see the relationship between these events.
5 diary design relates two categories.
10 diary design relates three categories.
15 diary design relates four categories .

Color serves two functions in an asthma diary. It clearly demarcates the three peak flow zones: green, yellow and red. When scores move into a different zone, it signals the need to change treatment. Color also attracts the eye to the page, leading to more frequent use of the diary.
10 green, yellow and red colors clearly delineate the peak flow zones.

Printer Friendly Rating Scale and Instructions (PDF)

Comparison of Asthma Diaries Published after 1991

Each category is scored based on completeness, accuracy and ease of use (0, 5, 10, 15)

Company Publication Date Source Instruction PF


Meds Comments Design Color Total
Pedipress Asthma
Peak Flow Diary
2002 sheet 15 15 15 15 15 15 10 100
Pedipress Flujo Maximo 1996 sheet 15 15 15 15 15 15 10 100
Pedipress Asthma
Diary *
2002 sheet 15 15 15 15 15 15 10 100
Guidelines 1997 book 0 5 15 15 15 10 0 60
3-M Symptom/
Peak Flow
1996 sheet 10 5 5 5 15 10 0 50
AAFA You Can Control
1994 work book 10 0 0 5 10 10 0 35
AAN/MA Asthma
2004 sheet 5 5 5 5 0 10 0 30
Spirometrics Spir-O-Flow 2002 insert 15 10 0 0 5 0 0 30
Respironics Personal
1992 insert 10 10 0 10 0 0 0 30
Monaghan Truzone 1994 insert 15 10 0 0 0 0 0 25
Ferraris Medical PocketPeak 2002 insert 5 10 0 5 0 0 0 20
Vital-O-Graph Asthma
N/A insert 0 10 5 0 0 5 0 20
Respironics Assess 2001 insert 0 10 0 0 5 0 0 15
Clement Clarke MiniWright 2000 insert 5 10 5 0 0 0 0 15
Dey Lab Astech 1992 insert 0 5 0 0 5 0 0 10

* For children under five years of age; substitute signs for peak flow score.
Modified from a Pedipress diary.

§ Use these spaces to rate other diaries.

Printer Friendly Rating Scale and Instructions (PDF)

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