EAC_Setup

0

Easy Asthma Clinic

. . M.D., Ph.D.

1

Easy Asthma Clinic

1 2

10-12% 3, 4 6.9% 5 66,679 .. 2538 100,808 ..2550 1

6 14.8% 1 21.7% 1 6.7% 7 8

(Easy Asthma Clinic) 9 Easy Asthma Clinic

2

PEFR inhaled corticosteroids 10

5 Easy Asthma Clinic

Easy Asthma Clinic web database

Easy Asthma Clinic

1.

2. 3. 4.

1. easy asthma clinic

13

3

easy asthma clinic



4. /

5.

2552- 2555

1.

2. 3. 4.

4

3 .. 2530

(airway hyperresponsiveness) , , 11 B2-agonists B2-agonists

.. 2530-2540 12 (asthmatic attack) (inhaled steroids) inhaled corticosteroids

.. 2540 airway remodeling13 14 airway remodeling airway remodeling airway remodeling15 airway remodeling (inhaled steroids)

5

16, 17 18

(Asthma Guidelines)

(WHO) National Heart Lung and Blood Institute (NHLBI) .. 1995 Global Initiative for Asthma Guidelines (GINA Guidelines 1995)19 GINA guidelines

.. 20022 .. 200620

GINA guidelines 1995 GINA guidelines 1995

GINA guidelines 1995

6

(Peak expiratory flow rate) peak flow (peak flow variability) 4 ( 1)

1. Intermittent asthma () 2. mild persistent asthma () 3. Moderate persistent asthma () 4. severe persistent asthma ()

1. (FEV1 PEFR) PEFR

19

PEFR Peak Flow variability

1. 1. Intermittent 1 / >2/ > 80% 20-30%

3. 3. Moderate persistent ()

>1/ 60-80 % > 30%

4. 4. Severe persistent ()

< 60% > 30%

7

2 1. (relievers) short-acting beta2 agonists(SABA)

2. (controllers) long-acting beta2 agonists (LABA)

sustained release theophylline 4

1 (Intermittent) b2- agonist 2 (mild persistent) Inhaled corticosteroids

(beclomethasone budesonide 200-800 g/d fluticasone 100-400 g/d ) b2- agonist 3 (Moderate persistent) Inhaled

corticosteroids (beclomethasone budesonide 800-1600 g/d fluticasone 400-

800 g/d) 4 (severe persistent) Inhaled corticosteroids

(beclomethasone budesonide 1600-2000 g/d fluticasone 800-1000 g/d ) long acting b2-agonists, sustained release theophylline prednosolone 3

GINA guidelines 2002 2 3

Inhaled corticosteroids long acting b2-agonists Inhaled corticosteroids long acting b2-agonists Inhaled corticosteroids Inhaled corticosteroids 16, 17,

8

21 long acting b2-agonists Inhaled corticosteroids

GINA guidelines 2006 GINA guidelines 1995 2002

22 23 guidelines guidelines

GINA guidelines 2006 guidelines (asthma controlled)

1. 2. 3. 4. 5. 6.

(controlled) (partly controlled) (uncontrolled) 2

9

2 Characteristic Controlled

(All of the following)

Partly Controlled (Any measure present in any week)

Uncontrolled

Daytime symptoms None (twice or less/week)

More than twice/week Three or more features of partly controlled asthma present

Limitations of activities

None Any

Nocturnal symptoms/awakening

None Any

Need for reliever/ rescue treatment

None (twice or less/week)

More than twice/week

Lung function (PEF or FEV1)

Normal < 80% predicted or personal best (if known)

Exacerbations None One or more/year* One in any week

5

1. short-acting b2- agonist (SABA) 2. inhaled corticosteroids 3. inhaled corticosteroids (ICS) long acting b2-agonists (LABA) 4. inhaled corticosteroids (ICS) long acting b2-agonists (LABA) 5. inhaled corticosteroids (ICS) long acting b2-agonists (LABA)

prednisolone

inhaled corticosteroids (ICS) long acting b2-agonists (LABA)

10

inhaled corticosteroids (ICS) 1

1

11

.. 2537

24 GINA guideline 1995 .. 2540 25 .. 254726 GINA guideline 2002 .. 255227 GINA guideline 2008

GINA guideline 6 14.8% 1 21.7% 1 6.7% 2550 28 1.08 % (Peak Expiratory Flow ) 10.92% GINA guideline 7 8

1. 6

2.

12

(inhaled corticosteroids)

3.

4. peak flow meter peak flow

5. 5-10

13

(Easy Asthma Clinic) GINA guideline

(Easy Asthma Clinic) 3 2547

1. (Easy Asthma Guideline) GINA guideline 1995 GINA guideline 2002 4 Intermittent asthma, mild persistent asthma, moderate persistent asthma severe persistent asthma Easy Asthma Guideline (asthma control) 4 3 Peak Flow PEFR 80% inhaled corticosteroids 500 -1000ug/d controller ( theophylline, LABA Leukotriene antagonist ) controller

2.

3. http://eac2.dbregistry.com

14

3. (asthma control questionnaires) 4

1. 4

2. 4 ,,

3. 4 ()? 4. 2

1. ( appendix1)

(appendix2) ( Peak Expiratory Flow Rate: PEFR)

2. (Easy Asthma Guideline) (500-1000 ) controller 3 controller 1

3.

15

Peak Flow Meter Peak Flow Meter

/ (Peak Expiratory Flow rate,PEFR)

Peak Flow Meter

Peak Flow Meter 1. 0 2. ( ) 3. 4.

5. 6. 1-5 2 ( 3 ) 7.

8. (Predicted)

Easy Asthma Clinic 1. 10, 29-31 2.

10, 29-31 3. 4.

16

.. 2551 Easy Asthma Clinic Easy Asthma Clinic 98 () 25.95 71.71% 32 .. 2553 Easy Asthma Clinic 500 2554 Easy Asthma Clinic

17

References 1. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet. 1998; 351(9111): 1225-32. 2. Global initiative for asthma. Global strategy for asthma management and prevention NHLBI/WHO revised 2002; 2002. 3. Vichyanond P, Jirapongsananuruk O, Visitsuntorn N, Tuchinda M. Prevalence of asthma, rhinitis and eczema in children from the Bangkok area using the ISAAC (International Study for Asthma and Allergy in Children) questionnaires. J Med Assoc Thai. 1998; 81(3): 175-84. 4. Teeratakulpisarn J, Pairojkul S, Heng S. Survey of the prevalence of asthma, allergic rhinitis and eczema in schoolchildren from Khon Kaen, Northeast Thailand. an ISAAC study. International Study of Asthma and Allergies in Childhood. Asian Pac J Allergy Immunol. 2000; 18(4): 187-94. 5. Boonsawat W, Charoenphan P, Kaitboonsri S, Wiriyachaiyoo V, Pothirat C, Wongtim S, et al. Prevalence of asthma symptoms in adult in 4 cities of Thailand. Joint scientific meeting the Thoracic Society of Thailand, the Malaysia Thoracic Society and the Singapore Thoracic Society; 2002; Bangkok, Thailand; 2002. p. 112. 6. Boonsawat W, Charoenphan P, Kiatboonsri S, Wongtim S, Viriyachaiyo V, Pothirat C, et al. Survey of asthma control in Thailand. Respirology. 2004; 9(3): 373-8. 7. Adams RJ, Fuhlbrigge A, Guilbert T, Lozano P, Martinez F. Inadequate use of asthma medication in the United States: results of the asthma in America national population survey. J Allergy Clin Immunol. 2002; 110(1): 58-64. 8. Rabe KF, Vermeire PA, Soriano JB, Maier WC. Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study. Eur Respir J. 2000; 16(5): 802-7. 9. . (Easy Asthma Clinic). In: , , editors. 5th BGH Annual academic meeting:From the basic to the top in Medicine. : . ; 2548. p. 83-7.

18

10. Kanchit Chermchitrphong, Kookwan Sawadpanich, Jinjutha Klaiwong, Niphon Thitiyanviroj. Improvement of standard treatment of asthma at Manjakiree Hospital. Khon Kaen Medical Journal. 2007; 31(3): 231-40. 11. Shepherd GL, Hetzel MR, Clark TJH. Regular versus symptomatic aerosol bronchodilator treatment of asthma. Br J Dis Chest. 1981; 75: 215-7. 12. Holgate ST, Finnerty JP. Recent advances in understanding the pathogennesis of asthma and its clinical implications. Quarterly Journal of Medicine. 1988; New Series 66(249): 5-19. 13. Busse W, Elias J, Sheppard D, Banks-Schlegel S. Airway remodeling and repair. Am J Respir Crit Care Med. 1999; 160(3): 1035-42. 14. Redington AE, Howarth PH. Airway wall remodelling in asthma. Thorax. 1997; 52(4): 310-2. 15. Haahtela T, Jarvinen M, Kava T, Kiviranta K, Koskinen S, Lehtonen K, et al. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med. 1994; 331(11): 700-5. 16. Greening AP, Ind PW, Northfield M, Shaw G. Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. Lancet. 1994; 344(8917): 219-24. 17. Woolcock AJ. The combined use of inhaled salmeterol and inhaled corticosteroids. Eur Respir Rev. 1995; 5(27): 142-5. 18. Condemi JJ, Goldstein S, Kalberg C, Yancey S, Emmett A, Rickard K. The addition of salmeterol to fluticasone propionate versus increasing the dose of fluticasone propionate in patients with persistent asthma. Salmeterol Study Group. Ann Allergy Asthma Immunol. 1999; 82(4): 383-9. 19. Global initiative for asthma. Global strategy for asthma management and prevention NHLBI/WHO workshop report; 1995. 20. Global initiative for asthma. Global Srategy for Asthma Management and Prevention (revised 2006): The GINA reports are available on www.ginasthma.org.; 2006. 21. Pauwels RA, Lofdahl CG, Postma DS, Tattersfield AE, O'Byrne P, Barnes PJ, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroids Establishing Therapy (FACET) International Study Group. N Engl J Med. 1997; 337(20): 1405-11.

19

22. Liwsrisakun C, Pothirat C. Actual implementation of the Thai Asthma Guideline. J Med Assoc Thai. 2005; 88(7): 898-902. 23. Chipps BE, Spahn JD, Sorkness CA, Baitinger L, Sutton LB, Emmett AH, et al. Variability in asthma severity in pediatric subjects with asthma previously receiving short-acting beta2-agonists. J Pediatr. 2006; 148(4): 517-21. 24. . . 2538; 24(1): 17-29. 25. . ( ). . 2541; 19(3): 179-93. 26. . .. 2547. 1 ed. : ; 2547. 27. .. 2551. : .. 2551. : (); 2552. 28. . 2550; 2551. 29. . . . 2550; 22(4): 449-58. 30. . . . 2550; 31(3): 262-8. 31. Aree Duangdee. Outcomes of an Easy Asthma Clinic, Banphai Hospital, Khon Kaen Province. Journal of Health System Research. 2007; 1(2 supplement1): 45-50. 32. . ; 2551.

20

Appendix

(Appendix 1) (first visit) .. 1) HN.Asthma No 2) . .. 3) M) F) 4) .. .. 5) . ... ... 6) // / / 7) . .. 8) . 9) 12

0) 1) .. ( .) 10) 12

0) 1) . 11)

* B2 agonist inhaler No Yes *B2 agonist Tab No Yes *Theophylline No Yes *Steroid inhaler No Yes *Oral steroid No Yes * B2 + Ipratropium inhaler No Yes * B2 + ICS inhaler No Yes *ICS + LABA No Yes *Anti-Leukotriene No Yes

12) 0) 1) 13) 0) 1) ( 1 1 20 )

1. 0) 1) 2...

3. .. 4.../

14) // 15)

Thailand Asthma and Respiratory Forum

APPENDIX 2 ASTHMA / COPD

Updted 22 .. 2552

l.HNAsthma / COPD No..Predicted PEFR..L/min .... 1. 4 0) 1) 1 / 2) 1 / 3) 4) 2. 4 0) 1) 2 / 2) 2 / 3) 1 / 4) 3. 4 () 0) 1) 1/ 2) 3) 4) 4 / 2 4. 4 0) 1) ( ...) 5. 4 0) 1) ( ..) 6. 0) 1) 2) 3) . 7. PRE PEFRL/min Predicted PEF.L/min % Predicted..... POST PEFR...L/min.%Predicted FVC..L Predicted FVC.L % Predicted.. FVC L....%Predicted

FEV1 L Predicted PEV1...L % Predicted.. FEV1.. L....%Predicted PD20..

8. ( 4 ) 1. .. 2. .. 3. .. 4. .. 9. 1. . 2. . 3. . 4. . 10. .........

APPENDIX 2 ASTHMA / COPD

Updted 22 .. 2552

11. 0) 1) 12. . ( COPD) 0) 1) 13. . ( COPD)

( ) 0) 1) 2) 3) 100 4)

14. ( COPD) SIX minute walk .

15 16 17 18 (0-100%) %

19 ()

(Appendix 3) OPD Card Easy Asthma clinic HN Asthma No

Predicted PEFR L/min

Date

Day s

ym

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ms

Nig

ht

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od

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Un

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Ad

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FR

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, %

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PEFR (Appendix 4) Reference: Dejsomritrutai W, Nana A, Maranetra KN, et al Reference spirometric values for healthy lifetime nonsmokers in Thailand.J Med Assoc Thai. 2000;83(5):457-66 (.)

150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 18415 374 390 405 420 435 450 465 480 495 511 526 541 556 571 586 601 616 63216 381 396 411 426 441 456 471 486 501 516 531 546 561 576 591 606 621 63617 386 401 416 431 446 461 476 491 505 520 535 550 565 580 595 610 624 63918 392 407 422 436 451 466 481 495 510 525 540 554 569 584 599 613 628 64319 397 412 427 441 456 471 485 500 515 529 544 558 573 588 602 617 632 64620 403 417 432 446 461 475 490 504 519 533 548 562 577 591 606 620 635 65021 408 422 436 451 465 480 494 508 523 537 552 566 580 595 609 624 638 65222 412 427 441 455 470 484 498 512 527 541 555 570 584 598 612 627 641 65523 417 431 445 459 474 488 502 516 530 544 559 573 587 601 615 629 644 65824 421 435 449 463 477 492 506 520 534 548 562 576 590 604 618 632 646 66025 425 439 453 467 481 495 509 523 537 551 565 579 593 606 620 634 648 66226 429 443 457 471 485 498 512 526 540 554 567 581 595 609 623 636 650 66427 433 447 460 474 488 501 515 529 543 556 570 584 597 611 625 638 652 66628 437 450 464 477 491 504 518 531 545 559 572 586 599 613 626 640 654 66729 440 453 467 480 494 507 520 534 547 561 574 588 601 615 628 641 655 66830 443 456 470 483 496 509 523 536 549 563 576 589 603 616 629 643 656 66931 446 459 472 485 498 512 525 538 551 564 578 591 604 617 630 644 657 67032 448 461 474 488 501 514 527 540 553 566 579 592 605 618 631 645 658 67133 451 464 477 490 503 516 528 541 554 567 580 593 606 619 632 645 658 67134 453 466 479 491 504 517 530 543 556 568 581 594 607 620 633 645 658 67135 455 468 480 493 506 518 531 544 557 569 582 595 608 620 633 646 658 67136 457 469 482 494 507 520 532 545 557 570 583 595 608 620 633 646 658 671


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 18437 458 471 483 496 508 521 533 546 558 570 583 595 608 620 633 645 658 67038 459 472 484 497 509 521 534 546 558 571 583 595 608 620 633 645 657 67039 461 473 485 497 510 522 534 546 558 571 583 595 607 620 632 644 656 66940 461 474 486 498 510 522 534 546 558 571 583 595 607 619 631 643 655 66841 462 474 486 498 510 522 534 546 558 570 582 594 606 618 630 642 654 66642 463 474 486 498 510 522 534 546 558 570 581 593 605 617 629 641 653 66543 463 475 486 498 510 522 533 545 557 569 580 592 604 616 627 639 651 66344 463 474 486 498 509 521 533 544 556 568 579 591 603 614 626 637 649 66145 463 474 486 497 509 520 532 543 555 566 578 589 601 612 624 635 647 65946 462 474 485 496 508 519 531 542 553 565 576 588 599 610 622 633 645 65647 462 473 484 495 507 518 529 541 552 563 574 586 597 608 620 631 642 65348 461 472 483 494 505 517 528 539 550 561 572 584 595 606 617 628 639 65149 460 471 482 493 504 515 526 537 548 559 570 581 592 603 614 625 636 64750 458 469 480 491 502 513 524 535 546 557 568 579 590 600 611 622 633 64451 457 468 479 489 500 511 522 533 543 554 565 576 587 597 608 619 630 64152 455 466 477 487 498 509 519 530 541 551 562 573 583 594 605 615 626 63753 453 464 474 485 496 506 517 527 538 548 559 570 580 591 601 612 622 63354 451 462 472 483 493 503 514 524 535 545 556 566 576 587 597 608 618 62955 449 459 470 480 490 500 511 521 531 542 552 562 573 583 593 604 614 62456 446 456 467 477 487 497 507 518 528 538 548 558 569 579 589 599 609 62057 444 454 464 474 484 494 504 514 524 534 544 554 564 575 585 595 605 61558 441 450 460 470 480 490 500 510 520 530 540 550 560 570 580 590 600 610


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 18459 437 447 457 467 477 486 496 506 516 526 536 546 555 565 575 585 595 60560 434 444 453 463 473 482 492 502 512 521 531 541 551 560 570 580 589 59961 430 440 449 459 469 478 488 497 507 517 526 536 545 555 565 574 584 59362 426 436 445 455 464 474 483 493 502 512 521 531 540 550 559 569 578 58863 422 432 441 450 460 469 478 488 497 507 516 525 535 544 553 563 572 58164 418 427 436 446 455 464 473 483 492 501 510 520 529 538 547 557 566 57565 413 423 432 441 450 459 468 477 486 496 505 514 523 532 541 550 559 56966 409 418 427 436 445 454 463 472 481 490 499 508 517 526 535 544 553 56267 404 413 422 430 439 448 457 466 475 484 493 501 510 519 528 537 546 55568 399 407 416 425 434 442 451 460 469 477 486 495 504 513 521 530 539 54869 393 402 411 419 428 436 445 454 462 471 480 488 497 506 514 523 531 54070 388 396 405 413 422 430 439 447 456 464 473 481 490 498 507 515 524 53371 382 390 399 407 415 424 432 441 449 457 466 474 483 491 499 508 516 52572 376 384 392 401 409 417 426 434 442 450 459 467 475 483 492 500 508 51773 370 378 386 394 402 410 419 427 435 443 451 459 468 476 484 492 500 50874 363 371 379 387 395 403 411 419 427 435 444 452 460 468 476 484 492 50075 356 364 372 380 388 396 404 412 420 428 436 444 452 459 467 475 483 49176 350 357 365 373 381 389 396 404 412 420 428 435 443 451 459 467 474 48277 342 350 358 366 373 381 389 396 404 412 419 427 435 442 450 458 465 47378 335 343 350 358 365 373 381 388 396 403 411 418 426 433 441 449 456 46479 328 335 342 350 357 365 372 380 387 395 402 409 417 424 432 439 447 45480 320 327 335 342 349 356 364 371 378 386 393 400 408 415 422 430 437 444


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 182 18481 312 319 326 333 341 348 355 362 369 377 384 391 398 405 413 420 427 43482 304 311 318 325 332 339 346 353 360 367 375 382 389 396 403 410 417 42483 295 302 309 316 323 330 337 344 351 358 365 372 379 386 393 400 407 41484 287 294 300 307 314 321 328 335 341 348 355 362 369 376 382 389 396 40385 278 285 291 298 305 311 318 325 332 338 345 352 359 365 372 379 385 39286 269 275 282 289 295 302 308 315 322 328 335 341 348 355 361 368 374 38187 260 266 273 279 285 292 298 305 311 318 324 331 337 344 350 357 363 37088 250 256 263 269 276 282 288 295 301 307 314 320 326 333 339 345 352 35889 240 247 253 259 265 272 278 284 290 297 303 309 315 321 328 334 340 34690 230 237 243 249 255 261 267 273 279 286 292 298 304 310 316 322 328 33591 220 226 232 238 244 250 256 262 268 274 280 286 292 298 304 310 316 32292 210 216 222 228 234 239 245 251 257 263 269 275 281 286 292 298 304 31093 199 205 211 217 222 228 234 240 246 251 257 263 269 274 280 286 292 29794 189 194 200 206 211 217 222 228 234 239 245 251 256 262 268 273 279 28595 178 183 189 194 200 205 211 216 222 227 233 238 244 249 255 260 266 27296 166 172 177 183 188 193 199 204 210 215 220 226 231 237 242 247 253 25897 155 160 166 171 176 181 187 192 197 203 208 213 218 224 229 234 240 24598 143 149 154 159 164 169 174 180 185 190 195 200 205 210 216 221 226 23199 132 137 142 147 152 157 162 167 172 177 182 187 192 197 202 207 212 217

100 119 124 129 134 139 144 149 154 159 164 169 174 178 183 188 193 198 203


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 18215 338 348 357 366 375 382 390 397 403 409 415 420 424 428 432 435 43716 340 350 359 368 376 384 391 398 404 410 415 420 425 429 432 435 43817 342 351 360 369 377 385 392 399 405 411 416 421 425 429 433 435 43818 343 353 362 370 378 386 393 400 406 411 417 421 426 429 433 436 43819 345 354 363 371 379 387 394 400 406 412 417 422 426 430 433 436 43820 346 355 364 372 380 388 395 401 407 413 418 422 426 430 433 436 43821 347 356 365 373 381 388 395 402 408 413 418 422 426 430 433 436 43822 348 357 366 374 382 389 396 402 408 413 418 423 426 430 433 435 43723 349 358 367 375 382 390 396 402 408 413 418 423 426 430 433 435 43724 350 359 367 375 383 390 397 403 408 414 418 422 426 429 432 435 43625 351 360 368 376 383 390 397 403 408 414 418 422 426 429 432 434 43626 351 360 368 376 384 391 397 403 408 413 418 422 426 429 431 433 43527 352 361 369 377 384 391 397 403 408 413 418 422 425 428 431 433 43428 352 361 369 377 384 391 397 403 408 413 417 421 425 427 430 432 43329 353 361 369 377 384 391 397 403 408 412 417 421 424 427 429 431 43230 353 361 369 377 384 391 397 402 407 412 416 420 423 426 428 430 43131 353 362 369 377 384 390 396 402 407 411 415 419 422 425 427 429 43032 353 362 369 377 384 390 396 401 406 411 415 418 421 424 426 428 42933 353 361 369 376 383 389 395 401 405 410 414 417 420 423 425 426 42734 353 361 369 376 383 389 395 400 405 409 413 416 419 421 423 425 426


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 18235 353 361 368 375 382 388 394 399 404 408 412 415 418 420 422 423 42436 353 360 368 375 381 387 393 398 403 407 410 414 416 419 420 422 42237 352 360 367 374 381 387 392 397 402 406 409 412 415 417 419 420 42138 352 359 367 373 380 386 391 396 400 404 408 411 413 415 417 418 41939 351 359 366 372 379 385 390 395 399 403 406 409 412 414 415 416 41740 350 358 365 371 378 383 389 393 398 401 405 407 410 412 413 414 41541 349 357 364 370 376 382 387 392 396 400 403 406 408 410 411 412 41242 348 356 363 369 375 381 386 390 394 398 401 404 406 408 409 410 41043 347 355 362 368 374 379 384 389 393 396 399 402 404 406 407 407 40844 346 353 360 366 372 378 383 387 391 394 397 400 402 403 404 405 40545 345 352 359 365 371 376 381 385 389 392 395 398 399 401 402 402 40246 344 351 357 363 369 374 379 383 387 390 393 395 397 398 399 400 40047 342 349 356 362 367 372 377 381 385 388 391 393 395 396 397 397 39748 341 347 354 360 365 370 375 379 382 386 388 390 392 393 394 394 39449 339 346 352 358 363 368 373 377 380 383 386 388 389 390 391 391 39150 337 344 350 356 361 366 370 374 378 381 383 385 387 388 388 388 38851 335 342 348 354 359 364 368 372 375 378 380 382 384 385 385 385 38552 333 340 346 352 357 361 366 369 372 375 378 379 381 381 382 382 38153 331 338 344 349 354 359 363 367 370 372 375 376 378 378 379 378 37854 329 336 341 347 352 356 360 364 367 369 372 373 374 375 375 375 374


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 18255 327 333 339 344 349 354 358 361 364 366 368 370 371 372 372 371 37156 325 331 337 342 347 351 355 358 361 363 365 367 368 368 368 368 36757 322 328 334 339 344 348 352 355 358 360 362 363 364 365 365 364 36358 320 326 331 336 341 345 349 352 355 357 359 360 361 361 361 360 35959 317 323 328 333 338 342 345 349 351 353 355 356 357 357 357 356 35560 314 320 325 330 335 339 342 345 348 350 351 352 353 353 353 352 35161 311 317 322 327 332 335 339 342 344 346 348 349 349 349 349 348 34762 308 314 319 324 328 332 335 338 341 342 344 345 345 345 345 344 34263 305 311 316 321 325 329 332 334 337 339 340 341 341 341 340 339 33864 302 308 313 317 321 325 328 331 333 335 336 337 337 337 336 335 33365 299 304 309 314 318 321 324 327 329 331 332 332 333 332 332 330 32966 295 301 306 310 314 317 320 323 325 326 328 328 328 328 327 326 32467 292 297 302 306 310 314 316 319 321 322 323 324 324 323 322 321 31968 288 294 298 303 306 310 312 315 317 318 319 319 319 319 318 316 31469 285 290 294 299 302 305 308 310 312 313 314 315 314 314 313 311 30970 281 286 291 295 298 301 304 306 308 309 310 310 310 309 308 306 30471 277 282 287 290 294 297 299 302 303 304 305 305 305 304 303 301 29972 273 278 282 286 290 293 295 297 298 299 300 300 300 299 297 296 29373 269 274 278 282 285 288 290 292 294 295 295 295 295 294 292 290 28874 265 270 274 277 281 283 286 288 289 290 290 290 289 288 287 285 282


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 18275 261 265 269 273 276 279 281 283 284 285 285 285 284 283 281 279 27776 256 261 265 268 271 274 276 278 279 280 280 279 279 277 276 274 27177 252 256 260 264 267 269 271 273 274 274 274 274 273 272 270 268 26578 247 252 255 259 262 264 266 267 268 269 269 268 268 266 264 262 25979 243 247 251 254 257 259 261 262 263 263 263 263 262 260 258 256 25380 238 242 246 249 252 254 255 257 258 258 258 257 256 254 252 250 24781 233 237 241 244 246 248 250 251 252 252 252 251 250 248 246 244 24182 228 232 235 238 241 243 245 246 246 247 246 245 244 242 240 237 23483 223 227 230 233 236 238 239 240 241 241 240 239 238 236 234 231 22884 218 222 225 228 230 232 233 234 235 235 234 233 232 230 227 225 22185 212 216 219 222 224 226 228 228 229 229 228 227 225 223 221 218 21586 207 211 214 216 219 220 222 222 223 222 222 221 219 217 214 211 20887 202 205 208 211 213 214 216 216 217 216 215 214 213 210 208 205 20188 196 199 202 205 207 208 210 210 210 210 209 208 206 204 201 198 19489 190 194 197 199 201 202 203 204 204 203 202 201 199 197 194 191 18790 185 188 191 193 195 196 197 197 197 197 196 194 192 190 187 184 18091 179 182 185 187 189 190 191 191 191 190 189 188 185 183 180 176 17392 173 176 178 181 182 183 184 184 184 183 182 181 178 176 173 169 16593 167 170 172 174 176 177 178 178 177 177 175 174 171 169 165 162 15894 160 163 166 168 169 170 171 171 170 170 168 166 164 161 158 154 150


150 152 154 156 158 160 162 164 166 168 170 172 174 176 178 180 18295 154 157 159 161 163 164 164 164 164 163 161 159 157 154 151 147 14296 148 151 153 155 156 157 157 157 156 155 154 152 149 146 143 139 13597 141 144 146 148 149 150 150 150 149 148 146 144 142 139 135 131 12798 135 137 139 141 142 143 143 143 142 141 139 137 134 131 127 123 11999 128 130 132 134 135 136 136 135 135 133 131 129 126 123 120 115 111

100 121 124 126 127 128 128 128 128 127 126 124 121 119 115 112 107 103

PEFR for Under 15 years ( Male and Female)Reference: Polgar G., Promadhat V., Pulmonary function testing in children: techniques and standards. Philadelphia: WB Saunders, 1971

Height (cm)

PEFR Value (L/Min)

Height (cm)

PEFR Value (L/Min)

Height (cm)

PEFR Value (L/Min)

100 99 127 240 154 382101 104 128 246 155 387102 109 129 251 156 392103 114 130 256 157 398104 120 131 261 158 403105 125 132 266 159 408106 130 133 272 160 413107 135 134 277 161 419108 141 135 282 162 424109 146 136 287 163 429110 151 137 293 164 434111 156 138 298 165 439112 162 139 303 166 445113 167 140 308 167 450114 172 141 314 168 455115 177 142 319 169 460116 183 143 324 170 466117 188 144 329 171 471118 193 145 335 172 476119 198 146 340 173 481120 204 147 345 174 487121 209 148 350 175 492122 214 149 356 176 497123 219 150 361 177 502124 225 151 366 178 508125 230 152 371 179 513126 235 153 377 180 518

/

PEFR (L/Min) = - 425.5714 + [ 5.2428 X height (cm) ]

Easy Asthma and COPD Clinic Network Online

1. Website EACC Website : http://eac2.dbregistry.com Google easy asthma clinic http://eac2.dbregistry.com

2. Username Password Enter Login Website Personal profile

Asthma clinic research Asthma COPD COPD **** Asthma clinic research / COPD Manage Links Asthma clinic research Add Links OK Manage Links COPD Add Links OK ****

Asthma clinic research COPD

1. Case Appendix I 1 HN

[ Appendix I]

Appendix I a. 1 1 HN b. HN / c. ( 13 ) d. Asthma Number (

Asthma Number e. ( Search

f. ( Peak flow) g. Case ( Peak flow) h. // ( .. 01/10/2553)

01/01/ i. 1 9 .1 .9 10 1 11 10

12 j. ( 11) yes seretide accuhaler

(250) 1*2 No ( ) k. l. (

Appendix 2 ) 2. Appendix I ( Case) Appendix II 7 HN

Appendix III ( Case )

HN Enter

Appendix2 [ Add Followup] () Appendix2

Appendix II a. Enter b. (// ..)

Enter Appendix I

c. Enter Peak Flow d. 1 7 Enter + e. 7 Peak Flow

Peak Flow ( 3 ) 7.1 Peak Flow Spiro Enter ( Enter )

f. 8

g. () Enter Enter ( trade name ) Seretide accuhaler(250) , Budecort(200) Seretide accuhaler(250) 1 puff Seretide accuhaler(250) 1*2 Ventolin 2 puff Ventolin inhaler 2 prn

h. 9 Order + Ventolin inhaler

i. // j. 14 k. 18 1 30 100% 3

90 100% 3. Appendix I

7 HN Appendix I HN Enter HN

4. Appendix II 7 HN Appendix III HN Enter

Appendix II HN

5. HN 7 HN HN HN Enter

6. Admit

Admit HN Enter Enter Enter () Enter () Enter

HN Enter

7. ER ER HN Enter

Enter Tab Enter

HN Enter

8. Missing

Easy Asthma Clinic

1. 2

- Appendix I .. HN

- Appendix I Appendix II

- Export data Excel [csv] 2. OPD Follow up

Total control, Well control, Poor control HN

2Easy Asthma Clinic Setupappendix1-3Appendix1no-codeAppendix2_NewAppendix3

normal_pEFR_updatemalefemale

normal_PEFR_for_ChildrenSheet1

Manual_Data_entry

Documents

EAC_Setup