Validated questionnaires such as the ACT and those from the RCP should be used to monitor asthma control in people aged 17 and over. Spirometry or peak expiratory flow rate (PEFR) variability should be used for children and young people and can also be used for adults. 

PEFR is widely available and can be used during the investigation and diagnosis of asthma, as well as alongside symptom recognition for the monitoring of asthma control. Normative tables are often outdated and do not encompass ethnic diversity, therefore changes in PEFR, rather than the absolute value, should be used to monitor asthma control. 

A personalised asthma action plan (PAAP) should include a person’s personal best PEFR and what actions to take when it drops below a particular value. This should be individualised for each person and based on their personal best rather than their predicted PEFR.

Asthma reviews should also cover adherence, inhaler technique and discussion about the person’s triggers and how their impact can be reduced.