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Spirometry and FeNO testing for asthma in children in UK primary care: a prospective observational cohort study of feasibility and acceptability.

journal contribution
posted on 19.11.2020, 14:51 by David Lo, Caroline Beardsmore, Damian Roland, Matthew Richardson, Yaling Yang, Lesley Danvers, Andrew Wilson, Erol A Gaillard
BACKGROUND:The National Institute for Health and Care Excellence recommends the use of spirometry and measuring the fraction of exhaled nitric oxide (FeNO) as part of the diagnostic work-up for children with suspected asthma, and spirometry for asthma monitoring, across all care settings. However, the feasibility and acceptability of these tests within primary care are not known. AIM:To investigate the feasibility, acceptability, training, and capacity requirements of performing spirometry and FeNO testing in children managed for asthma in UK primary care. DESIGN AND SETTING:Prospective observational study involving 10 general practices in the East Midlands, UK, and 612 children between 2016 and 2017. METHOD:Training and support to perform spirometry and FeNO in children aged 5 to 16 years were provided to participating practices. Children on the practice's asthma registers, and those with suspected asthma, were invited for a routine asthma review. Time for general practice staff to achieve competencies in performing and/or interpreting both tests, time to perform the tests, number of children able to perform the tests, and feedback on acceptability were recorded. RESULTS:A total of 27 general practice staff were trained in a mean time of 10.3 (standard deviation 2.7) hours. Usable spirometry and FeNO results were obtained in 575 (94%) and 472 (77%) children respectively. Spirometry is achievable in the majority of children aged ≥5 years, and FeNO in children aged ≥7 years. All of the staff and 97% of families surveyed provided positive feedback for the tests. CONCLUSION:After training, general practice staff obtained quality spirometry and FeNO data from most children tested. Testing was acceptable to staff and families. The majority of general practice staff reported that spirometry helped them to manage children's asthma better.

History

Citation

British Journal of General Practice 2020; 70 (700): e809-e816. DOI: https://doi.org/10.3399/bjgp20X713033

Author affiliation

Department of Respiratory Sciences, University of Leicester

Version

AM (Accepted Manuscript)

Published in

The British journal of general practice : the journal of the Royal College of General Practitioners

Volume

70

Issue

700

Pagination

e809-e816

Publisher

Royal College of General Practitioners

issn

0960-1643

eissn

1478-5242

Acceptance date

13/05/2020

Copyright date

2020

Available date

29/10/2021

Spatial coverage

England

Language

eng