Literature DB >> 33077507

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

David Lo1, Caroline Beardsmore2, Damian Roland3, Matthew Richardson4, Yaling Yang5, Lesley Danvers6, Andrew Wilson7, Erol A Gaillard8.   

Abstract

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. © British Journal of General Practice 2020.

Entities:  

Keywords:  asthma; child health; general practice; implementation science; spirometry

Mesh：

Substances：

Year:  2020        PMID： 33077507      PMCID： PMC7575406          DOI： 10.3399/bjgp20X713033

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN： 0960-1643            Impact factor:   5.386


  14 in total

1.  Spirometric pulmonary function in healthy preschool children.

Authors:  H Eigen; H Bieler; D Grant; K Christoph; D Terrill; D K Heilman; W T Ambrosius; R S Tepper
Journal:  Am J Respir Crit Care Med       Date:  2001-03       Impact factor: 21.405

2.  ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005.

Authors: 
Journal:  Am J Respir Crit Care Med       Date:  2005-04-15       Impact factor: 21.405

3.  Standardisation of spirometry.

Authors:  M R Miller; J Hankinson; V Brusasco; F Burgos; R Casaburi; A Coates; R Crapo; P Enright; C P M van der Grinten; P Gustafsson; R Jensen; D C Johnson; N MacIntyre; R McKay; D Navajas; O F Pedersen; R Pellegrino; G Viegi; J Wanger
Journal:  Eur Respir J       Date:  2005-08       Impact factor: 16.671

4.  Overdiagnosis of asthma in children in primary care: a retrospective analysis.

Authors:  Ingrid Looijmans-van den Akker; Karen van Luijn; Theo Verheij
Journal:  Br J Gen Pract       Date:  2016-03       Impact factor: 5.386

Review 5.  Asthma reviews in children: what have we learned?

Authors:  Mark L Levy; Louise Fleming
Journal:  Thorax       Date:  2020-01-02       Impact factor: 9.139

6.  Measurement of FeNO with a portable, electrochemical analyzer using a 6-second exhalation time in 7-10-year-old children with asthma: comparison to a 10-second exhalation.

Authors:  Kathleen Rickard; Neal Jain; M MacDonald-Berko
Journal:  J Asthma       Date:  2018-11-19       Impact factor: 2.515

7.  Underdiagnosis of childhood asthma: A comparison of survey estimates to clinical evaluation.

Authors:  Grzegorz Marek Brożek; Małgorzata Farnik; Joshua Lawson; Jan Eugeniusz Zejda
Journal:  Int J Occup Med Environ Health       Date:  2014-01-25       Impact factor: 1.843

8.  The use of exhaled nitric oxide monitoring in primary care asthma clinics: a pilot study.

Authors:  Kevin Gruffydd-Jones; Sabbi Ward; Carol Stonham; Tatiana V Macfarlane; Mike Thomas
Journal:  Prim Care Respir J       Date:  2007-12

9.  Spirometry and regular follow-up do not improve quality of life in children or adolescents with asthma: Cluster randomized controlled trials.

Authors:  Michael J Abramson; Rosa L Schattner; Christine Holton; Pam Simpson; Nancy Briggs; Justin Beilby; Mark R Nelson; Richard Wood-Baker; Francis Thien; Nabil D Sulaiman; Eleonora Del Colle; Rory Wolfe; Alan J Crockett; R John Massie
Journal:  Pediatr Pulmonol       Date:  2014-09-08

10.  Lung function and asthma control in school-age children managed in UK primary care: a cohort study.

Authors:  David Kh Lo; Caroline S Beardsmore; Damian Roland; Mathew Richardson; Yaling Yang; Lesley Danvers; Andrew Wilson; Erol A Gaillard
Journal:  Thorax       Date:  2019-10-30       Impact factor: 9.139
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  2 in total

1.  Factors Influencing the Concentration of Exhaled Nitric Oxide (FeNO) in School Children Aged 8-9-Years-Old in Krakow, with High FeNO Values ≥ 20 ppb.

Authors:  Marta Czubaj-Kowal; Grzegorz Józef Nowicki; Ryszard Kurzawa; Maciej Polak; Barbara Ślusarska
Journal:  Medicina (Kaunas)       Date:  2022-01-18       Impact factor: 2.430

2.  Implementing spirometry and fractional exhaled nitric oxide testing in childhood asthma management in UK primary care: an observational study to examine training and implementation cost and impact on patient's health use and outcome.

Authors:  Yaling Yang; David Kh Lo; Caroline Beardsmore; Damian Roland; Matthew Richardson; Lesley Danvers; Andrew Wilson; Erol A Gaillard
Journal:  Arch Dis Child       Date:  2021-07-09       Impact factor: 3.791
  2 in total

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