Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews

Current methods to assess asthma and guide inhaled corticosteroid (ICS) dose titration mainly centre on patient-reported symptoms and lung function assessments. However, these methods correlate only weakly with airway inflammation making them unreliable predictors of future exacerbations and ICS req...

Full description

Bibliographic Details
Main Authors: Santillo, M, Ainsworth, B, Van Velthoven, M, Yardley, L, Thomas, M, Wang, K, Tonkin-Crine, S
Format: Journal article
Language:English
Published: Springer Nature 2022
_version_ 1826307496685338624
author Santillo, M
Ainsworth, B
Van Velthoven, M
Yardley, L
Thomas, M
Wang, K
Tonkin-Crine, S
author_facet Santillo, M
Ainsworth, B
Van Velthoven, M
Yardley, L
Thomas, M
Wang, K
Tonkin-Crine, S
author_sort Santillo, M
collection OXFORD
description Current methods to assess asthma and guide inhaled corticosteroid (ICS) dose titration mainly centre on patient-reported symptoms and lung function assessments. However, these methods correlate only weakly with airway inflammation making them unreliable predictors of future exacerbations and ICS requirement. Fractional Exhaled Nitric Oxide (FeNO) is a simple non-invasive objective measure of airways inflammation used predominantly in specialist clinics. Previous qualitative studies have mainly focused on the acceptability of FeNO in secondary care and there is limited insight to support clinicians and patients using FeNO in primary care asthma reviews. This study aimed to explore adult patient with asthma and primary care health care professional (HCP) views on introducing FeNO as part of routine asthma reviews. Twenty-three health care professionals and 22 patients were interviewed over the phone or online. Both groups reported that current asthma reviews are often seen as tick-box exercises and that introducing the FeNO test would make reviews more tailored to the individual patient, rather than relying on subjective patient reports of asthma control. Adults with asthma also highlighted support more open communication and their understanding of asthma, as they desired to feel more engaged in decisions and conversations about their asthma. HCPs reported valuing patient education and empowerment over a paternalistic approach, when time and resources allow. They also recognised FeNO to provide an objective measure of inflammation that could support them in the education and empowerment of patients. FeNO was seen by both groups as a potentially valuable addition to current asthma reviews mainly led by nurses, both for increasing their understanding of current risk of exacerbation and also to provide more tailored and personalised asthma management to patients. Our findings highlighted the need for open and clear communication about how to interpret FeNO results.
first_indexed 2024-03-07T07:03:56Z
format Journal article
id oxford-uuid:e9053340-a906-40d1-809e-7b784262a6f7
institution University of Oxford
language English
last_indexed 2024-03-07T07:03:56Z
publishDate 2022
publisher Springer Nature
record_format dspace
spelling oxford-uuid:e9053340-a906-40d1-809e-7b784262a6f72022-04-13T14:08:33ZQualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviewsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e9053340-a906-40d1-809e-7b784262a6f7EnglishSymplectic ElementsSpringer Nature2022Santillo, MAinsworth, BVan Velthoven, MYardley, LThomas, MWang, KTonkin-Crine, SCurrent methods to assess asthma and guide inhaled corticosteroid (ICS) dose titration mainly centre on patient-reported symptoms and lung function assessments. However, these methods correlate only weakly with airway inflammation making them unreliable predictors of future exacerbations and ICS requirement. Fractional Exhaled Nitric Oxide (FeNO) is a simple non-invasive objective measure of airways inflammation used predominantly in specialist clinics. Previous qualitative studies have mainly focused on the acceptability of FeNO in secondary care and there is limited insight to support clinicians and patients using FeNO in primary care asthma reviews. This study aimed to explore adult patient with asthma and primary care health care professional (HCP) views on introducing FeNO as part of routine asthma reviews. Twenty-three health care professionals and 22 patients were interviewed over the phone or online. Both groups reported that current asthma reviews are often seen as tick-box exercises and that introducing the FeNO test would make reviews more tailored to the individual patient, rather than relying on subjective patient reports of asthma control. Adults with asthma also highlighted support more open communication and their understanding of asthma, as they desired to feel more engaged in decisions and conversations about their asthma. HCPs reported valuing patient education and empowerment over a paternalistic approach, when time and resources allow. They also recognised FeNO to provide an objective measure of inflammation that could support them in the education and empowerment of patients. FeNO was seen by both groups as a potentially valuable addition to current asthma reviews mainly led by nurses, both for increasing their understanding of current risk of exacerbation and also to provide more tailored and personalised asthma management to patients. Our findings highlighted the need for open and clear communication about how to interpret FeNO results.
spellingShingle Santillo, M
Ainsworth, B
Van Velthoven, M
Yardley, L
Thomas, M
Wang, K
Tonkin-Crine, S
Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title_full Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title_fullStr Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title_full_unstemmed Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title_short Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews
title_sort qualitative study on perceptions of use of fractional exhaled nitric oxide feno in asthma reviews
work_keys_str_mv AT santillom qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT ainsworthb qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT vanvelthovenm qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT yardleyl qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT thomasm qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT wangk qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews
AT tonkincrines qualitativestudyonperceptionsofuseoffractionalexhalednitricoxidefenoinasthmareviews