Abstract
Background:
Asthma is defined as a chronic inflammatory disease. Hospital studies have used exhaled nitric oxide (eNO) as an inflammation biomarker.
Aims:
To assess the practicality of eNO monitoring in primary care.
Methods:
Prospective observational study. 37 asthmatics treated in primary care were enrolled (18 male, age range 6–71 yrs, inhaled corticosteroid dose median (Inter-Quartile Range): 400 (200–600) mcg/day, % predicted FEV1 mean (SD) 85 (21) %); 2 weekly assessments were made over 12 weeks.
Results:
95% of subjects were able with training to perform the controlled expiration required for analysis; the 2 patients who could not withdrew. eNO measurement were made at 232 out of 236 study visits (98.3%) for the remaining patients. 90.1% of readings conformed to ERS standards, on the other occasions it was impossible to get 3 consistent readings, and less rigorous criteria were accepted. The median (interquartile range) measurements preformed/patient/visit was 4 (2–5) expiratons. The average number of attempts needed reduced from 6.2 (first visit) to 4.0 (final visit), p > 0.001. On a 7 point Lickert rating scale of ease of use, 75% of subjects found monitoring easy, with adults (13/17) and children (11/15) reporting ease. Acceptability was reported by 97%; all children (15/15) and 16/17 adults. Measurements were rated as difficult by the asthma nurses in 9% of cases, and as ‘easy’ or ‘very easy’ on 75% of patients.
Conclusions:
eNO testing is feasible in most children over 6 and adults in general practice. The test is rated as easy by 3/4 of patients, and by asthma nurses on 3/4 of patients. Routine eNO monitoring in community practice is possible.
Conflict of interest and funding
No conflict of interest declared. Funded by The Royal Collage of General Practitioners Scientific Foundation Board grant.
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Stonham, C., Ward, S., Gruffydd-Jones, K. et al. ABS002: Is exhaled nitric oxide monitoring possible in general practice asthma clinics: a feasibility and acceptability study. Prim Care Respir J 15, 185 (2006). https://doi.org/10.1016/j.pcrj.2006.04.106
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DOI: https://doi.org/10.1016/j.pcrj.2006.04.106