Abstract
Background: Confirming a diagnosis of asthma in children can be difficult and in primary care is predominantly centred on clinical history. Recent reports highlight that misdiagnosis of asthma is common (Looijmans-van den Akker, I. et al. Br J Gen Pract 2016; 66(644):e152-7). Current UK draft guidelines propose objective tests to diagnose and monitor children with asthma in all care settings. Feasibility and acceptability of objective testing in primary care are not known.
Aim: To evaluate the success and acceptability of spirometry and FeNO testing in children treated for asthma and barriers to their implementation in a primary care setting.
Methods: We currently conduct a 2 year observational study to investigate feasibility and acceptability of spirometry, bronchodilator reversibility and FeNO. Questionnaires are used to elicit opinions about acceptability of the tests from GP practice staff before and after implementation, and to ascertain views of children and their parents.
Results: To date 17 staff at 7 practices have received training and 225 children (5-16yrs) recruited. Spirometry was successful in 210 children (93%) and FeNO in 175 (78%). Of those who provided feedback 153/172 children (89%) would be happy to do the tests again and 167/170 parents (98%) would recommend the tests. Practice staff reported they found the tests useful in their management 92% (n=155) of the time. Pre-implementation questionnaires highlighted staff concerns regarding funding (n=13/35, 37%), workload (n=21/35, 60%) and training (n=16/35, 46%).
Conclusion: Our data suggests that providing spirometry and FeNO testing is feasible and acceptable to children treated for asthma and their parents.
- Copyright ©the authors 2017