Part of the implementation
process for FeNO is likely to involve thinking about prioritising patient
groups who will be suitable for testing. It is likely that practices will
already have a 'waiting' list of patients who are awaiting diagnostic testing.
In addition to this, there may be groups of patients who have exhibited asthma
symptoms and who have been treated for some time with asthma medicines but who
do not have a formal diagnosis of asthma recorded in their notes.
A study of GP data from 72 UK general practices (2 CCGs in England and 1 Health Board in Scotland) in 2018*,
found that 25% of patients who received at least one respiratory
medication in the
previous 12 months had no clinical diagnosis recorded
for asthma or COPD.
In order to resolve this area of risk, patients
without a recorded,
formal diagnosis of asthma or COPD but who are
receiving prescriptions for inhalers and or oral
prednisolone should undergo review using a diagnostic algorithm for asthma. If
FeNO is available to
the Practice, it can help the clinician to accurately make the
diagnosis of asthma.
To identify patients who could have their care improved by clarifying their diagnosis, practices can run a simple system search using criteria that can include, for example, specific respiratory symptoms and/or repeat prescriptions of inhalers or oral steroids and/or those coded 'suspected asthma'.
Alternatively Practices can use ePACT2 ePACT2 | NHSBSA / Prescription data | NHSBSA dashboards to generate lists of patients who have been prescribed inhalers and/or oral steroids.
Further examples of case finding and proactive care tools below
- CDRC Precision digital resources are developed by clinicians in the North East of England, working on existing clinical IT systems (SystmOne and EMIS) and are quality assured by the North of England Care Support Unit (NECS). Dynamic templates help guide and prompt clinical management in line with current best practice. Standardised regional referral information and letters are included, to improve communication, patient care and referral pathways.
You can contact CDRC to access these tools using this link; Resources - Clinical Digital Resource Collaborative (cdrc.nhs.uk)
- UCLP (North West London AHSN) proactive care frameworks
provide a platform for optimising clinical care and self-care for people asthma
and COPD, supporting primary care teams to do things differently and at scale.
Read the descriptions of the
support offered for respiratory conditions below:
For more information you can
visit UCL Partners Proactive Care Frameworks
Prevalence data
To understand more about
prevalence of asthma and other respiratory diseases we have included examples
of accessible supporting data/information below;
https://fingertips.phe.org.uk/search/asthma
https://fingertips.phe.org.uk/profile/inhale
https://www.respiratoryfutures.org.uk/
https://www.england.nhs.uk/rightcare/products/nhs-rightcare-intelligence-tools-and-support/
https://www.nhsbsa.nhs.uk/prescription-data
https://statistics.blf.org.uk/asthma
Resources