The new BTS/NICE/SIGN guideline, Asthma: Diagnosis, monitoring and chronic asthma management (NG245) has placed fractional exhaled nitric oxide (FeNO) early in the diagnostic algorithm, which has caused some concern. Many healthcare settings do not have access to FeNO and are not therefore familiar with its use. It also has cost implications for healthcare commissioners across the UK, at a time when they have been asked to reduce running costs.
This document outlines a consensus recommendation based on the best available evidence and expert opinion. Its purpose is to provide guidance on a safe approach within the limitations of the evidence and devices currently available. It will be important that these recommendations are regularly reviewed and there is careful and close monitoring of patients whose care is based on this guidance, especially in younger age groups.
In this position statement we outline the background, key issues and provide key steps on how to make a firm diagnosis of asthma in this important group.
2024 marked a pivotal change in the management of asthma in the UK with the publication of a joint British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guideline. This guideline, ‘Asthma: diagnosis, monitoring and chronic asthma management’, has the potential to be the paradigm shift that is needed to improve asthma care in the UK.In the 2024 BTS/NICE/SIGN guideline1 there is a clear statement that says:
A personal perspective on using the plan on a page tool to support the development of FeNO services. An article on using the FeNO Plan-on-a-Page tool, with accompanying working example and editable template.
Corinne Beirne, Advanced Nurse Practitioner and Amanda Roberts, from PCRS’s patient reference group, discuss what constitutes a good asthma review from a patient’s perspective.
Sharing asthma knowledge using storytelling
The PCRS Integrated Care Board (ICB), Health Board and Trust toolkit aims to support healthcare commissioners across the UK to implement the new BTS/NICE/SIGN asthma guideline effectively and ensure the best possible care and outcome for all their asthma patients.
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