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To consider how and when we use FeNO testing, we need to go to the definition of asthma. Both BTS/SIGN1 and GINA2 define it as a predominantly inflammatory disorder of the airways with airway hyperresponsiveness and variability in symptoms. Nitric oxide is a gas involved in the respiratory process and is present in the atmosphere in very small amounts (parts per billion). It can be easily measured in exhaled breath using a fractional exhaled nitric oxide (FeNO) test.

The common chronic respiratory disorders diagnosed in primary care—asthma and chronic obstructive pulmonary disease (COPD)—are both characterised by airway obstruction. In asthma, this varies markedly with time and treatment, while in COPD, the airway obstruction is typically fixed and permanent. Some people have fixed obstruction with some degree of reversibility—the so-called asthma COPD overlap syndrome (ACOS).

Asthma is a long-term condition characterised for the vast majority by trigger induced eosinophilic airway inflammation resulting in wheeze, breathlessness, cough, and chest tightness. Before embarking on any treatment for asthma, it is essential to ensure that you, as the prescriber, can describe to the person with asthma:

In this PCRS Podcast episode, Carol Stonham (Primary Care Nurse and PCRS Policy Lead) is in conversation with Amanda Roberts (PCRS Patient Reference Group and PCRS Education Committee Patient Representative) to delve into the positive and negative aspects of Amanda's asthma reviews of the past, discussing what could and should be better, and how a really good asthma review should be for both the patient and the healthcare professional.

This spring, Primary Care Respiratory Update comes to you with a new focus on asthma. Our contributor bring you pragmatic and succinct information that you can adopt in your practice to support early diagnosis, improved management, reduced reliance on short-acting bronchodilator inhalers and advice on managing patients with severe asthma.

In this one hour live webinar we will cover:

Originally presented at the PCRS Respiratory Conference 2020 Dr Glenis Scadding presents One airway: if they're wheezing, are they sneezing too?

NICE Diagnostic Guidance 12 (DG12); Measuring fractional exhaled nitric oxide concentration in asthma: NIOX MINO, NIOX VERO and NObreath. A short, objective comparison of these two devices has been created by Wessex AHSN, Here you can review a comparison between the two products.

Making a case for change In order to justify any investment on new services or equipment, it is important to make a case for change (business case), describe the intended impacts and outcomes of your project, and outline the costs and project plan to deliver it.