Month: September 2023

World Lung Day – 25th September 2023

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Access to prevention and treatment for all. Leave no one behind:

Organised by the Forum of International Respiratory Societies (FIRS) since 2016, World Lung Day is a time for everyone to take a look at what we can do individually and as a society, to work toward clean air and healthy lungs for all. Asthma is closely related to World Lung Day because it is one of the major lung health conditions that the day seeks to address.

Under-diagnosis of asthma

In 2019, asthma affected an estimated 262 million people worldwide1 and led to 455,000 deaths globally2. A study completed by Nolte et al. in 2006 involved 10,877 participants aged 14-44 years old, 11% (1,149) of whom had previously reported asthma symptoms. After further assessment provided by Global Initiative for Asthma (GINA) recommendations, 43% (493) of the 11% were diagnosed with asthma, of which a further 50% (246) had not been diagnosed before3.

When asthma remains undiagnosed or receives inadequate treatment, it can lead to stress, anxiety, or depression, as well as lung infections, hindered growth and delayed puberty in children. Additionally, it can escalate to critical asthma attacks that can be life-threatening4.

FeNO testing and asthma:

The use of FeNO testing, in conjunction with a comprehensive clinical history and additional examinations, contributes to more efficient asthma diagnosis and enhances patient care. Furthermore, it enables the monitoring of patients’ responses to asthma interventions.

FeNO testing can be completed within seconds and provides nearly instantaneous results, compared to traditional testing like spirometry with a bronchodilator test. Thereby ensuring a larger number of individuals receive appropriate treatment for their specific conditions, leading to reduced medication wastage5. In England, a two-year programme from 2021-2023 showed an estimated 58,000 people with newly diagnosed asthma received faster treatment, after more than 1,200 FeNO devices entered primary care6, highlighting the impact FeNO testing can have on asthma care.

Visit https://www.nobreathfeno.com to find out how you can support your patients with FeNO monitoring, with the NObreath® from Bedfont® Scientific Ltd.

References:

  1. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, Abdelalim A, and Abdollahi M. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204-1222. DOI: 10.1016/S0140-6736(20)30925-9.
  2. Asthma [Internet] World Health Organization. 2023. [Cited 24th August 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma
  3. Nolte H, Nepper-Christensen S, and Backer V. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respiratory medicine. 2006;100(2):354-362. PMID: 16005621. DOI: 10.1016/j.rmed.2005.05.012
  4. The Global Asthma Report 2018 [Internet]. 2018. [Cited 25th August 2023]. Available from: http://globalasthmareport.org/2018/index.html
  5. Improving access to FeNO testing in primary care [Internet]. 2023. [Cited 25th August 2023]. Available from: https://www.ahsnnetwork.com/programmes/respiratory-disease/bettering-access-to-feno-testing-in-primary-care/
  6. New report shows impact of FeNO national programme on asthma care in England [Internet] Primary Care Respiratory Society. 2023. [Cited 24th August 2023]. Available from: https://www.pcrs-uk.org/news/new-report-shows-impact-feno-national-programme-asthma-care-england#:~:text=During%20the%20two%2Dyear%20programme,in%20primary%20care%20in%20England.

The National FeNO Programme: Accelerated Access Collaborative (AAC)

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The National FeNO Programme has recently released its Impact Report, promoting how their programme has improved access to fractional exhaled nitric oxide (FeNO) testing across the National Health Service (NHS) in England. The programme ran from April 2021 to March 2023.

The National FeNO Programme was part of a wider programme by the Accelerated Access Collaborative’s (AAC)’s Rapid Uptake Products Programme. The AAC brings together the NHS, patients, industry, government and more, with the goal of removing barriers to innovative and revolutionary new treatments and technology1. In England, the AAC has helped encourage the adoption of FeNO, with the help of the AHSN Network which delivered the programme as part of its commission from the NHS England Innovation Research and Life Sciences (IRLS) team1. The National FeNO Programme included two FeNO devices appraised by NICE, with NObreath®, manufactured by Bedfont® Scientific Ltd., being one of them.

What is FeNO?

FeNO is very minuscule particles of nitric oxide (NO), measured in parts per billion (ppb). NO is naturally produced by your body to help combat inflammation and when your airway is inflamed, NO is produced in the lungs and exhaled on the breath. The production of NO is often found to be higher in inflammatory conditions such as asthma and therefore FeNO monitoring can be used for the detection and management of such conditions.

Programme impact on FeNO device and testing

Over the duration of the programme, 1,244 new FeNO devices are now available in primary care. Notably, it is estimated that 53% of Primary Care Networks (PCNs) in England now have access to FeNO testing2, thanks to the National FeNO Programme. Yhe AAC and Office for Life Sciences (OLS), funded 33 national FeNO projects through their Pathway Transformation Fund (PTF), a total of £915,000 was given from the PTF, resulting in the implementation of 118 new FeNO devices.

Programme’s impact on education and funding for FeNO

The AHSN Network has supported training and development for FeNO testing, with two FeNO training modules developed for healthcare professionals. This has resulted in over 4,900 hours of training being delivered. A FeNO implementation toolkit was created as an aid to support the adoption of FeNO testing, and has been viewed over 13,500 times. After training modules were completed, a survey was carried out by 1,047 healthcare professionals enrolled on the FeNO training modules, 91% indicated the training will help in their role.

FeNO programme impact on asthma care for patients in England

During the course of the programme, the report estimates a potential 58,000 new asthmatics in England receiving an asthma diagnosis with the support of FeNO testing. In turn, helping to increase the accuracy and speed of the diagnosis of asthma, thus speeding up access to essential treatments for patients2.

What’s next?

The FeNO programme has now finished, but the incredibly important work around FeNO still continues. NICE, the Scottish Intercollegiate Guidelines Network (SIGN), and the British Thoracic Society (BTS) are currently developing joint asthma guidelines expected in 20243. In addition to this, the FeNO toolkit, training modules and resources developed during the AAC FeNO programme will remain accessible. Future opportunities still remain for improving asthma care in England, including the continuous sustainable growth of FeNO within primary and secondary care, and establishing a sustainable funding mechanism for FeNO testing across England.

With a handheld, portable, easy-to-use device, Bedfont® Scientific Ltd., is helping to break FeNO accessibility barriers. Previously FeNO breath analysis has been expensive, however, they have made it more cost-effective by having low-cost mouthpieces with a long shelf-life. The NObreath® includes a 5-year warranty on the device and sensor, and the service and maintenance options they offer have also been simplified. To find out how you can support your patients with FeNO monitoring, visit https://www.nobreathfeno.com.

Read the full National FeNO Programme Impact Report here:

https://wessexahsn.org.uk/img/projects/FeNO%20-%20national%20programme%20impact%20report%20-%20FINAL.pdf

References:

  1. NHS Accelerate Access Collaborative [Internet] NHS England. 2023. [Cited 5th July 2023]. Available from: https://www.england.nhs.uk/aac/
  2. National FeNO programme impact report [Internet]. Wessex Academic Health Science Network. 2023. [Cited 6th July 2023]. Available from: https://wessexahsn.org.uk/img/projects/FeNO%20-%20national%20programme%20impact%20report%20-%20FINAL.pdf
  3. FeNO programme impact report [Internet]. Wessex Academic Health Science Network. 2023. [Cited 10th July 2023]. Available from: https://wessexahsn.org.uk/projects/604/feno-programme-impact