How the FeNO monitor from Bedfont Scientific Ltd. can help GP’s and patients with a more accurate diagnosis and management of asthma.
World Asthma Day, organized by the Global Initiative for Asthma (GINA), occurs every 1st May to raise awareness and improve asthma care around the world1. The World Health Organization (WHO) believes that approximately 300 million people currently suffer from asthma and the diseases is estimated to have been attributable to 383,000 deaths in 2015 alone2. NObreath® FeNO monitor, recommended by NICE2, provides GP’s and patients with a quick and non-invasive method of measuring airway inflammation to improve the diagnosis and management of asthma.
Typically, asthma is a chronic respiratory disease that causes difficulty in breathing3, however, according to Asthma UK, it is the over-simplification of asthma that leads to the over-, under-, and mis-diagnosis of asthma. The report has sparked concerns over the number of people not responding to medication, being misdiagnosed with asthma, and the mis-understanding of different asthma subtypes. Bedfont has specialised in the design and manufacture of breath analysis medical devices for over 40 years and in 2017 their NObreath® FeNO monitor celebrated 10 years of improving asthma management. Bedfont have been campaigning vigorously to raise awareness of FeNO measuring and its benefits, especially after the increasing concerns surrounding asthma.
Bedfont hopes to help improve basic asthma care and save future lives with the NObreath®, which is also conformed to ATS and ERS guidelines4. The NObreath® works by measuring FeNO through breath analysis, making the process quick, simple and non-invasive for both the GP and the patient. Interpreting FeNO levels aids in identifying patients who do/do not require on-going treatment5 whilst also differentiating between allergic (eosinophilic) and non-allergic asthma6, and if used daily, FeNO measurements can help to predict exacerbations and attacks.7
Jason Smith, Managing Director of Bedfont, says, “On November 29th 2017, NICE published the final guidelines on Asthma: diagnosis, monitoring and chronic asthma management, to improve asthma care, which included our NObreath® FeNO monitor. Using FeNO measurements to evaluate airway inflammation in asthma represents a significant advance in respiratory medicine that had been expensive to deliver in everyday practice, until now with the NObreath®. The theme for World Asthma Day this year is ‘never too early, never too late’ and I believe that can definitely be said about FeNO monitoring in asthma care.”
Dr. Stephen O’Hickey, a Respiratory Consultant at Worcestershire Acute NHS Trust, comments, “FeNO monitoring has been a big development in the management of difficult asthma in peripheral clinics. We first chose to use the NObreath® because we needed a cost-effective and easily portable device for community-based clinics and it has proven to be a valuable tool in monitoring asthma control. By assessing patient’s FeNO levels frequently, we are able to investigate symptoms such as the cause of coughing and identify triggers, helping us to differentiate if it is an inflammatory or non-inflammatory subtype of asthma. This, in turn, enables us to identify the correct inhaled corticosteroids, but also adjust the level of medication, if needed, safely and accurately.”
REFERENCES
1. World Asthma Day [Internet]. Global Initiative for Asthma – GINA. 2018 [cited 20 April 2018]. Available from: http://ginasthma.org/wad/
2. Measuring fractional exhaled nitric oxide concentration in asthma: NIOX MINO, NIOX VERO and NObreath | Guidance and guidelines | NICE [Internet]. Nice.org.uk. 2014 [cited 20 April 2018]. Available from: https://www.nice.org.uk/guidance/dg12
3. Asthma [Internet]. World Health Organization. 2018 [cited 20 April 2018]. Available from: http://www.who.int/mediacentre/factsheets/fs307/en/
4. ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005; American Journal of Respiratory and Critical Care Medicine; vol. 171: 912-930;2005
5. Andrew D. Smith, Jan O. Cowan, Sue Filsell, Chris MacLachlan, Gabrielle Monti-Sheehan, Pamela Jackson and D. Robin Taylor. Diagnosing Asthma: Comparisons between Exhaled Nitric Oxide Measurements and Conventional Tests. Am J Respir Crit Care Med Vol 169. pp 473-478, 2004.
6. Coumou HBel E. Improving the diagnosis of eosinophilic asthma [Internet]. Taylor and Francis online. 2017 [cited 20 April 2018]. Available from: http://www.tandfonline.com/doi/full/10.1080/17476348.2017.1236688
7. Harkins M. Exhaled Nitric Oxide Predicts Asthma Exacerbation [Internet]. Taylor & Francis. 2017 [cited 20 April 2018]. Available from: http://www.tandfonline.com/doi/abs/10.1081/JAS-120033990