Development and evaluation of an online FeNO-guided primary care asthma management intervention

Most monitoring of asthma occurs in primary care, where treatment decisions are based on symptoms and lung function.  However, these measures do not reliably indicate eosinophilic airway inflammation or future exacerbation risk.  Fractional exhaled nitric oxide (FeNO) is a simple, non-invasive breath test which is already extensively used to assess eosinophilic airway inflammation in UK hospital settings, but rarely in primary care. The National Institute for Health and Care Excellence (NICE) recognises the value of FeNO in diagnosis of asthma, but has highlighted the need for more robust evidence to guide its use in monitoring asthma treatment

This study aims to iteratively develop and refine a complex online FeNO-guided asthma management intervention for use in primary care; to determine whether our intervention is more effective than usual care in reducing acute exacerbations of asthma; to assess the cost-effectiveness of this intervention; and to investigate potential influences on implementation and outcomes of the intervention in primary care.