DEFINE: Determining the Effectiveness of an Online FeNO-guided asthma management intervention in primary care
Contact Details
We are a multidisciplinary group of researchers and patient representatives funded by the UK’s National Institute for Health Research investigating whether measuring FeNO in GP surgeries can improve management of patients with asthma.
Email (Oxford team): define@phc.ox.ac.uk
Email (Southampton team): define-rct@uhs.nhs.uk
Background and Study Aims
The DEFINE study will help health care professionals in GP surgeries provide a more personalised approach to managing patients’ asthma by using FeNO to guide decisions about their treatment.
Around 5.4 million people in the UK receive treatment for asthma. However, although more and more asthma medications are being prescribed each year, numbers of serious asthma attacks are not going down.
To help prevent serious asthma attacks, we need to make sure the right treatments are given to the right people in the right amounts.
INTRODUCTION TO THE INTERVENTION
FeNO stands for fractional exhaled nitric oxide. It is measured using a simple breath test.
Nitric oxide is a gas which everyone breathes out. People with inflamed airways breathe out more nitric oxide than people whose airways are not inflamed. These patients are more likely to have an asthma attack if their inflammation remains untreated.
FeNO is already measured in patients with severe asthma who are seen in hospital clinics. However, very few GP surgeries routinely use FeNO to help them monitor treatment.
We have designed an online intervention to support health care professionals and patients with using FeNO during asthma reviews in GP surgeries. To help us improve and refine our intervention, we tested it in a small number of GP surgeries in 2021.
The intervention offers the following tools:
• A n online training tool to support health care professionals in how to measure and interpret FeNO.
• A digital FeNO-guided management algorithm to personalise asthma care.
• Information materials for patients on FeNO and its role in asthma management.
Click here to download Identifying acute exacerbations of asthma - guidance document .
Study Updates
We are currently doing a large study to find out whether using our online intervention during asthma reviews in GP surgeries helps reduce people’s risk of having an asthma attack. We are aiming to recruit just over 2500 people with asthma into our study from GP surgeries in Thames Valley, Wessex and East Midlands.
We are looking for GP surgeries who would be interested in helping us recruit patients. GP surgeries who recruit 25 or more patients within 6 months of site initiation will be allowed to keep their FeNO analyser (NIOX VERO®, RRP approx. £2700 plus VAT).
Please email us at define@phc.ox.ac.uk if you would like more information.
Who can participate?
Asthma patients aged 12 years or older.
Information for Patients
Information for Healthcare Professionals
Funding Details
The DEFINE study is funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference RP-PG-0618-20002).
This study has been reviewed and given favourable opinion by London – Fulham East Research Ethics Committee. The reference number is 22/LO/0139 (IRAS no: 307116)
Related Publications
Santillo, M., Ainsworth, B., Van Velthoven, M.H. et al. Qualitative study on perceptions of use of Fractional Exhaled Nitric Oxide (FeNO) in asthma reviews. npj Prim. Care Respir. Med. 32, 13 (2022). https://doi.org/10.1038/s41533-022-00272-0