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Asthma is a common lung condition that causes occasional breathing difficulties.

It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.

There's currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a big impact on your life.

Improving outcomes for patients with respiratory disease is a clinical priority in the NHS Long Term Plan. To support delivery of this commitment, the Accelerated Access Collaborative (AAC) selected asthma biologics as a Rapid Uptake Product (RUP). These are medicines approved by NICE but that are not yet integrated into everyday practice.

Asthma biologics

Asthma biologics are an innovative group of medicines that offer an important treatment option for people with severe asthma. Severe asthma is a specific type of asthma which is difficult to control, even with optimised inhaled asthma medication. It is a complex condition which may be driven by different inflammatory pathways, but typically severe asthma patients face a substantial burden of illness, marked reductions in quality of life and require a significant amount of health resource.

Many people with severe asthma live with poor asthma control typified by emergency trips to hospital, intensive care and regular doses of strong oral corticosteroids. These oral steroids may stop the asthma symptoms, but they can have devastating side effects on physical and mental health, from kidney and bone damage to insomnia, anxiety and depression.

Severe asthma is associated with very high healthcare costs due to medication use, unscheduled healthcare utilisation and management of oral steroid-related adverse events. These costs have been shown to be four times higher for uncontrolled severe asthma patients than the general asthma population.

Asthma biologics work in a targeted way by disrupting pathways causing airways inflammation, helping to manage symptoms, reduce relapses and may also reduce reliance on other medicines such as oral steroids. Currently there are four NICE approved biologics for severe asthma: omalizumabmepolizumabreslizumab and benralizumab. They are given as an injection or infusion (depending on which biologic is being taken), either regularly in hospital or self-injected by patients at home.

The decision to start a biologic treatment for severe asthma is made by specialist severe asthma multi-disciplinary teams based in severe asthma centres. People receiving biologics are closely monitored to ensure that they are receiving the right treatment to help manage their symptoms.

It is estimated that in England over 60,000 patients currently suffering with severe asthma would benefit from an asthma biologic. However, prescribing data suggests that only 8-10,000 of these patients are currently able to access these treatments. The AAC asthma biologics programme aims to support improvements in pathways and practices to ensure more patients are able to receive specialist care for their severe asthma and access asthma biologics.

 

New FeNO (Fractional exhaled Nitric Oxide) test in Asthma elearning module is available

Although developed for primary care professionals, other healthcare professionals may find the module useful.

 

The aim of the FeNO Rapid Uptake Product (RUP) programme is to:

  • Improve patient care and outcomes by more effectively diagnosing patients with suspected asthma
  • Increase widespread patient and clinician access to FeNO testing across primary care

A Fractional exhaled Nitric Oxide (FeNO) test is a way of measuring the amount of nitric oxide in an exhaled  breath. This test can help with the diagnosis of asthma by showing the level of inflammation in the lungs.

Benefits of FeNO - Clinicians (Primary Care):

  • Faster and more accurate diagnosis within primary care
  • Increased objectivity of patient evaluation by using fractional exhaled nitric oxide as a biomarker for the indication of active airway inflammation
  • A positive FeNO test, alongside respiratory diagnosis and lung function tests, supports diagnosis which could otherwise be complex
  • Reduced time taken for asthma diagnosis – test takes seconds to perform
  • Potential for use in monitoring patient response to treatment by measuring their FeNO score before and after treatment – treatment could be adjusted accordingly
  • Deemed as low risk for being aerosol generating as per published guidance from The Association for Respiratory Technology and Physiology (ARTP)
  • FeNO is recommended by NICE as a diagnostic tool for asthma.

Benefits of FeNO - Patients:

  •       More accurate diagnosis of asthma
  •       Non-invasive, simple and safe test
  •       Improved patient experience
  •       Patients are less likely to be referred onto secondary care for additional testing
  •       Opportunity for increased understanding of condition as patients can relate to their own FeNO score.

More information

For further details on the AAC FeNO programme, visit the NHS England website
To access the FeNO deployment toolkit, visit the Wessex ASHN website

Access the elearning

You can read more about the FeNO elearning module on the programme page.
If you wish to leave feedback on this elearning module, please complete the evaluation survey

 

Proactive management @Home

COVID-19 has placed unprecedented pressure on our health system. Immediate focus has understandably been on supporting patients with or at risk of the virus. However, there are a large number of people living with long-term conditions (LTCs) who need continuing, proactive management to prevent a wave of exacerbations, increasing healthcare demand in the months ahead. Find out more about proactive care @Home.

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