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Unlocking Better Asthma Care: The Benefits of FeNO Testing in Primary Care

Asthma affects over 5.4 million people in the UK, with many patients experiencing delayed or inaccurate diagnoses due to the limitations of traditional diagnostic tools. In recent years, Fractional exhaled Nitric Oxide (FeNO) testing has emerged as a powerful tool in the diagnosis and management of asthma, particularly in primary care settings. As the NHS continues to prioritise respiratory health, integrating FeNO testing into routine practice is proving to be beneficial for clinicians and patients alike.

FeNO testing measures the concentration of nitric oxide (NO) in a patient’s exhaled breath. Nitric oxide is a biomarker for eosinophilic airway inflammation, a hallmark of asthma. Elevated FeNO levels typically indicate inflammation in the airways, which can help confirm a diagnosis of asthma and guide treatment decisions, especially regarding the use of inhaled corticosteroids (ICS).

The test is non-invasive, quick, and easy to perform, making it ideal for use in primary care. Patients simply exhale into the FeNO device for about 10 seconds, with the results available almost immediately.

Why FeNO Testing is important in Primary Care

1. Improved Diagnostic Accuracy
Traditional asthma diagnostic tools, such as spirometry and peak flow monitoring, assess lung function but do not detect the underlying inflammation. FeNO testing adds a biological dimension to asthma diagnosis, helping to confirm or rule out eosinophilic inflammation when other tests are inconclusive.

2. Personalised Treatment Plans
FeNO testing allows clinicians to tailor asthma treatment based on the levels of airway inflammation detected. For example, patients with high FeNO levels may benefit from increased doses of medication, while those with low levels may avoid unnecessary medication changes.

3. Monitoring Treatment Response
FeNO testing is not just for diagnosis - it is also a powerful tool for ongoing asthma management. Regular FeNO measurements can help assess adherence to medication, detect early signs of worsening inflammation, and guide decisions on stepping up or stepping down treatment.

4. Enhanced Patient Engagement
Seeing a number on a screen can help patients to better visualise their condition, making them more likely to adhere to treatment. It also facilitates shared decision-making, as patients can better understand the rationale behind medication adjustments.

5. Reduced Referrals to Secondary Care
By providing primary care clinicians with the tools to diagnose and manage asthma more effectively, FeNO testing can reduce unnecessary referrals to secondary care. This eases the burden on specialist services and ensures patients receive timely care closer to home.

Clinical Guidelines Supporting FeNO Testing

FeNO testing is now part of several national and international clinical guidelines, including:

  • NICE/BTS/SIGN (UK): Recommends FeNO as a first-line test for asthma diagnosis and a key tool for monitoring chronic asthma management.
  • GINA (Global Initiative for Asthma): Recognises FeNO as a valuable biomarker for diagnosing asthma and guiding treatment.
  • ATS/ERS (US and Europe): Strongly support FeNO testing for both diagnosis and treatment monitoring.

The Sunvou FeNO Monitor: An Accurate, Reliable and Affordable FeNO Solution

One of the barriers to widespread adoption of FeNO testing has been the cost and complexity of traditional devices. The Sunvou FeNO Monitor addresses many of these concerns by providing the following features:

  • Affordability: Starting at just £1,200 (ex. VAT), it is one of the most cost-effective FeNO systems available in the UK. Low cost rental options are also available.
  • All-in-One Solution: The Sunvou FeNO Starter Pack provides everything you need to start testing, including the Sunvou HA1101 monitor, Nitric Oxide sensor, and bacterial/viral mouthpieces.
  • No Annual Servicing: Once the NO sensor has expired, you simply purchase a Continuation Pack to continue testing. This eliminates the cost and inconvenience of annual servicing and sensor recalibration.
  • Portability and Ease of Use: The monitor is lightweight, battery-powered, and equipped with a touchscreen. It is very quick and simple to use.
  • Environmentally Friendly: The use of very small disposable mouthpieces helps to support NHS net-zero goals.
  • Compliance with Guidelines: Supports clinical decision making in line with current UK NICE/BTS/SIGN asthma guidelines for FeNO testing.

Real-World Impact: NHS Adoption and Innovation

FeNO testing has been part of the NHS Accelerated Access Collaborative (AAC) as a Rapid Uptake Product, with support from Academic Health Science Networks (AHSNs) to embed it into routine care. This initiative has demonstrated that early diagnosis and targeted treatment using FeNO can significantly improve asthma outcomes and reduce healthcare costs.

Conclusion: A Breath of Fresh Air for Asthma Care

FeNO testing represents a shift in how asthma is diagnosed and managed in primary care. With accessible and affordable solutions like the Sunvou FeNO Monitor, there has never been a better time for GP practices to integrate FeNO testing into their respiratory care pathways. This ensures better outcomes for patients, more efficient use of NHS resources, and a stronger foundation for proactive asthma management.