Using FeNO in the diagnosis and management of asthma

Being able to identify inflammation of the lung through the measurement of nitric oxide is an excellent new way to assist in the accurate diagnosis of asthma and to monitor the effectiveness of asthma medication. An accurate reading can be taken in minutes and the technology will assist in a correct diagnosis. This increases patient confidence from the first consultation, which helps in creating a working relationship, something that is vital in managing chronic diseases over the longer term. FeNO testing also helps us to monitor the effectiveness and adherence of inhaled steroids. Patients often overuse rescue medication because it brings short-term rapid relief for asthma, while poor use of inhaled steroids can cause symptomatic problems of their own, including the risk of a serious lifethreatening asthma attack. My understanding is many asthmatics who die have moderate, not severe asthma, but underuse inhaled steroids and rely only on bronchodilator medication (Anagnostou et al, 2012). Use of a handheld device that can quickly and accurately measure lung inflammation is an excellent way of identifying the likelihood of poor adherence with prescribed preventative medication such as inhaled steroids. These aspects of asthma care are crucial for the primary care practitioner and patient, in terms of accurate diagnosis, management of the condition and also in retaining the patient’s confidence.