Manchester-led research contributes to development of new UK-wide guideline for asthma
Research delivered through the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre (BRC) has contributed to improved diagnostic guidelines for identifying and managing asthma, announced by NICE last week (Wednesday 27 November 2024).
The new joint guideline recommends chronic asthma should be diagnosed by healthcare professionals when people first show symptoms by using simple tests.
For the first time, the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) have collaborated to produce new UK-wide joint guidance for the diagnosis and management of chronic asthma in adults, young people and children.
Asthma is a common lung condition, where people have breathing difficulties. Symptoms include breathlessness, coughing, wheezing and tightness in the chest. In the UK, around 5.4 million people have asthma, which is about eight in every 100 people, and there are several different types of asthma. For people with newly diagnosed asthma, the guideline recommends prescribing combination treatments rather than ‘reliever’ medications alone.
Professor Stephen Fowler, Respiratory Medicine Theme Co-Lead at Manchester BRC, (pictured) was the subject matter expert for adults on the NICE Asthma Guideline committee, which advised NICE on the development of these guidelines.
His work through the Manchester BRC-funded Rapid Access Diagnostics in Asthma (RADicA) study, which aims to develop new and better breathing tests to diagnose asthma, also contributed high-quality evidence which was used to inform these guidelines.
Prof Fowler said: “The NICE committee reviewed adult data collected through the RADicA study alongside the current published literature to inform the new asthma diagnostic guidelines, and the study is extensively cited through the evidence reviews.
“The previous NICE guidelines published in 2017 highlighted the lack of high-quality data available to support the development of diagnostic pathways for asthma. Through RADicA we have been able to add significantly to the quantity and quality of data underpinning this updated guidance.”
The RADicA research clinic is based at Wythenshawe Hospital, part of Manchester University NHS Foundation Trust (MFT). Manchester BRC worked with local GPs to recruit people to the study from diverse communities across South Manchester, with almost 400 participants having taken part to date.
Assessments (example pictured) include a FeNO test, where people breathe into a machine that measures the level of nitric oxide in breath (a sign of inflammation in lungs), spirometry, which measures how fast people can breathe out and how much air lungs can hold, and responsiveness to inhaled corticosteroid therapy (ICS) treatment.
Prof Fowler, who is also a Consultant Respiratory Physician at MFT, added: “Around one in three people taking treatment for asthma don’t have the condition and many other people across the UK are undiagnosed, so I am delighted that evidence gathered from RADicA has helped inform these new guidelines and produced a diagnostic pathway that is simple, useable in the community and cost effective.
“Now GPs can use simple tests to diagnose asthma the first time an adult or child presents with symptoms, which has benefits for our population locally, regionally and nationally and really demonstrates the impact of our ongoing research.”
Respiratory researchers from NIHR Manchester BRC highlighted recently that previously used guidelines for diagnosing asthma contained variation and required improvement. Asthma diagnosis: a comparison of established diagnostic guidelines in adults with respiratory symptoms was published earlier this year in eClinical Medicine, part of The Lancet Discovery Science.