NEWS
Use spirometry first to improve diagnosis of asthma, says NICE By Tony Green
BARNEY NEWMAN
Clinicians should use spirometry – the measurement of breath – as the first test for asthma in adults and children over five, says draft guidance by the National Institute for Health and Care Excellence (NICE). More than one million people have been wrongly diagnosed with asthma in the UK, according to NICE. The draft guidance follows recommendations by the British
Thoracic Society and Scottish Intercollegiate Guidelines Network last year that the first line for diagnosing asthma in adults and children over five should be spirometry. NICE also advises healthcare professionals to check patients’ levels of nitric oxide, which is found in larger volumes in people with asthma, and give them a bronchial challenge test. Association of Respiratory Nurse Specialists chair and network lead Rebecca Sherrington
said that although there are many misdiagnoses of asthma, the condition still goes unidentified. ‘Underdiagnosis and undertreatment is a problem,’ she said. ‘One of the reasons is that we do not have a single definitive test.’ She added that practice nurses’ workload was likely to rise as a result of the new guidelines. ‘It would increase the workload of practice nurses and the time needed to do a thorough respiratory assessment,’ said Ms Sherrington. ‘It is going to have an effect on primary and secondary care, and an investment in equipment is essential. ‘We need to make sure that not only diagnoses, but the basics in asthma care are done, so people have a personal asthma management plan, their inhaler technique is checked and smoking cessation is discussed.’
Views sought
MPs shown how to love their liver Politicians helped launch this year’s Love Your Liver campaign with the aid of a specialist nurse. The campaign, now in its fourth year, aims to raise awareness of liver disease. It is often only diagnosed in its advanced stages, leading to a high mortality rate. MPs were screened by specialist liver nurse Susanne Johansen at a Westminster event organised by the British Liver Trust. Ms Johansen screened shadow public health minister Luciana Berger (pictured right with Ms Johansen) using a non-invasive test similar to an ultrasound
scan that is designed to measure a liver’s elasticity, an indicator of its healthiness. The recorded number of liver deaths has increased by 400 per cent in the past 40 years. Excess alcohol consumption, poor diet and viral hepatitis contribute to disease rates, said the British Liver Trust. ‘It is partly to do with obesity,’ said Ms Johansen. ‘Generation to generation we are getting bigger and less active, but we are also better at getting the message across for screening and early diagnosis.’ An online test at www.loveyourliver. org.uk can assess the risk of liver damage.
NICE director of clinical practice Mark Baker said: ‘Accurate diagnoses of asthma have been a significant problem, which means people may be wrongly diagnosed or cases might be missed in others. ‘This new draft guideline provides advice for primary, secondary and community care healthcare professionals on the most suitable tests for accurately diagnosing asthma and how to help people monitor and control their symptoms. ‘We want to hear from all those who provide care for people with asthma in the NHS to ensure that all relevant views are considered for the final guideline,’ Professor Baker said. The draft guideline for asthma is out for consultation and can be downloaded at tiny.cc/NICE_ asthma_guideline
NURSING february :: voluses 29 no 23 ::permission. 2015 11 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No4other without Copyright © 2015 RCNi Ltd. All rights reserved.
Use spirometry first to improve diagnosis of asthma, says NICE By Tony Green
BARNEY NEWMAN
Clinicians should use spirometry – the measurement of breath – as the first test for asthma in adults and children over five, says draft guidance by the National Institute for Health and Care Excellence (NICE). More than one million people have been wrongly diagnosed with asthma in the UK, according to NICE. The draft guidance follows recommendations by the British
Thoracic Society and Scottish Intercollegiate Guidelines Network last year that the first line for diagnosing asthma in adults and children over five should be spirometry. NICE also advises healthcare professionals to check patients’ levels of nitric oxide, which is found in larger volumes in people with asthma, and give them a bronchial challenge test. Association of Respiratory Nurse Specialists chair and network lead Rebecca Sherrington
said that although there are many misdiagnoses of asthma, the condition still goes unidentified. ‘Underdiagnosis and undertreatment is a problem,’ she said. ‘One of the reasons is that we do not have a single definitive test.’ She added that practice nurses’ workload was likely to rise as a result of the new guidelines. ‘It would increase the workload of practice nurses and the time needed to do a thorough respiratory assessment,’ said Ms Sherrington. ‘It is going to have an effect on primary and secondary care, and an investment in equipment is essential. ‘We need to make sure that not only diagnoses, but the basics in asthma care are done, so people have a personal asthma management plan, their inhaler technique is checked and smoking cessation is discussed.’
Views sought
MPs shown how to love their liver Politicians helped launch this year’s Love Your Liver campaign with the aid of a specialist nurse. The campaign, now in its fourth year, aims to raise awareness of liver disease. It is often only diagnosed in its advanced stages, leading to a high mortality rate. MPs were screened by specialist liver nurse Susanne Johansen at a Westminster event organised by the British Liver Trust. Ms Johansen screened shadow public health minister Luciana Berger (pictured right with Ms Johansen) using a non-invasive test similar to an ultrasound
scan that is designed to measure a liver’s elasticity, an indicator of its healthiness. The recorded number of liver deaths has increased by 400 per cent in the past 40 years. Excess alcohol consumption, poor diet and viral hepatitis contribute to disease rates, said the British Liver Trust. ‘It is partly to do with obesity,’ said Ms Johansen. ‘Generation to generation we are getting bigger and less active, but we are also better at getting the message across for screening and early diagnosis.’ An online test at www.loveyourliver. org.uk can assess the risk of liver damage.
NICE director of clinical practice Mark Baker said: ‘Accurate diagnoses of asthma have been a significant problem, which means people may be wrongly diagnosed or cases might be missed in others. ‘This new draft guideline provides advice for primary, secondary and community care healthcare professionals on the most suitable tests for accurately diagnosing asthma and how to help people monitor and control their symptoms. ‘We want to hear from all those who provide care for people with asthma in the NHS to ensure that all relevant views are considered for the final guideline,’ Professor Baker said. The draft guideline for asthma is out for consultation and can be downloaded at tiny.cc/NICE_ asthma_guideline
NURSING february :: voluses 29 no 23 ::permission. 2015 11 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No4other without Copyright © 2015 RCNi Ltd. All rights reserved.
