{
  "abstract": "Home spirometry (HS) can provide longitudinal evidence of variable airflow obstruction, reversibility and obstruction during symptomatic episodes to support respiratory diagnosis and treatment optimisation. The utility of home spirometry for children aged 5–18 y has not been widely reported. One study has suggested asthma overdiagnosis and underdiagnosis is potentially as high as 15% and 40% respectively in primary care (PC). 1 Methods The aim of this study was to determine if the waiting time between referral and first appointment could be utilised to provide enhanced clinical information (more than a single spirometry and FeNO value) to facilitate respiratory diagnosis and treatment. Children and young people (CYP) aged 5–16 y referred from PC to a respiratory specialist consultant were offered a home spirometry assessment during the 8–12 week waiting period between referral and clinic appointment. Spirometry was coached by videocall with a paediatric respiratory physiologist.Results Demographics are shown in table 1. 22 of 25 referred children were onboarded and recorded on average 26 spirometry tests each (target 4–5 tests weekly). HS supported a diagnosis of asthma in 76% of children. 77% of children had evidence of obstruction on HS despite a normal clinic FeNO in 57% (<35ppb). In 5 there was obstruction when symptomatic but normal clinic spirometry, 3 of which also had a normal clinic FeNO result.3/22 children had normal spirometry and were discharged (not asthma). 9/22 children were confirmed as asthmatic with evidence of variable airflow obstruction and/or a current steroid inhaler, enabling treatment optimisation. The secondary care team reported that fewer attempts were required to record spirometry and FeNO in the clinic than those not referred for HS, further improving the efficiency of secondary care appointments.Abstract P140 Table 1Demographics and resultsConclusion Home spirometry can be a beneficial way to collect information relevant to diagnosis and treatment in CYP, reducing misdiagnosis and improving the speed and accuracy in confirming or disproving asthma and streamlining secondary care clinical assessment.Reference David Lo, et al. Misdiagnosis of children’s asthma is common in UK primary care and can be improved with objective tests. European Respiratory Journal. 2018;52(suppl 62):PA1314",
  "authors": [
    {
      "affiliations": [
        "NuvoAir, London, UK"
      ],
      "name": "E Raywood"
    },
    {
      "affiliations": [
        "Salisbury NHS Foundation Trust, Salisbury, UK"
      ],
      "name": "A Whiting"
    },
    {
      "affiliations": [
        "NuvoAir, London, UK"
      ],
      "name": "C Oliver"
    },
    {
      "affiliations": [
        "NuvoAir, London, UK"
      ],
      "name": "H Parrott"
    },
    {
      "affiliations": [
        "Salisbury NHS Foundation Trust, Salisbury, UK"
      ],
      "name": "S Gray"
    }
  ],
  "title": "P140 Home spirometry to optimise respiratory secondary care new patient appointments",
  "uid": "969427e4-a7ed-5f1f-8511-3f0f435d16a7"
}