Asthma UK recently reported that many people diagnosed with asthma may not actually have it and may be taking medication unnecessarily. Dr Tim Harrison and his team at the Nottingham Respiratory Research Unit (NRRU), also recently confirmed that many patients in Nottingham who were recommended asthma treatment, do not have it and do not benefit from asthma inhalers.
The new trial is called ‘The Low NO Study’ and has been developed collaboratively with NHS Nottingham City Clinical Commissioning Group and funded by the NHS National Institute for Healthcare Research (NIHR). It aims to find out whether a new type of breath test can give a better indicator of whether steroid inhalers will work for patients with suspected asthma.
Dr Harrison said: “We believe a large proportion of patients diagnosed with asthma do not benefit from the asthma treatment they are taking because they have no evidence of airway inflammation. This occurs because the symptoms of asthma are very non-specific and excluding asthma is very difficult.
“Although low dose inhaled steroid treatment is relatively safe, the volume of prescriptions of it nationally represents a major cost to the NHS and patients, and some patients have their treatment escalated because there is no improvement with low dose treatment.
“We are looking for the support of around 20 GP practices in the Nottingham area to help recruit 165 patients who have recently been diagnosed with asthma or who are being considered for inhaled steroid treatment. The patients who take part will be asked to give a simple breath test that measures exhaled nitric oxide. The test will be carried out by the participating surgery asthma nurses or research nurses from the University’s Respiratory Research Unit.
“Patients with a nitric oxide reading of less than 27ppb (parts per billion) will be told that they may not actually benefit from an inhaled steroid and they will be invited to take part in a randomised trial to compare three months of steroid treatment with three months of placebo (dummy) treatment so we can confirm this.”
Dr Manik Arora, Clinical lead for long term conditions at the NHS Nottingham City Clinical Commissioning Group, said: “I am extremely pleased to be involved in such an important and invaluable piece of research that will make a real difference to the way we diagnose and treat patients with asthma. The research will enable us to deliver better targeted care for patients with asthma. This project has also been a great opportunity for me to work with Dr Tim Harrison and the team at the NRRU. I’m looking forward to sharing the learnings from this project with my patients.”
The patients who take part in the study will be asked to fill in three questionnaires and undergo two simple blowing tests at the start, and again at one month and three months later. The tests can be performed at the patient’s GP practice or at the Nottingham Respiratory Research Unit at Nottingham City Hospital.
The ‘Low NO’ research team will be recruiting participants from January 2016. GP practices will have the opportunity to be part of medical research which could change diagnosis and treatment guidelines for asthma, as well as reduce the cost of prescribed steroid inhalers for the condition.
For patients, the research promises to offer a better, more accurate diagnosis of their suspected asthma, free inhaled steroid or placebo treatments for the three months of the trial, and the avoidance of future steroid treatment if the tests reveal they are of no benefit to the patient.
Newly-diagnosed asthma patients will be recruited into the trial through their GP practice.
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Notes to editors: The University of Nottingham has 43,000 students and is ‘the nearest Britain has to a truly global university, with a “distinct” approach to internationalisation, which rests on those full-scale campuses in China and Malaysia, as well as a large presence in its home city.’ (Times Good University Guide 2016). It is also one of the most popular universities in the UK among graduate employers and the winner of ‘Research Project of the Year’ at the Times Higher Education Awards 2014. It is ranked in the world’s top 75 by the QS World University Rankings 2015/16, and 8th in the UK by research power according to the Research Excellence Framework 2014. It has been voted the world’s greenest campus for three years running, according to Greenmetrics Ranking of World Universities.
More information is available from Dr Tim Harrison in the School of Medicine, University of Nottingham on +44 (0)115 823 1714, firstname.lastname@example.org
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