Spirometry to manage asthma in children: study protocol for a randomised controlled trial (SPIROMAC).

Area of Science:

• Pediatric Pulmonology
• Clinical Trials
• Respiratory Medicine

Background:

• Childhood asthma affects over 1 million UK children, with treatment relying on subjective symptom assessment.
• Current guidelines lack clear protocols for adjusting asthma treatment based on objective lung function (spirometry) changes.
• Spirometry offers an objective measure of lung function, valuable for guiding pediatric asthma management.

Purpose of the Study:

• To evaluate the efficacy of spirometry-guided asthma treatment in reducing asthma attacks in children.
• To determine if objective lung function measurements can improve asthma management strategies.
• To assess the impact of spirometry on pediatric asthma exacerbation rates.

Main Methods:

• Multi-centre randomized controlled trial involving children aged 6-15 years with a recent asthma exacerbation.
• Participants randomized to asthma treatment guided by spirometry plus symptoms or by symptoms alone.
• Primary outcome: number of asthma attacks requiring oral/intravenous corticosteroids over 12 months.

Main Results:

• The study is designed to evaluate the effectiveness of spirometry in reducing asthma attacks.
• Results will quantify the difference in exacerbation rates between the intervention and standard care groups.
• Secondary outcomes include time to first attack, asthma control, and quality of life.

Conclusions:

• This trial will determine if spirometry-guided asthma management reduces future asthma attacks in children.
• Findings may inform and update national and international pediatric asthma treatment guidelines.
• Objective lung function monitoring shows potential for improving asthma care outcomes.