Expectations and attitudes in primary care towards home-based testing for diagnosing asthma: a mixed methods study

Area of Science:

• Respiratory Medicine
• Diagnostic Technology
• Primary Care Research

Background:

• Asthma diagnosis is often inaccurate due to the limitations of clinic-based tests in capturing disease variability.
• Misdiagnosis can lead to suboptimal patient outcomes and increased healthcare burden.

Purpose of the Study:

• To assess primary care healthcare professionals' (HCPs) perspectives on utilizing handheld spirometry and fractional exhaled nitric oxide (FeNO) for home-based asthma diagnostics.
• To identify key priorities, barriers, and facilitators for implementing home-based asthma diagnostic strategies in primary care settings.

Main Methods:

• A two-phase mixed-method study involving focus groups (Phase 1) and a national electronic survey (Phase 2) with UK primary care HCPs.
• Nominal Group Technique was employed in focus groups to inform survey development.

Main Results:

• Focus groups identified advantages, challenges, and facilitators for home-based asthma diagnostics.
• The national survey (n=104) indicated favorable views towards home-based diagnostics, with only 3% deeming it unlikely to be feasible.
• High device cost was the primary barrier, whereas patient engagement and device accessibility were key enablers. Improved asthma diagnosis accuracy was a major perceived benefit.

Conclusions:

• Primary care HCPs generally support home-based asthma diagnosis using handheld spirometry and FeNO, despite implementation challenges.
• Successful integration requires systemic changes in delivery and support for home-based testing.
• Future research will focus on test feasibility, accuracy, and clinical/cost-effectiveness.