P259 Should primary care be offering fractional exhaled nitric oxide (FeNO) testing? A review of raised FeNO levels in patients referred to secondary care with a suspicion of asthma

Background A direct access service for primary care patients to be referred into secondary care for pulmonary function tests has been in place for over 20 years. Due to the introduction of the BTS/NICE/SIGN guidance in November 2024, FeNO is now on the first stage of the flow chart as the initial test that should be performed in patients where a clinician has deemed the patient to have a history suggestive of asthma ( https://www.nice.org.uk/guidance/NG245). If a patient was to have this test in Primary Care this would allow a quick, non-invasive point of care diagnostic test which could be performed at initial presentation with the GP.Aim To identify the prevalence of raised FeNO levels in patients referred from Primary Care with a suspicion of asthma, whilst also investigating the ease of test procedure.Methods A 5 year retrospective analysis of patients who were referred by Primary Care with a suspicion of asthma was performed.Descriptive statistics were performed investigating patient demographics and FeNO results.Results 7395 patient results were returned on first search. All patients from direct access primary care with ?asthma as part of their clinical details.After data cleanse 4573 patients with only ?asthma as clinical details were included in the analysis.See table 1.96.4% (4410) achieved FeNO at their first visit, a failure rate of only 3.6%.Abstract P259 Table 1FeNO resultsConclusion 18.4% of patients attending directly from Primary Care would have a diagnosis of asthma using the BTS/SIGN/NICE 2024 guidance. A further 24.4% having an intermediate result which shows they may benefit from treatment with inhaled corticosteroids if they are symptomatic. Only 3.6% of patients were unable to perform the FeNO test.This data suggests that 42.8% of patients could have potentially been tested and initiated on treatment with the correct diagnosis without the need for referral to Secondary Care which would reduce waiting times for diagnosis and treatment.This study recommends the use of FeNO in Primary Care.