The focus of this study is childhood asthma exacerbations, which are common, potentially life-threatening and are a considerable financial burden to healthcare systems. Annually in the UK there are 200,000 children treated for an asthma exacerbation and around 25,000 are hospitalised.
Spirometry is a simple breathing test which does not change over time when asthma is controlled. Spirometry could be a very useful test to monitor asthma because it measures lung function, i.e. how the lungs are working. Clinicians are uncertain of the role of spirometry in guiding asthma treatment in children, and this means that spirometry is used inconsistently across UK asthma clinics. Spirometry is recommended in some (but not all) guidelines as part of monitoring children with asthma, but the guidelines do not say how treatment should change in the context of changing spirometry result. SPIROMAC will be the first study to rigorously evaluate how spirometry can be used to guide asthma treatment and reduce the risk for asthma attacks in children.
SPIROMAC is a multi-centre randomised controlled trial, which will run in both secondary care and primary care, aiming to recruit 550 children. The study will compare asthma treatment guided by “Spirometry and symptoms” versus asthma treatment guided by “symptoms only” (i.e. standard care) in children with asthma. Spirometry and symptoms, or symptoms alone, are assessed every three months and will be used to guide asthma treatment for the next three month period. Treatment recommendations in both groups are protocolised within a web-based algorithm. The primary outcome is asthma attacks over a 12 month period.
SPIROMAC is funded by the NIHR/MRC EME Programme.
SPIROMAC is led by Professor Steve Turner based at NHS Grampian.
For more information please see the SPIROMAC study page.