- Title
- Usual antenatal asthma management and the clinical translational potential of a fractional exhaled nitric oxide (FeNO)-based management strategy
- Creator
- McLaughlin, Karen Maree
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Asthma remains the most common chronic health condition to complicate pregnancy in Australia, with approximately 12.7% of pregnant women affected. If asthma is poorly controlled during pregnancy the risk of pre-eclampsia, preterm birth and low birth weight babies are increased. Guidelines including recommendations for the management of asthma during pregnancy are available, but the use of these guidelines and management recommendations in antenatal care is unknown. A new strategy aimed at reducing asthma exacerbations and improving maternal and neonatal outcomes of pregnancies affected by asthma is Fractional exhaled Nitric Oxide (FeNO)-based management. The efficacy of this strategy to reduce asthma exacerbations in pregnancy has been established, but the translational potential of it into antenatal care has not been examined. Aim: The studies contained in this thesis examine the usual antenatal asthma care currently occurring in Australia and the acceptability and feasibility of introducing a new management strategy involving the use of FeNO measurement to guide treatment. Methods: The AGREE II tool was used to appraise current asthma in pregnancy guidelines. Cross-sectional surveys were developed and distributed to healthcare professionals currently providing antenatal care and to pregnant women with asthma in order to determine ‘usual’ antenatal asthma care. Qualitative face-to-face interviews with video elicitation, involving healthcare professionals and pregnant women, were used to determine the acceptability and feasibility of implementing a FeNO-based asthma management strategy into antenatal care. Results: Recommendations for asthma management in pregnancy were found to be consistent, despite a level of ambiguity in specific elements. ‘Usual’ care described by survey respondents did not reflect guideline recommendations. The implementation of FeNObased asthma management into antenatal care was considered to be acceptable and feasible. Conclusion: An implementation strategy for FeNO-based management should be developed to provide a sustainable solution to the current inconsistent and ineffective management of asthma during pregnancy.
- Subject
- asthma; pregnancy; management; FeNO; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1413245
- Identifier
- uon:36600
- Rights
- Copyright 2020 Karen Maree McLaughlin
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 17 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 472 KB | Adobe Acrobat PDF | View Details Download |