Physiologist-led home spirometry service (PLHSS) helps identify different asthma phenotypes for an improved patient centred approach.

<bold>Introduction:</bold> Varying presentations of asthma, associated with comorbidities, poor adherence or dominated by breathing pattern disorder (BPD), can manifest with complex symptoms making diagnosis difficult in an outpatient setting. Home spirometry can deliver useful insights provided patient engagement and quality assured data (QA) is achieved. <bold>Aim:</bold> To investigate the value of PLHSS in mapping patient symptoms against spirometry to objectively evaluate asthma control and determine most appropriate management. <bold>Methods:</bold> We report data for the first 11 patients monitored over 4-12 weeks in the asthma clinic, onboarded to NuvoAir home assessment and coached by respiratory physiologists to perform QA spirometry four times weekly and when symptomatic. Nijmegen questionnaires completed if BPD suspected. <bold>Results:</bold> 314 spirometry sessions performed; 79% engaged with 86% test readings graded good QA. Distinct groups emerged; firstly, asthma controlled with persisting symptoms (n=6) and secondly, asthma uncontrolled with variable obstructive spirometry (n=5). Figure 1 shows how this information directed care. 80% felt PLHSS useful detecting decline or improvement in lung function and patterns in health, providing empowerment and reassurance. <bold>Conclusions:</bold> PLHSS improved asthma characterisation and patient centred care and was valuable in capturing objective data of uncontrolled asthma facilitating treatment optimisation.