Efficacy of a community paediatric asthma diagnostic pathway.

<bold>Background:</bold> Children and young people (CYP) living with asthma in the UK are at high risk of poor outcomes. A contributing factor to this is arguably inaccurate or delayed diagnosis as a result of limited access to diagnostic testing. The Leicester, Leicestershire and Rutland Integrated Care Board funded the Leicester paediatric community asthma diagnostic pathway (LPAP). The LPAP was the first paediatric asthma pathway to include challenge testing, in the UK that aids diagnosis within the community, aiming to improve the accuracy of asthma diagnosis and, in turn, improve management of the disease. <bold>Methods:</bold> Prospective cohort study evaluating the LPAP in CYP aged 5-17years referred directly from primary care. Where first line investigations (spirometry, FeNO, BDR) were inconclusive, patients progressed to indirect (exercise) and, if negative, direct (methacholine) bronchial challenge testing. <bold>Results:</bold> Since September 2023, 148 CYP completed the LPAP to date (Mean ± SD age 9 ± 3.48 yrs. 59% male), 72 (49%) of these CYP obtained a confirmed diagnosis of asthma, 4 of which were severely unwell upon presentation requiring acute clinical review. 15 CYP (10%) completed the full pathway and had a diagnosis of Asthma ruled out. Figure 1 details the pathway and outcomes. Figure 1 - LPAP diagnostic investigations and outcomes. <fig><object-id>erj;64/suppl_68/PA737/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> Paediatric asthma diagnostic pathways are an effective and efficient model of care to improve accuracy of asthma diagnosis.