Achieving asthma control in practice: understanding the reasons for poor control

John Haughney, David Brendan Price, Alan Kaplan, Henry Chrystyn, Rob Horne, Nick May, Mandy Moffat, Jennifer Versnel, Eamonn R Shanahan, Elizabeth V Hillyer, Alf Tunsäter, Leif Bjermer

Research output: Contribution to journalArticlepeer-review

183 Citations (Scopus)


Achieving asthma control remains an elusive goal for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to sub-optimal asthma control. Concomitant rhinitis, a common co-pathology and contributor to poor control, can often be identified by asking a simple question. Smoking too has been identified as a cause of poor asthma control. Practical barriers such as poor inhaler technique must be addressed. An appreciation of patients' views and concerns about maintenance asthma therapy can help guide discussion to address perceptual barriers to taking maintenance therapy (doubts about personal necessity and concerns about potential adverse effects). Further study into, and a greater consideration of, factors and patient characteristics that could predict individual responses to asthma therapies are needed. Finally, more clinical trials that enrol patient populations reflecting the real world diversity of patients seen in clinical practice, including wide age ranges, presence of comorbidities, current smoking, and differing ethnic origins, will contribute to better individual patient management.
Original languageEnglish
Pages (from-to)1681-1693
Number of pages13
JournalRespiratory Medicine
Issue number12
Early online date23 Sept 2008
Publication statusPublished - Dec 2008


  • Adult
  • Anti-Asthmatic Agents
  • Asthma
  • Child
  • Drug Resistance
  • Glucocorticoids
  • Humans
  • Nebulizers and Vaporizers
  • Patient Compliance
  • Patient Education as Topic
  • Randomized Controlled Trials as Topic
  • Rhinitis
  • Smoking


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