Table 1.

Reasons for poor control

Co-morbidity (e.g. rhinitis, COPD)

Severe therapy-resistant disease

Ongoing exposure to triggers (e.g. occupational asthma, pets, mite etc)

Inadequate assessment

Misdiagnosis

Inadequate treatment

Ineffective delivery of treatment (e.g. poor inhaler technique)

Limited treatment effectiveness (e.g. smoking interfering with steroid actions)

Inadequate use of action plans

Low patient and physician expectations

Low adherence with agreed asthma therapy

Functional and psychological problems affecting willingness to use therapy

Over-reliance on complementary/alternative treatment

Not attending medical consultations

Patients do not perceive symptoms as indicative of poor control