Adults aged 18–75 years Self-report of a doctor’s diagnosis of asthma -
Not used ICS in the 12 weeks prior to entry into the study and:
asthma symptoms or need for SABA ≥2 occasions in the last 4 weeks, or waking due to asthma ≥ once in the last 4 weeks, or exacerbation requiring oral corticosteroids in the last 52 weeks, or
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used ICS in the 12 weeks prior to entry in the study, and prescribed ICS at low or moderate doses (≤500 µg/day fluticasone propionate or small particle formulation beclomethasone dipropionate (Qvar); ≤800 µg/day budesonide; ≤1000 µg/day beclomethasone dipropionate (Beclazone)), and
has partly or well-controlled asthma as defined by GINA guidelines, or has uncontrolled asthma as defined by GINA guidelines and either poor adherence to ICS and/or unsatisfactory inhaler technique*
Willing and able to give informed consent for participation in the trial In the investigator’s opinion, able and willing to comply with all trial requirements Willing to allow their general practitioner (and specialist if appropriate) to be notified of participation in the trial
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Self-reported use of LABA, leukotriene receptor antagonist, theophylline, anticholinergic agent or cromone as maintenance therapy in the 12 weeks before potential study entry; nasal corticosteroid therapy is permitted Self-reported past admission to the intensive care unit with life-threatening asthma (representing patients at highest risk of adverse asthma outcomes) Self-reported treatment with oral prednisone or other systemic corticosteroids in the 6 weeks before potential study entry (representing recent unstable asthma) A home supply of prednisone for use in worsening asthma, as part of a current asthma plan Self-reported diagnosis of chronic obstructive pulmonary disease, bronchiectasis or interstitial lung disease Self-reported greater than 20 pack year smoking history, or onset of respiratory symptoms after the age of 40 years in current or ex-smokers with ≥10 pack year history Self-reported current pregnancy or breast feeding at the time of enrolment or planned pregnancy within the study period Unwilling or unable to switch from current asthma treatment regimen Other illness(es) likely to compromise participant safety or impact on the feasibility of results, at the discretion of the investigator (examples include unstable coronary disease and malignancy)
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