It may be time to adopt a common strategy to simplify treatment

The drug treatment regimen for most patients with asthma is straightforward and is documented in the British Thoracic Society guidelines.1 The choice of which drug delivery device to use is less clear as we become more confused by an ever increasing choice. For example, when a child with asthma taking prophylactic steroids is seen in clinic or the accident and emergency department for the first time the parents are often unsure which inhalational devices the child uses. If the child is not taking steroids by nebulisation the clinician has a 1 in 125 chance of guessing the correct combination of inhalation device, drug, and strength of inhaler that the child is using. It should be possible to devise a simple prescribing strategy that would avoid this confusion.

The confusion is added to by the way devices are marketed. In several cases insufficient published information is available to allow clinicians to make an informed choice. Promotional material is often based on unpublished data on file or non-peer reviewed abstracts. Many people assume that drug delivery devices are strictly regulated, but this is not …