Optimising inhaled therapy for patients with asthma

A 30 year old woman attends her general practice for her annual asthma review. She says her asthma is well controlled, but she has been issued two inhaled corticosteroid (ICS) preventer inhalers and six short acting beta agonist (SABA) reliever inhalers in the past year. On further questioning, she says that she limits her exercise because this brings on her asthma symptoms, and she experiences occasional night-time waking with cough. She describes irregular use of her ICS preventer inhaler, especially during the summer months, and almost daily use of her SABA reliever inhaler. On demonstrating her inhaler technique, she uses a quick and deep inhalation with her pressurised metered dose inhaler and does not use her spacer device.

Asthma is one of the most common non-communicable diseases and carries a substantial morbidity and mortality burden worldwide.1 A cross-sectional study from 17 countries carried out by the Global Asthma Network in 2022 found that about 7% of adults were affected by asthma symptoms that were not well controlled, resulting in a high burden of preventable symptoms, restrictions on activity, and an increased risk of asthma attacks.2 Sub-optimally …