Poor technique and missed doses are among the commonest reasons that asthma appears uncontrolled. Before adding a drug or raising the dose, watch the patient use their device, check the spacer where one is needed, and ask how often doses are missed.
A correct technique, a spacer for a pressurised inhaler, and a clear written plan often achieve what a higher dose does not. Review technique at every visit, not only at the first.
- Watch the patient use the inhaler at each review.
- Use a spacer with a pressurised metered-dose inhaler where appropriate.
- Ask about missed doses and cost barriers.
- Provide a written action plan and confirm the patient understands it.
Why it matters
Escalating treatment on a technique problem adds cost and side effects without benefit.
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