The asthma management gap - why current treatment strategies can fail to provide optimal asthma control

Standard asthma management strategies are not always successful at providing optimal control. Despite the availability of effective asthma drugs and the publication of numerous asthma management guidelines, many patients are not adequately controlled and experience frequent asthma symptoms and exacerbations. Current guidelines advocate a stepwise approach to treatment, initially through inhaled corticosteroids, with the addition of a long-acting beta(2)-agonist or another asthma medication when required. Once asthma control has been achieved with an appropriate starting dose, corticosteroids should be reduced to the lowest effective dose with the option to step up during periods of asthma worsening. Such strategies require personalised, written action plans to enable patients to make appropriate changes in medication with less requirement for intervention by the physician. Adjustable maintenance dosing with budesonicle/formoterol in a single inhaler offers an effective means to adapt the medication to the needs of the patient, as indicated in the current guidelines.