What does good asthma control look like?

What Neil and others are reporting from the consultations chimes very much with what I've encountered personally, i.e. that there is very low awareness of the fact that using your reliever inhaler more than 3 times per week can be a sign of poor control, with all its attendant risks. In fact, in 2005 I made a bet with myself that if I met anybody with what they perceived as mild/moderate asthma or a parent of such a child, who was aware of the 'over 3 puffs/week' threshold, I'd donate £10 to A Good Cause. 2006 came without call to donate my £10, I'm afraid. A common perception I came across was that it was ok to use the blue puffer up to 4 times per day: a few people insisted that they had been told by their doctor that "you can't overuse salbutamol". I tried to explain that there is a difference between how much you need during an exacerbation as opposed to daily asthma control, which seemed to be where this confusion was arising. This message clearly needs better communication. I was impressed, a couple of years ago, when an older relative was diagnosed with adult onset asthma in London. His GP wrote a plan, which along with information on what to do about symptoms, also had a bit saying that the aim was control with minimal use of reliever. Perhaps asthma plans would be one means of communicating the "3 puffs and you might be losing control" message. And, I would have thought that it should be possible to keep tabs electronically on a patient's prescriptions for reliever inhalers and to have some kind of system prompt if these exceed expected levels?

hi all, i went to the consultation at Stanstead airport, and on our table was hearing the same as you Neil, too many people seem happy to live with regular symptoms becaquse they believe it is ok to cough or wheeze or have difficulties doing everyday things because they nhave asthma, this is so not right, all but a few asthmatics should as you say be able to live normal active lives, there needs to be a big campaign to highlight what people should expect from their lives with asthma. GEORGE XX

I suspect that we all feel guilty about troubling the dr with our asthma. So often by the time you get to the surgery you are clear and have to try and explain why you are there.At the moment I am taking about 24 puffs of blue a day and still cannot bring myself to face doctor idiot that I am

I think it has a lot do do with 'shut up and put up'. I get the impression that a lot of people think that as long as they are getting by and their asthma doesn't have too much of an impact on their lives, taking a few puffs of blue inhaler each day isn't a problem- when there are other treatments available that could reduce this.

You make such an important point, Neil, and it's something I agree with wholeheartedly. It's a difficult task though, to raise people's expectations when they are so low (compared to the RCP/BTS definitions of good control) and are sometimes re-enforced by poorly education health professionals.

Like many others, I'm often told, your chest sounds clear so you're fine. Just after I'd been in hospital for the 2nd time within 12 months I was told I was generally well controlled even though I was seeing massive quick onset peak flow dips + a 6 week chesty cough when I got a virus, inspite of following my plan and upping medication.

this doesn't surprise me. My aunt has a constant cough, but she ignores it, and ended up in hospital on monday in a severe condition. I've mentioned it before, but the asthma nurse has always said she's fine. clearly people don't know good control