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Table 1 Reasons for poor control

From: Can asthma control be improved by understanding the patient's perspective?

Co-morbidity (e.g. rhinitis, COPD)
Severe therapy-resistant disease
Ongoing exposure to triggers (e.g. occupational asthma, pets, mite etc)
Inadequate assessment
Misdiagnosis
Inadequate treatment
Ineffective delivery of treatment (e.g. poor inhaler technique)
Limited treatment effectiveness (e.g. smoking interfering with steroid actions)
Inadequate use of action plans
Low patient and physician expectations
Low adherence with agreed asthma therapy
Functional and psychological problems affecting willingness to use therapy
Over-reliance on complementary/alternative treatment
Not attending medical consultations
Patients do not perceive symptoms as indicative of poor control