Difficult to control asthma

2) Reasons for difficult to control asthma

Description: A mature woman patient consulting a GP in the surgery consulting room.

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Incorrect diagnosis
One reason for a poor response to treatment is that some people do not have asthma, but have another illness causing their symptoms.

Your GP may refer you to a respiratory specialist for further investigation to confirm asthma or look for an alternative diagnosis. Sometimes it  takes time and a trial of medication before an accurate asthma diagnosis can be made.

Poor compliance
Poor compliance means not taking medications you are prescribed by your doctor. It is one of the most common reasons for a poor response or feeling your treatment is not working. There are many reasons for poor compliance:

  • Lack of immediate benefit – some medicines take a while to give the full effect.
  • Not fully understanding the instructions you were given.
  • Your asthma team did not explain everything clearly to you.
  • Fears about side effects.
  • Complicated treatment, you may be taking several medicines at the same time.
  • Lack of insight or knowledge about how asthma affects you.
  • Psychological problems, anxiety or depression.

Discussing your medicines and any concerns with your doctor or asthma nurse will help. Following the instructions for taking your medicine and using inhalers correctly is one of the most important things you can do to help manage your asthma successfully.

Damage to the lung
Sometimes if the lung structure has been damaged this may affect how medicines are taken in to the lung or the effectiveness of those medicines. A scan of your chest may show if there is a structural reason why medicines are not getting in to the lung where they are needed. Some people need high doses of medicine before they get any effect.

If you have asthma you should not smoke. See the section on ‘Help to stop smoking‘ for advice on why and how to go about stopping smoking.