Part II: Inhaler technique and adherence to therapy.

Although the importance of effective asthma management has been well established, in many patients asthma control remains suboptimal. While numerous factors likely contribute to inadequate control of asthma symptoms, studies have demonstrated that many patients fail to use their inhaler devices correctly, which may compromise asthma treatment. To ensure that patients use their inhaler devices appropriately, the choice of inhaler should be matched to each individual patient's capabilities and preferences. Thorough patient education regarding the effective use of the selected inhaler, repeated demonstrations on proper inhalation technique, and frequent patient follow-up is necessary to ensure that inhalers are operated correctly. Patient adherence to therapy, which traditionally has been poor, is another factor that may negatively affect asthma control. Patient attitudes and perceptions regarding the effectiveness of therapy, the risks of inadequate asthma control, and the need for daily controller medications all influence compliance. Consequently, effective education regarding the benefits of treatment and the risks of nonadherence is critical to enhancing patient adherence, self-care skills, and, potentially, asthma control.