ABSTRACT
This chapter addresses asthma care in primary care practices. Asthma is one of the most common chronic conditions for both adults and children. The reliance on primary care is true even in places like the United States where specialists are common. Asthma specialist care systems can be adapted and transferred to primary care sites and for many that is what is happening in quality-improvement programs for asthma management. The British Thoracic Society guidelines also specifically state, “Before initiating a new drug therapy practitioners should check compliance with existing therapies, inhaler technique, and eliminate trigger factors.” Most practices with systems of asthma care assign this task to a nonphysician such as a clinical nurse specialist in the United Kingdom, the Netherlands, and Australia, or an asthma educator in the United States. Adherence is a known barrier to management of all chronic diseases and asthma is no exception. Unintentional nonadherence includes forgetting medications or taking them incorrectly, or poor inhaler technique.
