Do we correctly manage adult asthma patients in family medicine?

Although prevalence of asthma has increased particularly among children, asthma is still underdiagnosed and undertreated or inappropriately treated disease. Most of the health care for patients with asthma is provided by family physicians in primary health care. Nowadays recommendations (GINA 2006) are based on assessing asthma control levels, the cornerstone of therapy for persistent asthma of all degrees of severity, both in adults and children, are inhaled corticosteroids (ICS) as monotherapy, while long-acting beta2-agonists (LABA), leukotriene modifiers (LTRA) or theophylline are add-on therapy if the control of disease is not successfully achieved. Fixed combination (ICS + LABA) could be used only for moderate to severe persistent asthma and in cases when satisfactory control is not achieved using ICS alone. Unjustified trend towards initial fixed combination prescribing has become more and more popular, but with potential of overuse.