If a person’s asthma is not controlled following treatment with a LABA/ICS inhaler and a LTRA then a number of options could be considered. These include: 

Therapies such as theophylline and slow release beta2 agonist tablets may improve lung function and symptoms, but side effects and drug interactions occur more commonly. These are more often started after assessment by a respiratory team in primary or secondary care.

At each stage, aim to understand the person’s experience of using their inhalers and whether they are being used as prescribed. This is important for preventer therapies. Ensuring inhaler technique is effective before escalating treatment is also important. Non-adherence can be intentional, such as not wanting to take an inhaler containing a steroid, and/or unintentional, such as poor inhaler technique.