The management of severe asthma in daily clinical practice is challenging. It requires meticulous characterisation and close monitoring of the patients, and high-dose treatment with inhaled corticosteroids (ICS)/long-acting β2-agnoists and add-on medications. Severe asthma add-on treatments include systemic steroids that have side-effects and increased long-term risk, and/or biologicals that are effective in specific phenotypes but should be used in a targeted manner and have high cost. Therefore, these medications should be prescribed after careful selection of the patients and close follow-up over at least a few months. Moreover, before resorting to add-on treatments for severe uncontrolled asthma, it is important to examine exposure to triggers such as allergens or irritants, comorbidities, and importantly, adherence to treatment and proper use of inhaler devices [1, 2], as adherence to ICS regimens is a pivotal factor in achieving optimal asthma control. Combining electronic devices with traditional methods, a good patient–doctor relationship, and mutual, informed decisions about treatment might provide the best inhaler adherence in severe asthma http://ow.ly/Ra8630gDQm3

中文翻译：

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重度哮喘患者的吸入器依从性：有电子解决方案吗？

日常临床实践中重度哮喘的管理具有挑战性。它需要对患者进行细致的表征和密切监测，并使用吸入性皮质类固醇 (ICS)/长效 β2-不可知剂和附加药物进行高剂量治疗。重度哮喘附加治疗包括具有副作用和增加长期风险的全身性类固醇，和/或对特定表型有效但应以有针对性的方式使用且成本高的生物制剂。因此，这些药物应在仔细选择患者并密切随访至少几个月后开具处方。此外，在对严重不受控制的哮喘采取附加治疗之前，检查过敏原或刺激物、合并症等诱因的暴露情况很重要，重要的是，坚持治疗和正确使用吸入器装置 [1, 2]，因为坚持 ICS 方案是实现最佳哮喘控制的关键因素。将电子设备与传统方法、良好的医患关系以及相互知情的治疗决定相结合，可能会为重度哮喘患者提供最佳的吸入器依从性 http://ow.ly/Ra8630gDQm3