Are doctors following up-to-date guidelines to treat mild asthma?

A summary of research published in ERJ Open Research.

A new paper published in ERJ Open Research aims to understand how doctors in Europe treat patients with mild asthma and if they follow the up-to-date advice. 

Current guidelines recommend a combination inhaler, also called low-dose inhaled corticosteroid/formoterol fumarate (ICS/FF) inhaler, to control mild asthma in adults.  


Inhaler treatments for mild asthma have changed a lot over the last decade. Doctors previously prescribed a reliever inhaler to reduce symptoms as needed. However, the latest guidelines recommend combination inhalers that can both relieve and control symptoms, such as swelling of the airways.  

What did the study look at?

This study looked at real-life data on how doctors treat mild asthma in Europe. People with asthma were divided into three groups based on their inhaler use: 

  1. A preventer inhaler, also called steroid inhaler, used daily  
  2. A combination inhaler, used as needed  
  3. A reliever inhaler, used as needed. 

Participants used a diary to record their inhaler use over six months. Information was collected to see how well asthma was controlled, if there were any changes in how their lungs worked and if people experienced side effects from treatment. 

What do the results show?

The study found that the combined inhaler was used most often. The least commonly used was the reliever inhaler. 

Researchers also found that many people diagnosed with only mild asthma could have more severe forms of asthma. When doctors considered past flare-ups and how well the lungs worked, they found that less than half of the people in the study had well-controlled asthma despite treatment. 

Interestingly, most people studied did not change their medication during the research period. After 6 months, results showed that asthma symptoms improved in all groups. The most improvement was seen in the combined inhaler group. The combined inhaler can be used as needed and has been shown to be just as effective at preventing asthma flare-ups as a preventer inhaler used daily. The reliever inhaler was linked with a reduction in lung function and more frequent and severe flare-ups. 

Why is this important?

This study shows that most doctors are following the current guidelines and recommended treatments for mild asthma by prescribing combination inhalers. 

The combination inhaler appears to be effective, with people experiencing better asthma control and fewer flare-ups compared to other treatments.  

However, the study suggests that people diagnosed with mild asthma may have a more serious condition and current methods for assessing asthma control might not be accurate. Further research is needed to improve how we assess how severe a person’s asthma is. 


Read the original research paper here: Real-world use of inhaled corticosteroid/formoterol as-needed in adults with mild asthma: The PRIME study