Disease-related | |
Comorbidities: gastro-oesophageal reflux, obstructive sleep apnoea, psychiatric disease, allergic rhinitis and rhinosinusitis | [30–34] |
Asthma type: aspirin sensitivity, neutrophilic activity, severe therapy resistant | [17] |
Exposure to triggers: allergens, smoke, environmental and work-related irritants | [26] |
Patient-related | |
Low patient expectations regarding asthma control | [13, 17] |
Poor patient perception of asthma control | [14, 21] |
Low socioeconomic status | [17] |
Poor adherence to medication | [17] |
Incorrect use of inhaled medication | [17, 24] |
Physician-related | |
Absence of specialist care: inability of physicians to recognise poor asthma control, poor knowledge of current guidelines, misdiagnosis of asthma | [15, 17, 18] |
Poor doctor–patient communication | [16] |
No patient education on the correct use of inhaled medications | [24] |
Rare implementation of self-management plans | [17] |