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Asthma seems simple: intermittent airway narrowing causing typical symptoms (wheeze, cough, chest tightness and dyspnoea), which responds to bronchodilator and inhaled corticosteroids (ICS), however, it is deceptively difficult to manage:

These complexities reinforce the need to use objective measurements such as spirometry and peak flow recordings, understand how comorbidities affect symptoms, and increase knowledge to develop personalised asthma action plans.

Rachel*, 70, comes for review because of ongoing cough and mucus production following a chest infection four weeks previously. The focus of the referral is the prolonged recovery from this infection, with a background history of asthma.