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Canadian Respiratory Journal
Volume 14, Issue 4, Pages 229-234

The Paradox of Adult Asthma Control: “Who’s in Control Anyway?”

Rick Hodder

Divisions of Pulmonary and Critical Care Medicine, The Ottawa Hospital – Civic Campus, Ottawa, Ontario, Canada

Copyright © 2007 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Surveys of Canadian patients with asthma and their physicians consistently report satisfaction with asthma management; however, when objective indicators are used, these same surveys also observe very poor levels of asthma control. The reasons for this apparent discrepancy, with an emphasis on the factors influencing adherence to therapy, are explored in the present review. Clues to the identification of patients at risk of dying from asthma and an approach to difficult asthma are discussed.