Table 1: Factors that influence the achievement and the of asthma control maintenance.

Reasons of poor controlVariablesExamples

Disease-relatedComorbiditiesRhinitis, rhinosinusitis, gastrooesophageal reflux, obstructive sleep apnoea, and obesity
TriggersHouse dust mite, pets, occupational exposure, exercise, drug, passive smoking, new allergens, aspirin, and beta-blockers
Asthma typeAspirin-sensitivity, neutrophilic activity, and severe therapy-resistant

Patient relatedSociodemographic factorsFemale sex, education below secondary level, adolescence, and elderly age
AdherenceUndertreatment, overtreatment, irregular visits to healthcare providers, insufficient monitoring of symptoms, and no modifications in lifestyle
Psychiatric comorbidityAnxiety and depressive disorders
Psychological characteristicsAlexithymia (a personality trait characterized by difficulty in identifying and verbally expressing feeling) and inadequate coping strategies
PerceptionsTendency to tolerate symptoms, exacerbations and lifestyle limits as an inevitable consequence of asthma
ExpectationsLow expectations and aspirations about the achievable degree of control
BehavioursSmoking habits
Incorrect use of inhaler leading to ineffective/reduced drug delivery
KnowledgeInadequate information about the disease’s treatment.

Doctor relatedMisdiagnosisLimited awareness of asthma prevalence inadequate assessment
Knowledge of current guidelinesLack of consciousness and familiarity about guidelines availability
Attitude towards guidelinesDifficulty in accepting a particular document or the concept itself of the guidelines
Lack of confidence in personal abilities to put the recommendations into practice
Expectations of failure in following guidelines
Guidelines implementationsDifficulty changing deep-seated routines