Difficult to control asthma

Some people with asthma have 'difficult to control' asthma, where they often have symptoms and asthma attacks.

Having worse asthma symptoms for a short time - perhaps as a result of a cold virus, or hay fever, or when you're going through a period of stress - can happen to anyone with asthma.

But if you're having difficult asthma symptoms a lot of the time or you're finding it hard to manage your asthma well, you may have difficult to control asthma.

  • Around 12% of people with asthma have 'difficult to control' asthma. This means they have difficulty breathing almost all of the time and often have what could be life-threatening asthma attacks.
  • More rarely, you might have a specific type of asthma called 'severe asthma'. Only 5% of all people with asthma have a diagnosis of 'severe asthma'. You can find out more about severe asthma here.

Even if you're having many difficult symptoms a lot of the time, and finding it difficult to manage them well, it doesn't necessarily mean you have severe asthma.

But it does mean you could do with some extra support and treatment to help you get back on top of your asthma. 

Most of the time, difficult asthma symptoms can be treated. With the right medicines and support you can get your asthma back on track.

Why do some people have difficult to control asthma?

There are lots of different reasons why you might have asthma that's difficult to control.

These include:

  • having other long term conditions that make it harder to manage your asthma, for example a heart condition or diabetes
  • being a smoker, which makes asthma symptoms worse and stops asthma medicines working as well
  • finding it hard to get into a good routine of taking your inhalers and other asthma medicines regularly
  • not using a good inhaler technique. This means you're not getting the right dose at the right time to help get your symptoms under control.

If you're having symptoms don't ignore them. They're a sign that your asthma is not well controlled and that you're at risk of an asthma attack, so it's important to do something about them. Make an appointment to get your asthma reviewed.

How your GP or asthma nurse can help with difficult to control asthma

Your GP or asthma nurse can review the medicines you're taking, and check you're taking them in the best way. They can talk with you about: 

  • sticking to a good medicine routine
  • the best way to take your inhalers
  • what situations or triggers make your asthma worse, including work
  • how you cope with your asthma triggers
  • any other conditions or allergies you might have
  • other types of support, for example stop smoking advice.

In the short term your GP or asthma nurse might prescribe a course of steroid tablets to reduce the inflammation in your lungs. 

Longer term, you might be prescribed extra medicines to take every day alongside your usual preventer inhaler. These are to help you manage your asthma better. For example:

Whenever your GP makes a change to your usual prescription, you should get another appointment four to eight weeks later to check the new medicines are working and are right for you.

You can help things along by:

  • going to appointments to make sure you're doing all you can to stay symptom-free
  • sticking to your new treatment plan exactly as prescribed
  • keeping a diary of any symptoms or improvements to help you and your GP know if the new treatments are working well for you or not
  • using a written asthma action plan to help you manage your asthma well.

If you're still always having asthma symptoms, your GP may refer you to a specialist clinic for tests to see if you do actually have severe asthma.

Whatever treatment you're given, it can only work if you stick to it as prescribed

It's not unusual for people with long term conditions such as asthma to find it difficult or worrying to have to take medicines all the time.

Perhaps you don't believe you really need your asthma medicines, or you're worried about the side effects and it puts you off.

If concerns about your asthma medicines mean you're taking less of them, skipping doses or even stopping taking them altogether, this is likely to make your asthma worse.

And if you're always forgetting to take your asthma medicines or not taking your inhaler in the best way, you won't be doing a true test of the treatment prescribed to you.

Worried about difficult asthma symptoms?  

Call our Helpline 0300 222 5800, Mon- Fri, 9am-5pm to talk to an asthma nurse specialist.

Last updated December 2017

Next review due October 2019