Over 70 per cent of patients with asthma do not have full control of their condition and suffer unnecessarily from symptoms €“ mainly coughing, wheezing, shortness of breath and chest tightness. Many patients accept these as normal and are unaware of the steps they can take to gain better control. This lack of control can affect their quality of life and put them at risk of an asthma attack, which could lead to hospitalisation and, at worst, death. The major concordance issue relating to patients taking asthma medicines appears to be a lack of understanding of how to use the medicine most effectively.

An MUR is an ideal opportunity to ensure the patient is receiving the maximum benefit from their medication and to address any issues or concerns a patient may have. During an MUR, a simple way to recognise whether a patient has poor asthma control is through the use of the 'three questions' listed below, which have been devised by the Royal College of Physicians.

In the last week/month:

1. Have you had difficulty sleeping because of your asthma symptoms (including cough)?

2. Have you had your usual symptoms during the day?

3. Has your asthma interfered with your usual activities?

Answering 'yes' to one of these questions is an indication of medium morbidity. Answering 'yes' to two or three would be an indication of high morbidity. Should an indication of poor control be identified, the pharmacist needs to establish whether this has been caused by the condition worsening or a compliance issue.

The following questions, which build on those contained within the MUR structure, can be used to identify where a patient needs support.