ERJ Open Research (Feb 2019)
Pharmacological treatment of asthma in a cohort of adults during a 20-year period: results from the European Community Respiratory Health Survey I, II and III
- Christer Janson,
- Simone Accordini,
- Lucia Cazzoletti,
- Isa Cerveri,
- Sebastien Chanoine,
- Angelo Corsico,
- Diogenes Seraphim Ferreira,
- Judith Garcia-Aymerich,
- David Gislason,
- Rune Nielsen,
- Ane Johannessen,
- Rain Jogi,
- Andrei Malinovschi,
- Jesús Martinez-Moratalla Rovira,
- Alessandro Marcon,
- Isabelle Pin,
- Jennifer Quint,
- Valerie Siroux,
- Enrique Almar,
- Valeria Bellisario,
- Karl A. Franklin,
- José A. Gullón,
- Mathias Holm,
- Joachim Heinrich,
- Dennis Nowak,
- José Luis Sánchez-Ramos,
- Joost J. Weyler,
- Deborah Jarvis,
- The members of the ECRHS I scientific team.,
- P. Burney,
- S. Chinn,
- C. Luczynska,
- D. Jarvis,
- E. Lai,
- P. Burney,
- S. Chinn,
- C. Luczynska,
- D. Jarvis,
- P. Vermeire,
- H. Kesteloot,
- J. Bousquet,
- D. Nowak,
- J. Prichard,
- R. de Marco,
- B. Rijcken,
- J.M. Anto,
- J. Sunyer,
- J. Alves,
- G. Boman,
- N. Nielsen,
- P. Paoletti,
- M. Abramson,
- J. Kutin,
- P. Vermeire,
- F. van Bastelaer,
- R. Jõgi,
- A. Taytard,
- I. Pin,
- C. Pison,
- F. Neukirch,
- R. Liard,
- J. Bousquet,
- J. Knani,
- H-E. Wichmann,
- J. Heinrich,
- H. Magnussen,
- D. Nowak,
- T. Gislason,
- D. Gislason,
- A. Marinoni,
- I. Cerveri,
- M. Bugiani,
- C. Bucca,
- C. Romano,
- R. de Marco,
- L. Cascio,
- C. Campello,
- J. Droste,
- M. Kerkhof,
- A. Gulsvik,
- E. Omenaas,
- J. Martinez-Moratalla,
- E. Almar,
- A. Mateos,
- M. Arévalo,
- A. Sánchez,
- M. Vizcaya,
- X. Aguilar,
- A. Teixidó,
- J.M. Antó,
- M. Kogevinas,
- J. Sunyer,
- F. Burgos,
- J. Castellsagué,
- J. Roca,
- JB. Soriano,
- A. Tobías,
- N. Muiñozguren,
- J. Ramos González,
- A. Capelastegui,
- J. Maldonado Pérez,
- A. Pereira,
- J. Sánchez,
- J. Quiros,
- I. Huerta,
- F. Payo,
- N. Lindholm,
- P. Plaschke,
- G. Boman,
- C. Janson,
- E. Björnsson,
- L. Rosenhall,
- E. Norrman,
- B. Lundbäck,
- U. Ackermann-Liebrich,
- N. Küenzli,
- A. Perruchoud,
- M. Burr,
- J. Layzell,
- R. Hall,
- B. Harrison,
- The members of the ECRHS II scientific team.,
- P. Burney,
- S. Chinn,
- C. Luczynska,
- D. Jarvis,
- J. Knox,
- P. Burney,
- S. Chinn,
- C. Luczynska,
- D. Jarvis,
- P. Vermeire,
- J. Bousquet,
- J. Heinrich,
- M. Wjst,
- R. de Marco,
- J.M. Anto,
- J. Sunyer,
- C. Janson,
- U. Ackermann-Liebrich,
- N. Kuenzli,
- F. Neukirch,
- M. Abramson,
- E.H. Walters,
- J. Raven,
- P. Vermeire,
- J. Weyler,
- M. van Sprundel,
- V. Nelen,
- R. Jõgi,
- A. Soon,
- A. Taytard,
- C. Raherison,
- I. Pin,
- J. Ferran-Quentin,
- F. Neukirch,
- B. Leynaert,
- R. Liard,
- M. Zureik,
- J. Bousquet,
- P.J. Bousquet,
- J. Heinrich,
- M. Wjst,
- C. Frye,
- I. Meyer,
- H. Magnussen,
- D. Nowak,
- T. Gislason,
- E. Bjornsson,
- D. Gislason,
- K.B. Jörundsdóttir,
- A. Marinoni,
- S. Villani,
- M. Ponzio,
- F. Frigerio,
- M. Comelli,
- M. Grassi,
- I. Cerveri,
- A. Corsico,
- R. Bono,
- M. Bugiani,
- P. Piccioni,
- E. Caria,
- A. Carosso,
- E. Migliore,
- G. Castiglioni,
- R. de Marco,
- G. Verlato,
- E. Zanolin,
- S. Accordini,
- A. Poli,
- V. Lo Cascio,
- M. Ferrari,
- I. Cazzoletti,
- M. Kerkhof,
- A. Gulsvik,
- E. Omenaas,
- C. Svanes,
- B. Laerum,
- J. Martinez-Moratalla Rovira,
- E. Almar,
- M. Arévalo,
- C. Boix,
- G. González,
- J.M. Ignacio García,
- J. Solera,
- J. Damián,
- J.M. Antó,
- J. Sunyer,
- M. Kogevinas,
- J.P. Zock,
- X. Basagaña,
- A. Jaen,
- F. Burgos,
- C. Acosta,
- N. Muñozguren,
- J. Ramos,
- I. Urrutia,
- U. Aguirre,
- J. Maldonado,
- A. Pereira,
- J.L. Sanchez,
- F. Payo,
- I. Huerta,
- A. de la Vega,
- L. Palenciano,
- J. Azofra,
- A. Cañada,
- K. Toren,
- L. Lillienberg,
- A.C. Olin,
- B. Balder,
- A. Pfeifer-Nilsson,
- R. Sundberg,
- C. Janson,
- G. Boman,
- D. Norback,
- G. Wieslander,
- M. Gunnbjornsdottir,
- E. Norrman,
- M. Soderberg,
- K.A. Franklin,
- B. Lundback,
- B. Forsberg,
- L. Nystrom,
- N. Küenzli,
- B. Dibbert,
- M. Hazenkamp,
- M. Brutsche,
- U. Ackermann-Liebrich,
- M. Burr,
- J. Layzell,
- D. Jarvis,
- R. Hall,
- D. Seaton,
- D. Jarvis,
- B. Harrison,
- The members of the ECRHS III scientific team.,
- D. Jarvis,
- P. Burney,
- M. Tumilty,
- J. Potts,
- D. Jarvis,
- P. Burney,
- J. Heinrich,
- R. de Marco,
- J.M. Anto,
- C. Janson,
- K. Toren,
- T. Gislasson,
- T. Rochat,
- B. Leyneart,
- C. Svanes,
- J. Weyler,
- J.P. Zock,
- M. Abramson,
- G. Benke,
- S. Dharmage,
- B. Thompson,
- S. Kaushik,
- M. Matheson,
- J. Weyler,
- H. Bentouhami,
- V. Nelen,
- R. Jõgi,
- H. Orru,
- C. Raherison,
- P.O. Girodet,
- I. Pin,
- V. Siroux,
- J. Ferran,
- J.L. Cracowski,
- P. Demoly,
- A. Bourdin,
- I. Vachier,
- B. Leynaert,
- D. Soussan,
- D. Courbon,
- C. Neukirch,
- L. Alavoine,
- X. Duval,
- I. Poirier,
- J. Heinrich,
- E. Becker,
- G. Woelke,
- O. Manuwald,
- H. Magnussen,
- D. Nowak,
- A-M. Kirsten,
- T. Gislason,
- B. Benediktsdottir,
- D. Gislason,
- E.S. Arnardottir,
- M. Clausen,
- G. Gudmundsson,
- L. Gudmundsdottir,
- H. Palsdottir,
- K. Olafsdottir,
- S. Sigmundsdottir,
- K. Bara-Jörundsdottir,
- I. Cerveri,
- A. Corsico,
- A. Grosso,
- F. Albicini,
- E. Gini,
- E.M. Di Vincenzo,
- V. Ronzoni,
- S. Villani,
- F. Campanella,
- M. Gnesi,
- F. Manzoni,
- L. Rossi,
- O. Ferraro,
- M. Bugiani,
- R. Bono,
- P. Piccioni,
- R. Tassinari,
- V. Bellisario,
- G. Trucco,
- R. de Marco,
- S. Accordini,
- L. Calciano,
- L. Cazzoletti,
- M. Ferrari,
- A.M. Fratta Pasini,
- F. Locatelli,
- P. Marchetti,
- A. Marcon,
- E. Montoli,
- G. Nguyen,
- M. Olivieri,
- C. Papadopoulou,
- C. Posenato,
- G. Pesce,
- P. Vallerio,
- G. Verlato,
- E. Zanolin,
- H.M. Boezen,
- C. Svanes,
- E. Omenaas,
- A. Johannessen,
- T. Skorge,
- F. Gomez Real,
- J. Martinez-Moratalla Rovira,
- E. Almar,
- A. Mateos,
- S. García,
- A. Núñez,
- P. López,
- R. Sánchez,
- E. Mancebo,
- J-M. Antó,
- J.P. Zock,
- J. Garcia-Aymerich,
- M. Kogevinas,
- X. Basagaña,
- A.E. Carsin,
- F. Burgos,
- C. Sanjuas,
- S. Guerra,
- B. Jacquemin,
- P. Davdand Galdakao,
- N. Muñozguren,
- I. Urrutia,
- U. Aguirre,
- S. Pascual,
- J. Antonio Maldonado,
- A. Pereira,
- J.L. Sánchez,
- L. Palacios,
- F. Payo,
- I. Huerta,
- N. Sánchez,
- M. Fernández,
- B. Robles,
- K. Torén,
- M. Holm,
- J-L. Kim,
- A-C. Olin,
- A. Dahlman-Höglund,
- B. Forsberg,
- L. Braback,
- L. Modig,
- B. Järvholm,
- K.A. Bertilsson,
- H. Franklin,
- C. Wahlgreen,
- B. Andersson,
- D. Norback,
- U. Spetz Nystrom,
- G. Wieslander,
- G.M. Bodinaa Lund,
- K. Nisser,
- N.M. Probst-Hensch,
- N. Künzli,
- D. Stolz,
- C. Schindler,
- T. Rochat,
- J.M. Gaspoz,
- E. Zemp Stutz,
- M. Adam,
- C. Autenrieth,
- I. Curjuric,
- J. Dratva,
- A. Di Pasquale,
- R. Ducret-Stich,
- E. Fischer,
- L. Grize,
- A. Hensel,
- D. Keidel,
- A. Kumar,
- M. Imboden,
- N. Maire,
- A. Mehta,
- H. Phuleria,
- M. Ragettli,
- M. Ritter,
- E. Schaffner,
- G.A. Thun,
- A. Ineichen,
- T. Schikowski,
- M. Tarantino,
- M. Tsai,
- P. Burney,
- D. Jarvis,
- S. Kapur,
- R. Newson,
- J. Potts,
- D. Jarvis,
- M. Tumilty,
- N. Innes,
- D. Jarvis,
- M. Tumilty,
- A. Wilson
Affiliations
- Christer Janson
- Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
- Simone Accordini
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
- Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
- Isa Cerveri
- Division of Respiratory Diseases, IRCCS, Policlinico San Matteo Foundation, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Sebastien Chanoine
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France
- Angelo Corsico
- Division of Respiratory Diseases, IRCCS, Policlinico San Matteo Foundation, Dept of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
- Diogenes Seraphim Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Judith Garcia-Aymerich
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- David Gislason
- Dept of Respiratory Medicine and Sleep, Landspitali, Reykjavik, Iceland
- Rune Nielsen
- Dept of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
- Ane Johannessen
- Centre for International Health, Dept of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
- Andrei Malinovschi
- Clinical Physiology, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
- Jesús Martinez-Moratalla Rovira
- Servicio de Neumología, Complejo Hospitalario Universitario, Albacete, Spain
- Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Dept of Diagnostics and Public Health, University of Verona, Verona, Italy
- Isabelle Pin
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France
- Jennifer Quint
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
- Valerie Siroux
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Inserm, Université Grenoble Alpes, Grenoble, France
- Enrique Almar
- Facultad de Medicina Albacete, University of Castilla-La Mancha, Ciudad Real, Spain
- Valeria Bellisario
- Dept of Public Health and Paediatrics, University of Turin, Turin, Italy
- Karl A. Franklin
- Dept of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
- José A. Gullón
- Dept of Pneumology, Universitary Hospital San Agustín, Avilés, Spain
- Mathias Holm
- Dept of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
- Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC) Munich, Member German Center for Lung Research (DZL), Munich, Germany
- Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC) Munich, Member German Center for Lung Research (DZL), Munich, Germany
- José Luis Sánchez-Ramos
- Dept of Nursing, University of Huelva, Huelva, Spain
- Joost J. Weyler
- StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
- Deborah Jarvis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
- The members of the ECRHS I scientific team.
- P. Burney
- S. Chinn
- C. Luczynska
- D. Jarvis
- E. Lai
- P. Burney
- S. Chinn
- C. Luczynska
- D. Jarvis
- P. Vermeire
- H. Kesteloot
- J. Bousquet
- D. Nowak
- J. Prichard
- R. de Marco
- B. Rijcken
- J.M. Anto
- J. Sunyer
- J. Alves
- G. Boman
- N. Nielsen
- P. Paoletti
- M. Abramson
- J. Kutin
- P. Vermeire
- F. van Bastelaer
- R. Jõgi
- A. Taytard
- I. Pin
- C. Pison
- F. Neukirch
- R. Liard
- J. Bousquet
- J. Knani
- H-E. Wichmann
- J. Heinrich
- H. Magnussen
- D. Nowak
- T. Gislason
- D. Gislason
- A. Marinoni
- I. Cerveri
- M. Bugiani
- C. Bucca
- C. Romano
- R. de Marco
- L. Cascio
- C. Campello
- J. Droste
- M. Kerkhof
- A. Gulsvik
- E. Omenaas
- J. Martinez-Moratalla
- E. Almar
- A. Mateos
- M. Arévalo
- A. Sánchez
- M. Vizcaya
- X. Aguilar
- A. Teixidó
- J.M. Antó
- M. Kogevinas
- J. Sunyer
- F. Burgos
- J. Castellsagué
- J. Roca
- JB. Soriano
- A. Tobías
- N. Muiñozguren
- J. Ramos González
- A. Capelastegui
- J. Maldonado Pérez
- A. Pereira
- J. Sánchez
- J. Quiros
- I. Huerta
- F. Payo
- N. Lindholm
- P. Plaschke
- G. Boman
- C. Janson
- E. Björnsson
- L. Rosenhall
- E. Norrman
- B. Lundbäck
- U. Ackermann-Liebrich
- N. Küenzli
- A. Perruchoud
- M. Burr
- J. Layzell
- R. Hall
- B. Harrison
- The members of the ECRHS II scientific team.
- P. Burney
- S. Chinn
- C. Luczynska
- D. Jarvis
- J. Knox
- P. Burney
- S. Chinn
- C. Luczynska
- D. Jarvis
- P. Vermeire
- J. Bousquet
- J. Heinrich
- M. Wjst
- R. de Marco
- J.M. Anto
- J. Sunyer
- C. Janson
- U. Ackermann-Liebrich
- N. Kuenzli
- F. Neukirch
- M. Abramson
- E.H. Walters
- J. Raven
- P. Vermeire
- J. Weyler
- M. van Sprundel
- V. Nelen
- R. Jõgi
- A. Soon
- A. Taytard
- C. Raherison
- I. Pin
- J. Ferran-Quentin
- F. Neukirch
- B. Leynaert
- R. Liard
- M. Zureik
- J. Bousquet
- P.J. Bousquet
- J. Heinrich
- M. Wjst
- C. Frye
- I. Meyer
- H. Magnussen
- D. Nowak
- T. Gislason
- E. Bjornsson
- D. Gislason
- K.B. Jörundsdóttir
- A. Marinoni
- S. Villani
- M. Ponzio
- F. Frigerio
- M. Comelli
- M. Grassi
- I. Cerveri
- A. Corsico
- R. Bono
- M. Bugiani
- P. Piccioni
- E. Caria
- A. Carosso
- E. Migliore
- G. Castiglioni
- R. de Marco
- G. Verlato
- E. Zanolin
- S. Accordini
- A. Poli
- V. Lo Cascio
- M. Ferrari
- I. Cazzoletti
- M. Kerkhof
- A. Gulsvik
- E. Omenaas
- C. Svanes
- B. Laerum
- J. Martinez-Moratalla Rovira
- E. Almar
- M. Arévalo
- C. Boix
- G. González
- J.M. Ignacio García
- J. Solera
- J. Damián
- J.M. Antó
- J. Sunyer
- M. Kogevinas
- J.P. Zock
- X. Basagaña
- A. Jaen
- F. Burgos
- C. Acosta
- N. Muñozguren
- J. Ramos
- I. Urrutia
- U. Aguirre
- J. Maldonado
- A. Pereira
- J.L. Sanchez
- F. Payo
- I. Huerta
- A. de la Vega
- L. Palenciano
- J. Azofra
- A. Cañada
- K. Toren
- L. Lillienberg
- A.C. Olin
- B. Balder
- A. Pfeifer-Nilsson
- R. Sundberg
- C. Janson
- G. Boman
- D. Norback
- G. Wieslander
- M. Gunnbjornsdottir
- E. Norrman
- M. Soderberg
- K.A. Franklin
- B. Lundback
- B. Forsberg
- L. Nystrom
- N. Küenzli
- B. Dibbert
- M. Hazenkamp
- M. Brutsche
- U. Ackermann-Liebrich
- M. Burr
- J. Layzell
- D. Jarvis
- R. Hall
- D. Seaton
- D. Jarvis
- B. Harrison
- The members of the ECRHS III scientific team.
- D. Jarvis
- P. Burney
- M. Tumilty
- J. Potts
- D. Jarvis
- P. Burney
- J. Heinrich
- R. de Marco
- J.M. Anto
- C. Janson
- K. Toren
- T. Gislasson
- T. Rochat
- B. Leyneart
- C. Svanes
- J. Weyler
- J.P. Zock
- M. Abramson
- G. Benke
- S. Dharmage
- B. Thompson
- S. Kaushik
- M. Matheson
- J. Weyler
- H. Bentouhami
- V. Nelen
- R. Jõgi
- H. Orru
- C. Raherison
- P.O. Girodet
- I. Pin
- V. Siroux
- J. Ferran
- J.L. Cracowski
- P. Demoly
- A. Bourdin
- I. Vachier
- B. Leynaert
- D. Soussan
- D. Courbon
- C. Neukirch
- L. Alavoine
- X. Duval
- I. Poirier
- J. Heinrich
- E. Becker
- G. Woelke
- O. Manuwald
- H. Magnussen
- D. Nowak
- A-M. Kirsten
- T. Gislason
- B. Benediktsdottir
- D. Gislason
- E.S. Arnardottir
- M. Clausen
- G. Gudmundsson
- L. Gudmundsdottir
- H. Palsdottir
- K. Olafsdottir
- S. Sigmundsdottir
- K. Bara-Jörundsdottir
- I. Cerveri
- A. Corsico
- A. Grosso
- F. Albicini
- E. Gini
- E.M. Di Vincenzo
- V. Ronzoni
- S. Villani
- F. Campanella
- M. Gnesi
- F. Manzoni
- L. Rossi
- O. Ferraro
- M. Bugiani
- R. Bono
- P. Piccioni
- R. Tassinari
- V. Bellisario
- G. Trucco
- R. de Marco
- S. Accordini
- L. Calciano
- L. Cazzoletti
- M. Ferrari
- A.M. Fratta Pasini
- F. Locatelli
- P. Marchetti
- A. Marcon
- E. Montoli
- G. Nguyen
- M. Olivieri
- C. Papadopoulou
- C. Posenato
- G. Pesce
- P. Vallerio
- G. Verlato
- E. Zanolin
- H.M. Boezen
- C. Svanes
- E. Omenaas
- A. Johannessen
- T. Skorge
- F. Gomez Real
- J. Martinez-Moratalla Rovira
- E. Almar
- A. Mateos
- S. García
- A. Núñez
- P. López
- R. Sánchez
- E. Mancebo
- J-M. Antó
- J.P. Zock
- J. Garcia-Aymerich
- M. Kogevinas
- X. Basagaña
- A.E. Carsin
- F. Burgos
- C. Sanjuas
- S. Guerra
- B. Jacquemin
- P. Davdand Galdakao
- N. Muñozguren
- I. Urrutia
- U. Aguirre
- S. Pascual
- J. Antonio Maldonado
- A. Pereira
- J.L. Sánchez
- L. Palacios
- F. Payo
- I. Huerta
- N. Sánchez
- M. Fernández
- B. Robles
- K. Torén
- M. Holm
- J-L. Kim
- A-C. Olin
- A. Dahlman-Höglund
- B. Forsberg
- L. Braback
- L. Modig
- B. Järvholm
- K.A. Bertilsson
- H. Franklin
- C. Wahlgreen
- B. Andersson
- D. Norback
- U. Spetz Nystrom
- G. Wieslander
- G.M. Bodinaa Lund
- K. Nisser
- N.M. Probst-Hensch
- N. Künzli
- D. Stolz
- C. Schindler
- T. Rochat
- J.M. Gaspoz
- E. Zemp Stutz
- M. Adam
- C. Autenrieth
- I. Curjuric
- J. Dratva
- A. Di Pasquale
- R. Ducret-Stich
- E. Fischer
- L. Grize
- A. Hensel
- D. Keidel
- A. Kumar
- M. Imboden
- N. Maire
- A. Mehta
- H. Phuleria
- M. Ragettli
- M. Ritter
- E. Schaffner
- G.A. Thun
- A. Ineichen
- T. Schikowski
- M. Tarantino
- M. Tsai
- P. Burney
- D. Jarvis
- S. Kapur
- R. Newson
- J. Potts
- D. Jarvis
- M. Tumilty
- N. Innes
- D. Jarvis
- M. Tumilty
- A. Wilson
- DOI
- https://doi.org/10.1183/23120541.00073-2018
- Journal volume & issue
-
Vol. 5,
no. 1
Abstract
Asthma often remains uncontrolled, despite the fact that the pharmacological treatment has undergone large changes. We studied changes in the treatment of asthma over a 20-year period and identified factors associated with the regular use of inhaled corticosteroid (ICS) treatment. Changes in the use of medication were determined in 4617 randomly selected subjects, while changes in adults with persistent asthma were analysed in 369 participants. The study compares data from three surveys in 24 centres in 11 countries. The use of ICSs increased from 1.7% to 5.9% in the general population and the regular use of ICSs increased from 19% to 34% among persistent asthmatic subjects. The proportion of asthmatic subjects reporting asthma attacks in the last 12 months decreased, while the proportion that had seen a doctor in the last 12 months remained unchanged (42%). Subjects with asthma who had experienced attacks or had seen a doctor were more likely to use ICSs on a regular basis. Although ICS use has increased, only one-third of subjects with persistent asthma take ICSs on a regular basis. Less than half had seen a doctor during the last year. This indicates that underuse of ICSs and lack of regular healthcare contacts remains a problem in the management of asthma.