Assessing severe asthma.

It is now 13 years since we and others described results from protocolised assessment of patients seen in specialist centres because of lack of control of their asthma with high dose inhaled corticosteroids (ICS) plus additional controller (usually long acting beta agonists; LABA), or those requiring long term oral steroids to control the disease [2, 3]. In that time data have confirmed the usefulness of a systematic approach, and that it improves outcomes [4]. What does it add, other than transferring “heart sink” patients to others? There are several benefits to this approach, as follows.