Managing co-morbid allergic rhinitis and asthma

John, aged 15 years old, comes in to see you with his mother for his asthma review. He has been seen regularly for a number of years - however this year his symptoms aren't quite as well-controlled and he seems to have a persistent cold. How should he be assessed?

Asthma review

It is important to consider a structured review of people with asthma, covered in a time-efficient manner to improve patients' quality of life.¹ Consider using the SIMPLE ( stop smoking, inhalers, monitoring, pharmacology, education) approach² to management, or the SIMPLES (plus support) approach3 for difficult asthma. These approaches do not work without clarification of diagnosis and a robust search for other common co-morbidities.