1. Adherence to treatment: How can it be improved? Fulvio Braido Allergology & Respiratory Diseases University of Genoa Non-Adherent patient

2. Thorsson & Geller Respiratory Medicine 2005; 99: 836-849 Factor influencing the clinical outcomes of therapy

3. The extent of Non-Adherence WHO report 50% of patients from developed countries with chronic disease do not use their medications as reccommended.

4. 971 ptz – 12 countries ECRHS-1 (1990-1994) – ECRHS-2 (1998-2002) Adherent subjects in ECRHS-1543 Non Adherent subjects in ERCHS-1428 Adherence in ECRH-2 53.4% Nordic 67.6%Mediterranean 76.4.0%Continental 56.1%Extraeuropean areas Net change in adherence -2% +7.5% +15.0% +19.8%

5. Effectiveness =Efficacy X Adherence Clinical effects Side effects Drug Inhaler Treatment Schedule Disease Cognition Patient Behaviour Patient Satisfaction Patient-Physician Relationship

6. J Investig Allergol Clin Immunol 2006 Vol. 16(4):218-223

7. The concerns about the adverse effects of ICS, is not necessarly related to actual experience, but rather to beliefs about the link between regular use and dependency or other perceived side effects.

8. Barriers to Adherence Osterberg L. & Blasche T. N.E.J.M. 4 August 2005

9. Allergic Rhinitis and Asthma ad hoc survey: Clinical and Psychological perspectives F. Braido, I. Baiardini, S. Brandi, A. Porcu, G.W. Canonica Allergy and Respiratory Diseases, DIMI, Genoa University, Genoa, Italy 27.8% of asthmatic patients experience three or less rhinitic symptoms, 41% from 4 to 6 symptoms, 31.2 % more than 6 symptoms. These symptoms deeply interfere with daily life causing sleep problems (87.3%), lack of concentration (78.9%), difficulties in spare time (71.8%) and sport (71.7%). Rhinitis symptoms are responsible of the worsening of asthma, with an increase of dyspnoea (86.3%), cough (73.9%) wheezing (59%). 504 asthmatic patients

10. Improving Asthma Control Study (IMPACT) – post hoc analisys