What should be assessed before considering stepping up therapy?

Before considering stepping up therapy for conditions such as asthma or COPD, it is essential to assess the patient's adherence to their current treatment regimen and their inhaler technique. Inhaled medications are a cornerstone of therapy for these respiratory conditions, and proper use is critical for achieving the desired therapeutic effect.

If a patient is not using their inhaler correctly or is not taking their medications as prescribed, they may experience inadequate control of their symptoms, leading to the impression that higher doses or additional therapies are needed. By assessing adherence, the healthcare provider can identify potential barriers to effective treatment, such as misunderstanding of the medication schedule or financial issues, and adjust the management plan accordingly. Additionally, evaluating inhaler technique ensures that the patient is getting the full benefit of the medication, reducing symptoms and the risk of exacerbations.

While factors such as the patient's insurance status, family medical history, or nutrition may be relevant to the overall management of a patient, they do not directly impact the immediate effectiveness of prescribed therapies in the same way that adherence and technique do. Thus, the most pertinent factors to evaluate before escalating therapy are related to how well the current treatment is being utilized.