Sustainable asthma inhalers: who is offered the option to change, who declines and who successfully switches?

In a large UK survey of people with asthma, over half of those on pMDIs had been offered a switch. It was successful in most who attempted it but unsuccessful switches were associated with subjective and objective markers of poor disease control. Some patients decline the switch because they like their pMDI, but some have ongoing concerns about the efficacy and safety of a DPI and is most feasible when integrated into routine reviews for patients with stable disease, alongside ongoing efforts to optimise asthma outcomes.