One reason for the increased morbidity and mortality of asthma is that some individuals do not take their medications as prescribed. Inhaled steroids are particularly prone to under-use: they are expensive, inconvenient, have an unpleasant taste, and do not provide immediate relief of symptoms. MDI Chronologs were used to electronically record adherence to steroids and found that low socioeconomic status and poor patient-clinician communication was associated with poor adherence. The investigators propose a trial of electronic monitoring of inhaled steroid use in a low socioeconomic group to improve adherence by promoting patient-clinician communication. The hypothesis is that asthma adherence and control will be improved when the clinician and patient have accurate knowledge of beta-agonist consumption, inhaled steroid use, adequacy of inhaler technique, and can discuss this information.
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