Paul, a 23-year-old apprentice glazier, complains of nocturnal shortness of breath, cough and intermittent wheeze over the last 6 months.

You learn during this time Paul had 3 admissions with asthma to a local hospital near where he used to live. He has not required ICU management. He thinks he has asthma since he was very young. He has recently moved into your clinic’s area and wishes to transfer to your care.

His current medication is beclomethasone dipropionate 250 (Becloforte) MDI 2 puffs b.d. and salbutamol (Ventolin, Respolin) MDI 2 puffs 2-4 hourly.