1. The successful adherence to inhaled medications by the parents and the child will mainly depend upon the time spent by the physician during the first visit to explain, convince and support them.

2. The concept of Blue (reliever) and Brown (controller) and their differing yet contributory effects on Asthma control needs to be explained clearly during the first visit itself. Otherwise, as the Blue inhalers are less expensive and the Brown inhalers relatively 4 times the cost, and the effect of the Blue inhalations being evident within fifteen minutes in contrast to the brown inhalers which take weeks to perceive their effects, most often the Blue inhalers replace the Brown ones very shortly after initiation.

3. At each followup visit, the physician should always check, reinforce the technique of inhalation as well as encourage the child if he is compliant. Parents should carry the inhalers and the spacers and facemasks with them during followup visits. Serial peakflow recordings help in this regard.

4. Spacers should be an integral part of inhalation therapy along with metered dose inhalers . Face masks should be used when appropriate.

5. The success story of a child and his family with proper inhalation therapy should be shared with other parents during parent education sessions so as to motivate them to continue enthusiastically.

6. The time of consultation for children with asthma should be separate from the usual consultation hours in order to provide sufficient time to the child and his family.

7. Defaulting parents are receptive when they bring their child with acute exacerbations. This situation should be utilized optimally to bring home the concept that regular controller medications do prevent /bring down acute exacerbations.

8. To write the date of purchase on the inhaler will be useful to assess compliance to some extent.