Whether a patient has mild to moderate or severe asthma, there are specific actions that need to be taken to optimize control and outcomes. Effective communication between provider and patient is imperative. An evaluation for severe asthma involves confirming the diagnosis of asthma and then ruling out (and managing) possible factors that may be contributing to poor control – such as comorbid/coexisting conditions, poor adherence with recommended management strategies, and exposure to identified triggers. This is particularly important for patients with difficult-to-treat asthma, before a diagnosis of severe asthma should be considered.