Myth 1: Long-term management is not necessary Bronchial asthma is one of the most common chronic respiratory diseases with a duration of more than 10 years or lifelong, and like hypertension and diabetes mellitus, short-term pharmacologic interventions alone cannot improve the prognosis of patients. There is ample evidence that long-term management of asthma (including education, monitoring, and follow-up) can significantly reduce clinical symptoms, decrease acute exacerbations, emergency room visits, and hospitalizations, improve lung function, and enhance quality of life. Currently, about 80% of clinicians do not recognize the need for long-term management of asthma patients, and are in the position of “waiting for the patient to come to the door, and then leaving after writing the prescription”. Countermeasure 1: Enhance long-term awareness The education of doctors should be strengthened to raise the awareness of the “superior doctor treats the disease before it occurs” and advocate the establishment of a long-term partnership with patients Misunderstanding 2: Incorrect positioning of the treatment goal Patients and their families want to “cure” asthma, and look for medicines that can cure asthma everywhere. The first is that the patient’s body will be able to get rid of the asthma. This kind of asthma patients are easily confused by various so-called “ancestral single formula” “prescription” under the banner of “cure” asthma, and repeatedly fooled, cheated. Some doctors still believe that asthma “no rule of law”. Holding a negative attitude, patients with the onset of antibiotics, aminophylline and dexamethasone intravenous drip, not onset of any drug is not given to asthma patients. Such an attitude will invariably push asthma patients to “traveling doctors”. Countermeasure 2: Strengthen positive education, including overcoming the fear that there is no cure for asthma, strengthening the management of media advertisements, and promoting the development of relevant legal provisions. Since there is no cure for asthma in the world, any drug that claims to be a “cure” for asthma is a fraud! Clinicians and asthma patients and their families should strengthen the publicity of GINA and China’s Guidelines for the Prevention and Control of Bronchial Asthma. These two documents clearly state in the definition of asthma that bronchial asthma is a preventable and curable disease! Although asthma cannot be cured, the results of clinical studies such as GOAL have shown that 80% of asthma can be controlled (complete/good control) with the correct application of existing medications. Myth 3: Inadequate use of anti-inflammatory drugs Some doctors still do not consider inhaled corticosteroid (ICS) as the basis and first line of asthma treatment, and are satisfied with the use of β2 agonists (e.g., albuterol aerosol), anticholinergics (e.g., ipratropium bromide aerosol), and aminophylline to provide temporary relief of wheezing symptoms. Inadequate anti-inflammatory therapy is mainly characterized by insufficient ICS doses and short ICS courses. Moreover, there are many people who use ICS as a drug to relieve asthma symptoms, expecting immediate relief of asthma symptoms, and because the intended purpose is not achieved, they come to the wrong conclusion that “inhaled hormones are not as effective as β2 agonists”. Many asthma patients and their families are reluctant to use ICS (especially young female patients) because of the fear of side effects of hormones. Countermeasure 3: Help patients to establish correct concepts Doctors should help patients to understand the importance of airway inflammation in the development of asthma; help patients to recognize the necessity of using ICS; help patients to understand the characteristics of relieving drugs and controlling drugs and the different methods of use; help patients to overcome the fear of ICS; ICS is not the same as systemic hormones. ICS combined with a long-acting beta agonist (LABA) is the preferred treatment option for moderate-to-severe persistent asthma. Moreover, fixed-dose maintenance therapy, escalation and de-escalation regimens of controlled medications can achieve the combined goal of adequate anti-inflammatory and effective asthma control. Myth 4: Lack of attention to patient adherence As a chronic disease, bronchial asthma is mostly self-administered throughout the course of the disease, and therefore patient adherence is the key to the efficacy of bronchial asthma and all other chronic diseases. Possible reasons for poor adherence include: (1) pharmacologic factors, such as difficulty in using inhaler devices, complexity of treatment regimen, adverse effects of medications, cost of medications, and distance of patients from hospitals or pharmacies; (2) non-pharmacologic factors, such as misunderstanding or lack of instruction, fear of adverse effects, dissatisfaction with healthcare personnel, failure to discuss concerns, incorrect prognosis, poor supervision and training, or follow-up, low confidence in disease treatment, and underestimation of severity of the disease. low confidence in disease treatment, underestimation of severity, cultural differences, neglect or complacency, poor perception of health status, and religious beliefs. Countermeasure 4: Maintain adequate doctor-patient communication Ways to improve patient adherence: (1) repeated and adequate education; (2) active treatment, and obtaining obvious results after the initial diagnosis; (3) timely understanding of the patient’s true thoughts and concerns, and targeted persuasion; (4) the role of other standardized treatment of successful asthma patients. Doctors should also think about the following questions: (1) What are the asthma treatment goals I set for my patients? (2) Has my patient been seen or hospitalized for an asthma attack? (3) Is my patient using inhaled hormones as prescribed? If not, why not? (4) Do I have an action plan for my patient? (5) Do I provide health education to my patients? In the treatment of bronchial asthma, many doctors and patients use antibiotics habitually or routinely. The main reasons for this are: (1) Mistaking the upper respiratory tract viral infection that triggers and exacerbates an attack of bronchial asthma for a bacterial infection; (2) Mistaking yellow sputum caused by eosinophilia for a purulent bacterial infection; (3) Mistaking the abnormalities of the chest X-ray during an acute attack of bronchial asthma for a “lung infection”; (4) Attempting to use antibiotics to prevent bronchial asthma; and (5) Trying to use antibiotics to prevent bronchial asthma from developing. (4) Trying to prevent asthma attacks with antibiotics. In fact, there are few indications for the use of antibiotics in asthma. They are limited to asthma caused or exacerbated by paranasal sinusitis and severe asthma attacks. For patients with hormone-dependent asthma, it is inconclusive whether the trial of some macrolides can reduce the dose of hormones. Countermeasure 5: master the indications Improve the understanding of the pathogenesis of asthma, strictly grasp the indications for the application of antibiotics. Misconception six: did not pay attention to the environmental asthma factor The occurrence and attack of asthma and the external environment asthma factor has a close relationship, so actively identify and specific patients with asthma attacks related to allergens or other asthma factor, for the prevention and treatment of this disease is of great significance. Some patients with asthma who have identified asthma-causing factors can be cured without medication if they can effectively avoid re-exposure. There are many types of asthma-causing factors in the external environment, but the main allergens are dust mites, pollen and molds, and there are regional differences. Exercise, drugs, food, cold air and upper respiratory viral infections are also common asthma-causing factors. Other asthma-causing factors of recent concern include cockroaches, rat urine, silk, and occupationally related methylbenzene diisocyanate. Countermeasure 6: Identification of allergy history and allergens (1) Detailed medical history, including asthma attack triggers, living and working environments, the relationship between asthma attacks and environmental changes, etc., if necessary, do on-site investigation. (2) Laboratory tests, such as allergen skin test, bronchial provocation test, and in vitro tests such as serum total IgE and antigen-specific IgE antibody measurement. (3) In cases where treatment is “ineffective” according to the GINA classification scheme, do not blindly “escalate treatment”, but first check the environmental control. Misuse and misinterpretation of allergen skin test Allergen skin test is a simple and specific clinical test for detecting allergens, but there are a lot of misconceptions in the selection of patients for testing and in the judgment of its results. （However, there are many misconceptions in the selection of patients to be tested and in the judgment of their results. (1) It is believed that “allergens cannot be detected when there is no onset of disease”, and asthma patients are often asked to go to a higher level hospital to do allergen skin tests when they have an onset of disease. (2) that “the application of inhaled hormones have a great impact on the results of the skin test”. (3) Thinking that “food allergen skin test results are reliable”. In fact, most of the medications used by patients during the onset of asthma (including aminophylline, beta agonists, anti-allergic drugs and systemic application of high doses of hormones, etc.) can affect the results of the skin test, resulting in a false-negative result, so it is required to discontinue the use of these medications for at least 3 days. Allergen skin tests should be performed when the asthma is in remission. Small and medium doses of inhaled hormones have no significant effect on allergen skin test results. Food allergen skin tests are less reliable and have a higher rate of false positives than inhaled allergens. Misconception 8: Confusing pulmonary function tests As an objective clinical test, pulmonary function tests play an important role in the diagnosis and differential diagnosis of asthma. However, incorrectly selecting and interpreting the results of pulmonary function tests can not only lead to incorrect conclusions, but can also put the patient’s health and life at risk. Examples include: (1) performing a bronchodilator test on an asthmatic patient with normal lung function; (2) performing a bronchial provocation test on an asthmatic patient with abnormal lung function. The bronchodilator test is performed to find out whether the airflow obstruction in asthma patients is reversible, and only patients with previously subnormal lung function should undergo this test. The bronchial provocation test is designed to determine whether airway hyperresponsiveness exists in patients with asthma. The test looks at the concentration or cumulative dose of the provocative agent required to reduce lung function by 20%, with the risk of bronchospasm or exacerbation of symptoms in the asthmatic patient. Therefore, subjects with normal lung function should be selected, while subjects with abnormal lung function or audible rales should not undergo bronchial provocation. Conclusion: The hallmarks of successful management of bronchial asthma are: (1) achievement and maintenance of symptom control; (2) maintenance of normal activity levels, including exercise capacity; (3) maintenance of lung function as close to normal as possible; (4) prevention of acute asthma exacerbations; (5) prevention of adverse reactions to asthma medications; and (6) avoidance of asthma-related death. Only by overcoming the various misconceptions in asthma management mentioned above, seriously promoting GINA and China’s bronchial asthma prevention and treatment guidelines, and implementing standardized diagnosis and treatment, can the majority of patients with asthma be controlled and work and study like normal people.