In some patients the history is less typical (low probability of asthma), and airflow obstruction may be difficult to demonstrate unless the patient is seen when symptomatic or after exposure to a trigger.

In these patients:

1. Record the patient as having ‘suspected asthma’.
2. Start a treatment trial. Typically this will be six weeks of inhaled corticosteroids
3. Assess the baseline status using a validated questionnaire (e.g. Asthma Control Questionnaire or Asthma Control Test) and/or spirometry
4. Arrange a follow-up appointment in 6–8 weeks in order to assess response to treatment
5. At the follow-up appointment, symptomatic response may be assessed with a validated questionnaire and degree of bronchoconstriction may be monitored with Spirometry