Asthma is a chronic inflammatory disease, resulting from environmental, genetic and immunological factors. This is a triad specific to the diseases of the 21st century, linked to our environment, which the investigators thought were perfectly characterized and stable and which presents us with new challenges in their management. Our environment has not stopped changing over the past 30 years, so has our way of life and our way of working. The early detection of asthma and the initiation of an adequate therapy are most often carried out by primary care physicians, such as the general practitioner and the general pediatrician. These practitioners find themselves confronted with the medical complexity of asthma which essentially resides in the management of severe forms of asthma, defined by the high therapeutic charge needed to obtain a good control of the disease and, sometimes, in the management of difficult asthma which is an uncontrolled asthma independently of the patients' compliance and of the prescribed therapies. While general practitioners refer many cases of asthma to hospital experts, the investigators wanted to address the issue of difficult asthma, the management of which is less codified.

The main objective of this work is to identify, by a qualitative analysis of medical records, the profiles of patients referred for difficult asthma in a tertiary hospital in order, secondly, to target individual characteristics or subgroups on which therapeutic actions could be implemented, and to provide educational support for doctors.

Inclusion criteria:

• Patients assessed for difficult asthma, from December 2015 to November 2020, at the University Hospital of Montpellier
• Patients aged from 5 to 99 years

Exclusion criteria:

• Patients not affiliated to French Social Security
• Patients not capable of understanding French
• Patients who don't have a diagnosis of difficult asthma

Patients consulting in the Respiratory Diseases outpatients Unit of the Arnaud de Villeneuve Hospital with a diagnosis of difficult-to-treat asthma

NC