Good management principles direct that after any program begins, feedback and evaluation follow.  Now, we are 90 days into the ban on CFC-propelled albuterol inhalers.  The Asthma and Allergy Association of America ("AAFA") is getting feedback.  While we hope that millions of users that we have not heard from have made the transition satisfactorily, AAFA has heard from many patients who are not happy with the newer inhalers.  Perhaps they are not used to the feel of the new medications.  Perhaps they need more practice.  Maybe they should use spacers, clean or prime in a different manner. 

Are any of these valid assumptions?  How many people are actually not served by the newer medication, and are there practical options for them?  Now that people are actually using the HFA inhalers, are there people for whom these devices present a risk, or is the issue one of education on proper use?  Who is monitoring patients to assure that the new products are performing as expected?

The government and industry should not leave these important questions for patients with asthma and other lung diseases to answer in isolation or for organizations like AAFA to face based on patient complaints.  We did what we could to alert patients about the need to switch to ozone safer inhalers.  We posted advice on how to use the newer inhalers.  Now, we need nothing short of organized surveillance to assess the impact of this transition on patients. We have been impressed with the EPA's recent moves to clean up the air.  Now, we call on federal health officials to evaluate the transition where it counts - on real asthma patients.