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Medium adherence as assessed by the physician was significantly associated with higher risk of discordance, both for overestimation and underestimation of adherence (OR=14.50 (6.04 to 34.81) OR=2.21 (1.07 to 4.58)), while having a written action plan decreased the likelihood of discordance (OR=0.25 (0.12 to 0.52) OR=0.41 (0.22 to 0.78)) (R 2=44%). An uncontrolled asthma (OR=2.33 (1.25 to 4.34)), uncontrolled upper airway disease (OR=2.86 (1.35 to 6.04)) and prescription of short-acting beta-agonists alone (OR=3.05 (1.15 to 8.08)) were associated with overestimation. Discordance occurred in 56% of cases: in 28% physicians overestimated adherence and in 27% underestimated. Correlation between patient and physician VAS scores was moderate (r s=0.580 p<0.001). Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm 53% VAS>80) and by physicians (84 (68–95) mm 53% VAS>80). 36 Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto Faculty of Medicine, Porto, Portugalĭr Joao A Fonseca.35 Bloco operatório, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.34 Serviço de Imunoalergologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.33 Serviço de Imunoalergologia, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal.32 Imunoalergologia, Centro de Imunoalergologia do Algarve, Portimão, Portugal.31 NOVA Medical School, Lisbon, Portugal.

30 Pneumology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

29 Serviço de Pediatria, Centro Hospitalar Tondela Viseu EPE, Viseu, Portugal.

28 Serviço de Pneumologia, Hospital Garcia de Orta EPE, Almada, Portugal.

27 Laboratory of Clinical Pharmacology and Therapeutics, University of Lisbon Medical Faculty, Lisboa, Portugal.

26 Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.

25 Serviço de Pediatria, Centro Hospitalar do Médio Ave EPE, Santo Tirso, Portugal.

24 Serviço de Pneumologia, Centro Hospitalar Barreiro Montijo EPE, Barreiro, Portugal.

23 Imunoalergologia, Grupo HPA Saúde, Portimao, Portugal.

22 Serviço de Pneumologia, Centro Hospitalar de Trás-os-montes e Alto Douro EPE, Vila Real, Portugal.

21 Unidade de Imunoalergologia, Hospital do Divino Espirito Santo de Ponta Delgada EPE, Ponta Delgada, Portugal.

20 Cova da Beira University Hospital Centre, Department of Allergy & Clinical Immunology, Covilhã, Portugal.

19 University of Beira Interior, CICS - Health Sciences Research Centre NuESA – Environment & Health Study Group, Faculty of Health Sciences, Covilha, Portugal.

18 Serviço de Imunoalergologia, Hospital São João, Porto, Portugal.

17 Serviço de Imunoalergologia, Centro Hospitalar do Algarve EPE, Faro, Portugal.

16 Serviço de Imunoalergologia, Hospital Amato Lusitano, Castelo Branco, Portugal.

15 Serviço de Pediatria, Hospital da Senhora da Oliveira, Guimaraes, Portugal.

14 Serviço de Pneumologia, Hospital Beatriz Ângelo, Loures, Portugal.

13 Pathophysiology, CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisboa, Portugal.

12 Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central EPE, Lisboa, Portugal.

11 Serviço de Imunoalergologia, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.

10 Serviço de Pneumologia B, Hospital Geral, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.9 Serviço de Pediatria, Unidade Local de Saúde de Matosinhos EPE, Senhora da Hora, Portugal.8 Serviço de Imunoalergologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte EPE, Lisboa, Portugal.7 Imunologia Básica e Clínica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.6 Unidade de Imunoalergologia, Unidade Local de Saúde de Matosinhos EPE, Senhora da Hora, Portugal.5 Serviço de Pneumologia A, Hospital Universitário de Coimbra, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.4 MEDIDA – Medicina, Educação, Investigação, Desenvolvimento e Avaliação, Porto, Portugal.3 Serviço de Pediatria, Centro Materno Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal.2 Immunoalergology, CUF-Porto Hospital and Institute, Porto, Portugal.1 Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal.