Aims : To describe methods of diagnosing and managing patients with difficult-to-treat asthma; to present methods of assessing and treating patients with severe asthma phenotypes and of monitoring the effects of treatment of severe asthma based on recent updates; to describe methods of assessing COPD that can determine the severity of airflow limitation and the risk of exacerbations; to identify the main goals of COPD assessment that include determinations of the presence and severity of spirometric abnormalities, the magnitude of patient symptoms, the history of exacerbations and future risks, and the presence of comorbidities; to describe the ability of pharmacologic therapy to reduce COPD symptoms and the frequency and severity of exacerbations; and to describe the importance of individualising pharmacologic treatments based on the severity of symptoms, the risk of exacerbations, side-effects and comorbidities, patient preference, and patient ability to use drug delivery devices.