OBJECTIVES: As chronic asthma in Finland is mainly treated by general practitioners limited data is available on the natural course of the disease. We evaluated the burden of this disease on health care providers and the adherence to accepted treatment protocols in this retrospective study. METHODS: We examined the complete medical records of 50 asthmatic patients obtained from all reported health care providers (2000-05). Providers were registered according to site, location and personnel involved. Contact was specified as a visit, emergency room (ER) visit, phone call, prescription or procedure. The primary cause of contact labeled the event as asthma-(AR) or non-asthma related (NAR) according to clinical specifications. Data on all asthma medication and adverse drug reactions (ADR) were collected from medical records. RESULTS: Asthma was the main reason for contact with health care providers in 961 (52%) of all 1847 events recorded. The number of events ranged from four to 94 per patient with a mean of 23. The type of contact was typically a visit (61%) and provider a general practitioner. ER visits were found in 40% of the patients, 64% of these were AR. Longest period for hospitalization due to asthma was 23 days, but no intensive care treatment was necessary. All patients had short-acting beta-agonists and inhaled corticosteroids (CS) as first-line medication and 32% had no need for additional treatment during the follow-up. Long-acting beta-agonists were used by 55% at some point and 48% of all patients had acute exacerbations treated with oral CS. ADR were observed in 57% of all patients and in 2.5% of all asthma-related events. An alteration to medication was done in 45 % of asthma-related visits. CONCLUSIONS: Reliable data were obtained from this evaluation of patient records regarding disease history. Non-responders can be identified as well as those prone to ADR.