A nurse is planning care for a client with poorly controlled asthma who frequently misses doses of their inhaled corticosteroid. The client reports forgetting to take the medication due to a busy schedule. Which strategy should the nurse use in the client's care plan to improve medication adherence?

Choice A reason: Switching to oral corticosteroids is not indicated for long-term asthma maintenance due to the high risk of systemic adverse effects, including adrenal suppression, osteoporosis, and hyperglycemia. Inhaled corticosteroids remain the gold standard because they deliver localized anti-inflammatory action directly to the bronchial mucosa with minimal systemic absorption and fewer side effects. Choice B reason: Scheduled follow-up visits establish a therapeutic alliance and allow the nurse to provide positive reinforcement and longitudinal support. Regular monitoring enables the clinician to identify specific barriers to adherence, such as a busy lifestyle, and implement behavioral cues or digital reminders to integrate medication administration into the client's daily routine effectively. Choice C reason: Instructing a client to use an inhaled corticosteroid only when symptoms occur is a clinical error. Inhaled corticosteroids are maintenance "controller" medications designed for daily use to reduce chronic airway inflammation. They are not "rescue" medications; using them inconsistently fails to prevent the remodeling and hyperresponsiveness characteristic of poorly controlled asthma. Choice D reason: While providing written instructions on inhaler technique is an essential component of asthma education, it does not directly address the primary problem of forgetfulness or poor adherence. The client's issue is a behavioral one related to scheduling, not a lack of psychomotor skill or misunderstanding of how the device functions during use.