Asthma Control Score
During the past 4 weeks, how often did your asthma prevent you from getting as much done at work, school or home?
During the past 4 weeks, how often have you had shortness of breath?
During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, chest tightness, shortness of breath) wake you up at night or earlier than usual in the morning?
During the past 4 weeks, how often have you used your reliever inhaler (usually blue)?
How would you rate your asthma control during the past 4 weeks?
Asthma Management Plan
The questions below will help us produce an asthma management plan for you as recommended by Asthma UK.
Do you know of any triggers for your asthma?
What are your triggers?
Avoiding triggers and taking your preventer can reduce the number of exacerbations you may have.
Peak Flow Readings
Peak flow readings can help let you know how well your asthma is controlled and how severe an exacerbation is.
watch this video which explains how to measure your peak flow.
Do you have a peak flow meter?
Please enter your best peak flow reading:
You can buy a peak flow meter from a pharmacy or we can offer one on prescription.
Do you need a prescription for a peak flow meter?
Preventer inhalers if taken regularly can keep your asthma under control.
What preventer inhaler are you prescribed? (enter none if not on a regular preventer)
How many puffs do you take in the morning?
How many puffs do you take at night?
If you are not taking your preventer inhaler as prescribed, please can you tell us why?
Reliever inhalers are taken when you have symptoms to provide fast relief.
How many puffs of your reliever inhaler do you take when you have symptoms?
If Your Asthma Gets Worse
If you feel your asthma is getting worse, you should contact the surgery to speak to our asthma nurse by phone as soon as possible.
Signs that your asthma may be getting worse are:
Increased wheeze or shortness of breath
Taking your reliever inhaler more than normal
Waking at night due to asthma symptoms
Finding your daily activities are limited by your asthma
Using your reliever inhaler more than 3 times a week
If your peak flow readings are between 50-70% of your best
You may be having an asthma attack if you are using your reliever inhaler more than every 4 hours or needing more than 10 puffs.
You should seek medical advice either by contacting the surgery by phone/111 or 999 if you feel you need immediate help.
Your asthma plan is important as it provides clear advice about what to do in these situations and when to seek medical advice.
What would you do if you felt your asthma was getting worse?
You should have a flu jab every year. It is important as you may be at higher risk of becoming ill and requiring hospital treatment as an asthmatic.
Would you like to decline a flu jab?
Can you tell us why?
Inhaler technique is very important. If not used properly they will not be effective at treating your asthma and preventing asthma attacks.
Please follow visit
www.asthma.org.uk/advice/inhaler-videos to watch a demonstration.
If you would like further help with your inhaler technique or just aren't sure please take your inhalers to the local pharmacist who can demonstrate how you can use your inhalers more effectively and let us know if they feel you need a different type.
What Happens Next
We will use your answers to complete an asthma management plan that we will forward on.
You may already have one but it is recommended that it is reviewed every year.
An example form can be found at
Thank you for taking the time to answer these questions.
Our nursing team will review your information and update your records and reply with any relevant advice.