ACT test for asthma
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This one... ACT test
For above 12 year olds would be helpful1: In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
All of the time
Most of the time
Some of the time
A little of the time
None of the time
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2: During the past 4 weeks, how often have you had shortness of breath?
More than once a day
Once a day
3 to 6 times a week
Once or twice a week
Not at all
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3: During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning?
4 or more nights a week
2 to 3 nights a week
Once a week
Once or twice
Not at all
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4: During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as Salbutamol)?
3 or more times per day
1 or 2 times per day
2 or 3 times per week
Once or twice
Not at all
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5: How would you rate your asthma control during the past 4 weeks?
Not Controlled at All
Poorly Controlled
Somewhat Controlled
Well Controlled
Completely Controlled
Has to be cultural/ geographical/ ethnically appropriate