Asthma Review

Asthma Technique

We would ideally like to see how you use your inhaler, if you are able to record a very short video using your mobile phone on how you use your inhaler and upload it here this can be reviewed by our Asthma Nurse.

You are able to complete this form on your mobile device and upload the file directly from your phone, or you can transfer a video to your computer and upload that way.

This is not essential, however it does assist our Asthma Nurse with your Asthma review.

File size must be smaller than 64mb.

Asthma.org.uk has a number of useful videos to allow you to see how to use the various inhalers that are currently available.

Please click this link to view the full catalouge --> Inhaler Instructional Videos

The nurse at the surgery will also be able to provide you with help and advice if you need it when you attend for your annual Asthma Review.

Asthma Control Test

Question 1

During the last 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home?

Question 2

During the last 4 weeks, how often have you had shortness of breath?

Question 3

During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?

Question 4

During the last 4 weeks, how often have you used your rescue inhaler or nebuliser medication (such as Salbutamol)?

Question 5

How would you rate your asthma control during the last 4 weeks?

Your asthma symptoms may not be as well controlled as they could be

If your score is 15 or less, your asthma may be very poorly controlled. Please contact your healthcare provider right away. There may be more you and your healthcare provider could do to help control your asthma symptoms.

Your asthma symptoms may not be as well controlled as they could be

If your score is between 15 and 20, your asthma may be poorly controlled. Please contact your healthcare provider right away. There may be more you and your healthcare provider could do to help control your asthma symptoms.

Your Asthma Symptoms may be well controlled

Your asthma symptoms appear to be well-controlled. Even so, asthma control can change over time so it´s important to retest yourself regularly. Continue to talk to your healthcare provider about your asthma control.

Thank you for taking the time to complete your Asthma review using our online system. This will now be sent through to our specialist Asthma Nurse who will review your submission and make an assessment for you on the next steps to be taken.

If you fully completed the form, including uploading a video showing your Asthma technique, we may be able to complete your review without further contact and send you your personalised Asthma Plan by email to the address you supplied at the start of this form. If an element of risk has been identified we will contact you to book a review appointment.

Thank you