Asthma Review

 

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Asthma Review

Please answer all questions to help us understand how we can help you and your asthma.

Please note: once received it can take up to 1 month to review your answers, if you are in need of urgent advice/treatment call us or call 111 or 999 in life threatening situation.

On reviewing your submission, a nurse may want to speak to you, so we will arrange a telephone call for you to discuss your asthma management in more details, so please ensure we have the correct contact number for you.

Personal Details
 
Please double check you've entered the correct email address
UK mobile only
 
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Asthma Questions

The following test can help people with asthma assess their asthma control. 

  • Please chose the appropriate score for each question.
  • There are five questions in total.
  • Please answer the questions as honestly as possible.

Question 1

Question 2

Question 3

Question 4

Question 5

Score: - WELL DONE

Your asthma appears to have been under control over the past 4 weeks.

  • If you are experiencing any problems with your asthma, you should book an appointment with a nurse or GP as soon as possible.

Score ON TARGET

Your asthma appears to have been reasonably will controlled during the past 4 weeks.

  • If you are experiencing any problems with your asthma, you should book an appointment with a nurse or GP s soon as possible.

Score OFF TARGET

Your asthma may NOT HAVE BEEN CONTROLLED during the past 4 weeks. Your doctor or nurse can recommend an asthma action plan to help improve your asthma control.

  • If you have symptoms, please book an appointment with a nurse or doctor as soon as possible, or alternative visit a pharmacist for further advice, call 111, or 999 in life threatening situation.
 
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Exacerbation

Exacerbation means your asthma has become worse and you required antibiotic and / or oral steroid treatment

 
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Asthma Action Plan

Everyone with asthma can benefit from using an asthma action plan.

It tells you, and anyone with you:

  • which medicines you take every day to prevent symptoms and cut your risk of an asthma attack
  • what to do if your asthma symptoms are getting worse  
  • the emergency action to take if you’re having an asthma attack and when to call 999.

You fill it in with your GP or asthma nurse, so it’s personal to you and your asthma. Then take it along to all your asthma appointments, including any out of hours appointments or A&E, so your doctor or asthma nurse can help you keep it up to date.

“Experts recommend asthma action plans to look after your asthma well and cut your risk of an asthma attack,” says Dr Andy Whittamore, Asthma UK’s in-house GP.

Info taken from ASTHMA UK 15/03/2021

MORE INFORMATION ABOUT AN ASTHMA ACTION PLAN

A nurse will review your submission, and will send you a basic asthma action plan for your attention. If you like a more detailed version, based on your peak flow reading, please let us know your latest/best peak flow reading below and we can include that upon your asthma plan.

Medication
if you are not sure, state the colour of the inhaler, please including how many puffs you take a day, and how often you take these
 
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Inhaler Technique

Info taken from ASTHMA UK 15/03/2021

 

How does good inhaler technique help you manage your asthma?

If you’re using your preventer inhaler as prescribed, and using the right inhaler technique, it can help you:

  • cut your risk of an asthma attack
  • feel less breathless climbing stairs
  • cope better with your usual asthma triggers
  • get a good night’s sleep
  • have less time off work
  • take part in exercise and family activities.

Good inhaler technique can really make a difference to how well you manage your asthma. It could also mean you’ll be able to manage your asthma symptoms without needing to be prescribed higher doses. 

GUIDES FOR USING YOUR INHALERS

VIDEO GUIDES FOR USING YOUR INHALERS

 

If you are not sure if you are using it correctly, you can book an appointment to come in and see a practice nurse or a GP, or visit any Pharmacist and they too can help with your technique.

Asthma Attack
 
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Smoking Status
Please select one
Observations
if known
if known

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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