Asthma Review

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Asthma Review

Asthma Review 

What is an Asthma Review?

  • It is intended to measure and assess well you are managing your condition.

What does it involve?

  • There are 5 questions relating to different situations.
  • Once you have scored each question the values are added together to give an indication of how you are managing.
  • On reviewing your submission, a nurse may want to speak to you or arrange an appointment, please ensure we have the correct contact number for you so we can contact you as required.

Once received it can take up to 1 month to review your answers

  • If you are in need of urgent advice/treatment call the surgery or call 111
  • Call 999 in life threatening situations
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All questions marked with a * are mandatory

Personal Details
Please double check you've entered the correct email address
May be used to identify you
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Asthma Questions

During the past 4 weeks

How often did your asthma prevent you from getting as much done at work, school or home?: *
How often have you had wheeze or shortness of breath?: *
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?: *
How often have you used your rescue inhaler (such as Salbutamol)?: *
How would you rate your asthma control during the past 4 weeks?: *
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Asthma Question Results

Well Done

, your score is 

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

If you are experiencing any problems with your asthma

  • Book an appointment with a nurse or GP as soon as possible

On Target

, your score is 

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

If you are experiencing any problems with your asthma

  • Book an appointment with a nurse or GP as soon as possible

Off Target

, you have a score of 

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 call 111
  • Alternative visit a pharmacist for further advice
  • Call 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
Are you under the care of the chest clinic/asthma team at the hospital?: *
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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.

Information taken from the Asthma UK Website

“Experts recommend asthma action plans to look after your asthma well and cut your risk of an asthma attack”

Dr Andy Whittamore, Asthma UK's in-house GP

Do you have an asthma plan?:
Would you like an asthma plan?: *

How to get an asthma action plan

If you’re not using an asthma action plan yet, it’s easy to get started with support from Asthma UK

 How to get an asthma action plan

Do you have a peak flow meter at home?:
Would you like us to prescribe a peak flow meter for you?:
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Medication
Are you taking medication (inhaler and / or tablet) for your asthma?: *
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
Do you use a spacer with your inhalers?:
Is the spacer that you are using older than 12 months?:
Would you like a new spacer, as this should be renewed on a yearly basis?:
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Inhaler Technique

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.

Information taken from the Asthma UK Website

Inhaler
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Asthma Attack

Having an Asthma Attack

What to do when you are having an Asthma Attack

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Lifestyle

Your Height

What unit of measurement are you using?: *
Conversion from Feet & Inches to Centimetres

Your Weight

What unit of measurement are you using?: *
Conversion from Stones & Pounds to Kilograms
Your Smoking Status
Please choose from one of the following options: *
Stop Smoking

Steps to quit smoking

Stopping smoking lets you breathe more easily. People breathe more easily and cough less when they give up smoking because their lung capacity improves by up to 10% within 9 months.

  NHS Stop Smoking Services

  Take steps now to stop smoking

  10 self-help tips to stop smoking

Are you interested in further advice and support on how to quit?: *
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Additional Questions
Since your last review, have you needed to see a doctor as an emergency or attend the A&E department of a hospital as a result of your asthma?: *
Since your last review, have you needed a course of steroid tablets to get your asthma under control?: *
Did you have a flu vaccination last flu season?: *
Please select the types of inhalers that you use: *
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