1. In the past 4 weeks, how much of the time did your asthma keep you from being effective at work, school, or at home?
2. During the past 4 weeks, how often have you had shortness of breath?
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?
During the past 4 weeks, how often did you need a pump (such as Ventolin TM) or an inhaler to relieve symptoms?
5. How would you rate your asthma control during the past 4 weeks?
I have had a period of asthma exacerbation requiring an emergency room visit or hospitalisation in the past year.
I have had two or more exacerbations of my asthma requiring treatment with oral corticosteroids in the past year.
Self-evaluation points (explanation):
Answers to the questions (refers to questions 1-5) are scored with points from 1 to 5. Each question has 5 answers, where the first answer is always worth 1 point, the second 2 points and so on. By adding up the points of the answers to the first 5 questions, we arrive at the final score:
0-5 – Not controlled
6-10 – Poorly controlled
11-15 – Somewhat controlled
16-20 – Well-controlled
21-25 – Completely controlled