Guide for Assessing Asthma Control

The following questions are recommended by the RNAO expert panel as a guide for assessing a person’s asthma control:

1. When was the last time you used your reliever inhaler?

• If the person has used the quick relief inhaler within the past week, ask:
  • What was going on that made you need to use your inhaler?
    • Probe: Was it used for exercise or physical activity?
  • How often have you used your quick relief inhaler this week? How about the week before?
    • If using more than 3 times in a week, indicates asthma is not controlled.
       

2.  Has your asthma awakened you at night or in the early morning in the last two weeks?

• If answer is yes, indicates asthma is not controlled.

3. Over the past week, how many days have you experienced asthma symptoms (e.g., cough, trouble breathing, wheeze)?

• If experiencing asthma symptoms more than 3 days in a week, indicates asthma is not controlled.

4. Are you participating in your usual and desired activities, including physical activity?

• If answer is no, explore how asthma is interfering with desired activities.
• Controlled asthma does not interrupt normal activity and should permit physical activity/exercise.

5. Have you needed any urgent medical care for your asthma, such as an unscheduled visit to your provider, a walk-in clinic, or the emergency department?
   • If answer is yes, ask: “Did you need to add or change any of your asthma medications as a result?”

• Often, the use of quick relief or fast-acting beta₂-agonists was changed from use on an as-needed basis to every 4–6 hours and as needed. If this occurred, discuss and review the need to return to use on an as-needed basis and not regularly (e.g., every 4-6 hours).
• A short course of treatment with oral corticosteroids may have been advised, so review whether the treatment was completed and the person’s response to the therapy.

6. Have you missed work or school due to asthma symptoms in the past month?
   • People with controlled asthma do not regularly miss school or work due to asthma.
   • If answer is yes, ask: “How many days of work/school did you miss due to asthma symptoms?”

7. If the person measures peak expiratory flow rates, ask: “Have you noticed any changes in your peak flow rates, either up or down?”