One touch Ultra 100 Count


The following will help people with asthma who are 12yrs and above assess their asthma control
You study the following chart very well and circle the correct score for each question they are five in number.
You do this by adding up the total number for each of your response. You can take this to your doctor or pharmacist for review..
STEP 1: Circle your score for each question and write the number in the box. Pls be honest while answering this question.
During the past 4weeks how often did your asthma prevent you from getting as much work, school or home.
Question 1
All of the time 1
Most of the time 2
Some of the time 3
A little of the time 4
Non of the time 5
During the last 4weeks, how do you had shortness of breath
Question 2
More than once a day 1
Once a day 2
3 to 6 times a day 3
Once or twice a day 4
Not at all 5
During the past 4 weeks how often did your symptoms (wheezing,coughing,shortness of breath, chest tightness or pain) wake up at the night or either than usual in the morning.
Question 3
4 or more time a week 1
2 to 3 nights a week 2
Once a week 3
Once or twice in 4 weeks 4
Not at all 5
During the past 4weeks, how often have use inhaler or nebullizer medication (salbutamol)
Question 4
3 or more times a day 1
1 or 2 times a day 2
2 or 3 times a week 3
Once a week or less 4
Not at all 5
How would you rate your asthma control during the past 4 weeks
Question 5
Not controlld 1
Poorly controlled 2
Somewhat controlled 3
Well controlled 4
Completely controlled
STEP 2 Add up your score to get your total.
STEP3 below you can find out what your score means.
SCORE:25 Congratulations!
You have total control of your asthma.You have no symptoms and no asthma limitations. If you notice any change see your doctor or pharmacist.
Score: 20 to 40- Your on target
Your asthma may be WELL CONTROLLED but not totally controlled your doctor or pharmacist may be able to help you aim for total control.
Score:less than 20- Your off target
Your asthma may not be controlled. Your doctor or pharmacist can recommend an asthma action plan to help you improve your asthma control.

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