Asthma Review

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Asthma Review

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

Your asthma should be reviewed annually. We are aware that coming to the surgery can be difficult to fit into busy schedules and seems unnecessary when your asthma is under control, as such we have developed an electronic asthma review. This is a tool to help assess your asthma and guide your self management. 

The Asthma Control Questionnaire is a way to help you and Clapham Park Group Practice determine if your asthma symptoms are well controlled.

To be completed by those ages 12+ years

Personal Details
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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 may likely be well controlled. Well done! you do not need to take any action.

Score ON TARGET

  • Your asthma symptoms may not be as well controlled as they could be.
  • Please complete the remainder of this form and the surgery will contact you with next steps once your results have been reviewed

Score

Your asthma symptoms may not be as well controlled as they could be.

  • Please complete and submit the form and the surgery will contact you with next steps once your results have been reviewed.
  • 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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Peak Flow

For monitoring your asthma it's really important that you have a peak flow meter. If you do not have a peak flow meter, please add this to your next repeat prescription request.

 
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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. 

 

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.

If you are still uncertain on how to use your inhalers please:

  • Consult with your local pharmacist 
  • Make an appointment for an asthma review with the practice nurse or clinical pharmacist
 
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Smoking Status
Please select one

If you would like help or advice on quitting smoking please:

Triggers
 
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Inhaler Prescription

In light of the climate emergency we have been asked to review inhaler prescribing.

Metered dose inhalers (MDI) release hydrofluorocarbons and account for an estimated 4% of the entire NHS footprint.

Dry powder inhalers have a much lower carbon footprint and are clinically appropriate for many patients.

The BTS/SIGN guidelines (2019) recommend that inhalers with low global-warming potential should be used when they are likely to be equally effective.

As such we will be swapping your inhalers to a dry powdered inhaler unless you have tried these in the past and had a negative outcome. 

Please do contact the surgery to let us know if there is a medical reason why we should not swap your inhalers. If you find there is a deterioration in your asthma control on swapping then please get in touch so we can review your asthma and arrange to change you back to an aerosol inhaler if appropriate.

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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