Asthma Control Test (ACT)
In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home?
All of the time
Most of the time
Some of the time
A little of the time
None of the time
During the past 4 weeks, how often have you had shortness of breath?
More than once a day
Once a day
3-6 times a week
1-2 times a week
Not at all
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?
≥ 4 nights a week
2-3 nights a week
Once a week
1-2 times a week
Not at all
During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as Salbutamol)?
≥ 3 times per day
1-2 times per day
2-3 times per week
≤ 1 per week
Not at all
How would you rate your asthma control during the past 4 weeks?
Not controlled at all
Poorly controlled
Somewhat controlled
Well controlled
Completely controlled
Please complete all sections.
Reference
Michael Schatz, Christine A Sorkness, James T Li et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol. 2006 Mar;117(3):549-56.
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