Table 1.
Asthma Control Test (ACT) for people 12 yrs and older.
| 1. 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? | Score | ||||
|---|---|---|---|---|---|
| All of the time ① |
Most of the time ② |
Some of the time ③ |
A little of the time ④ |
None of the time ⑤ |
|
| 2. During the past 4 weeks, how often have you had shortness of breath? | |||||
| More than once a day ① |
Once a day ② |
3 to 6 times a week ③ |
Once or twice a week ④ |
Not at all ⑤ |
|
| 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? | |||||
| 4 or more nights a week ① |
2 or 3 nights a week ② |
Once a week ③ |
Once or twice ④ |
Not at all ⑤ |
|
| 4. During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)? | |||||
| 3 or more times per day ① |
1 or 2 times per day ② |
2 or 3 times per week ③ |
Once a week or less ④ |
Not at all ⑤ |
|
| 5. How would you rate your asthma control during the past 4 weeks? | |||||
| Not controlled at all ① |
Poorly controlled ② |
Somewhat controlled ③ |
Well controlled ④ |
Completely controlled ⑤ |
|