Asthma Review

CDM Asthma Review

Please complete this form so that we can review your Asthma.

We would highly recommend reading the Asthma UK website. It is full of helpful information telling you about your asthma and how to better manage it.

On submission of this form:

  • We will contact you for a review if you asthma control is poor or you have indicated you would like to speak to a clinician.
  • We will continue your current treatment if your control is good and you have indicated that you would not like to speak to a clinician.
This review works well on mobile but it is easier on a computer.

Your Details

Inhaler Use

How often do you use your RELIEVER? (blue inhaler)
If you have one, how often do you use your PREVENTER? (regular daily inhaler)

Asthma Control

During the last 4 weeks, how much of the time has your asthma kept you from getting as much done at work, school or home?
During the last 4 weeks, how often have you had shortness of breath?
During the last 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?
During the last 4 weeks, how often have you used your reliever inhaler?
How would you rate your asthma control during the last 4 weeks?

Score < 20
Your asthma does not seem well controlled.
It would probably help to have your treatment reviewed and increased. This will be discussed at your review.

Score of 20-24
Your asthma seems reasonably well controlled.
It would be reasonable for you to stay on your current treatment or possibly review and increase your treatment.
This will be discussed at your review if you like.

Score of 25
Your asthma appears to be VERY WELL CONTROLLED.
We would recommend considering reducing your current treatment and reviewing it again in a few months. It would also be reasonable to simply continue your current treatment if you are happy.

Inhaler Technique

  • Inhaler technique is VERY important.
  • Taking an inhaler is not like taking a pill. An inhaler will only work well if it’s taken well.
  • Poor inhaler technique means the medicine doesn’t get to where it’s needed and can lead to your asthma giving you lots of symptoms.
Which inhaler device types do you use? Clicking will reveal a video helping your technique.
Would you like to go over your inhaler technique with a clinician?
Would you like a SPACER device? (see above) This can often often help if you are struggling to take your inhaler properly.

Environmental factors

Many environmental or lifestyle factors can worsen or even cause asthma. To best control your asthma you must ensure that you:

  • do not smoke
  • maintain a healthy weight
  • keep potential ASTHMA TRIGGERS to a minimum around your home and work such as dust and pollen.
Smoking significantly worsens asthma. Do you smoke?

Here is some helpful information on stopping smoking. It includes how to access specialist clinics that can support you and also prescribe medication to help you stop.


How is your asthma on days away from work?
How is your asthma when you are on Holiday?

OCCUPATIONAL ASTHMA. There is a possibility that your work is worsening or even causing your asthma. We will discuss this at your review.

Peak Flows and your Asthma Plan

  • Even people with well controlled asthma will occasionally have worsening symptoms or even an asthma attack.
  • It is important that everyone with asthma has an asthma plan so that you know what to do if you have an attack.
  • CLICK HERE to get the NHS Lothian asthma plan.
  • “Peak Flow” readings taken with a “Peak Flow meter” can help you tell when your asthma control is poor and when to use your asthma plan.
Would you like a peak flow meter?

Would you like to discuss an asthma plan with a clinician?
This is the end of your Asthma eReview. How would you like to proceed?
This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our privacy policy to discover how we protect and manage your submitted data.
© 2022 Kristian Turnbull