Uncontrolled Asthma Survey

Survey for needs assesment.

Uncontrolled Asthma Survey

Survey Regarding Poorly-controlled/Uncontrolled Asthma

Definitions for this survey:

  • A “controller” inhaler is prescribed scheduled (as maintenance therapy to be used every day of the year)
  • A “reliever” inhaler is prescribed as needed for acute asthma symptoms
  • “Poorly-controlled/uncontrolled asthma” includes patients who need a reliever inhaler 3 or more times per week due to asthma symptoms and/or wake up 3 or more nights per month with asthma symptoms and/or whose asthma symptoms interfere with their daily life and/or who have had acute exacerbations within the last year.

ICS = inhaled corticosteroid (mometasone or budesonide)
LABA = long-acting beta-agonist (formoterol)
LAMA = long-acting muscarinic antagonist (tiotropium)
SABA = short-acting beta agonist (albuterol)