When are Asthma Control Questionnaires sent?

We use Asthma Control Questionnaires (ACQs) in two ways...

1. To complete asthma reviews without the need for an appointment
2. To gather information prior to an appointment

Completing Asthma Reviews without an appointment (full ACQ)

We have a more detailed ACQ that can be used to potentially complete an Asthma review without an appointment. This needs to be done with great care to avoid missing patients who require in-person attention. A patient is excluded from even being sent this questionnaire if any of the following criteria are met:

In the last 12m they have had...

• An Asthma exacerbation (one of our Prescribing prompts will advise coding this if Prednisolone is issued for an asthma exacerbation)
• An Asthma emergency admission
• >2 SABA inhalers issued
• >1 SABA inhaler issued with no ICS
• >15 AIR/MART inhalers
• >3 AIR/MART inhalers and they're coded as on an AIR regime

Or if they... 

• Have a dual diagnosis of Asthma AND COPD
• Issues that suggest they may struggle with understanding or completing the questionnaire, e.g. needing an interpreter, reading or literacy issues.
• Are under the age of 13 (this can be increased to exclude anyone under 18)

Or we think they need to be switched to a AIR/MART regime:

• SABA on repeat with no ICS/LABA
  
• LABA on repeat with no ICS
• ICS and SABA on repeat with no LABA

Practices can opt out of using these questionnaires completely. They can also choose to exclude patients who haven't had an Asthma review with a clinician in the last 2 years and choose whether the answers to questionnaires should be processed by admin staff or clinicians.

Once the patient completes the questionnaire, the following criteria have to be met for our system to suggest completing a review:

• ACT score of 20 or more
• No A&E attendances for asthma in the last 12m
• No more than 2 asthma exacerbations, and only if a clinician is satisfied that further review isn't needed at the present time
• Peak flow (if submitted by the patient) more than 75% of and more than 100 l/min below, the patient's best peak flow in last 5 years or their predicted peak flow (if it can be calculated), whichever is the higher.  

Patients may also request a follow up appointment with a clinician and/or an asthma inhaler technique check.

Gathering information before an appointment

We also have a smaller, simpler ACQ that can be used to gather information prior to an appointment. With these questionnaires, the intention is to support the Asthma review appointment by reducing the information that needs to be gathered at that time.