The Asthma Control test - what is it and why use it?

If you have completed an Asthma Control Test (ACT), as part of an assessment by your GP or practice nurse, you may ask what the test is and how it can help you manage your asthma.

The simple answer is that the ACT looks at how well your asthma is controlled. It highlights how much your symptoms are affecting you at present and whether you would benefit from a change in medication. Research shows that if doctors ask general questions such as “How is your asthma?” patients are less likely to say there’s a problem, whereas asking specific questions is much more likely to pick up uncontrolled symptoms.

The ACT asks a number of questions about your asthma symptoms over recent weeks and allocates you a score. A score of 25 means your asthma is very well controlled, one of less than 20 means that you should adjust your medication and/or seek additional help to get your symptoms under control.

There are other ways of gathering similar information. For example, your GP may have asked you three simple questions about your sleep, your symptoms and how much your asthma is interfering with your everyday activities; these are known as the three RCP (or Royal College of Physicians) questions and can highlight potential problems in a similar way.

You may feel you know how well you are without all these questions. In reality, lots of people think their asthma is better controlled than it actually is - and a few changes could make all the difference. Until you are asked some direct questions you may not have even noticed that your symptoms are interfering with your sleep. Or you may be struggling on with everyday life, reducing how much you do and believing that it is just how things are with asthma.

This is very common but, in fact, there is no need for asthma symptoms to affect your life significantly or even at all: asthma can be easily managed with the right medication in almost all cases. A change in your inhalers or how you use them may make all the difference to how you feel. You may need to increase your preventer inhaler (e.g. Clenil) or make a change to your reliever (e.g. Ventolin). Take a look at your Personal Action Plan if you have one, to see how to adjust your medication and/or seek help from your GP or practice nurse.

So in summary, the ACT is a simple tool that uses a few, specific questions to highlight how well you are managing your asthma. It reflects your control at the time you do the test and, as asthma symptoms often change, it is best to repeat it every three to six months or so. It will then provide a useful prompt to make changes if you need them - to ensure that you are always feeling as well as you possibly can.