How much does asthma affect your quality of life?

See for yourself: If asthma is limiting the choices you make in life, perhaps it’s time to look beyond medication alone. The following survey was created by a doctor and can help you recognize the many ways severe asthma may be affecting your life.

Be sure to share your answers with your doctor—and discover how Bronchial Thermoplasty (BT) may help you live a fuller life. BT, delivered by the Alair System, is not another medication—it’s a revolutionary and safe procedure proven to provide a long-lasting reduction in asthma attacks.1


survey top

This survey was designed to help you describe your asthma and how your asthma affects how you feel and what you are able to do. To complete, please select the most appropriate response.

Take a moment to answer these 6 simple questions.

1.
In the past 4 weeks, how much did your asthma limit your usual activities or enjoyment of everyday life?

Not at all

A little

Moderately

Quite a lot

Extremely

2
In the past 4 weeks, how often did your asthma limit you in performing your usual daily activities, including housework, work, school or social activities?

Never

Rarely

Sometimes

Very Often

Always

3
In the past 4 weeks, how often did your asthma keep you from socializing?

Never

Rarely

Sometimes

Very Often

Always

4
In the past 4 weeks, how often did you feel fed up or frustrated because of your asthma?

Never

Rarely

Sometimes

Very Often

Always

5
In the past 4 weeks, how often did your asthma leave you too tired to do work or daily activities?

Never

Rarely

Sometimes

Very Often

Always

6
In the past 4 weeks, how often did your asthma keep you from getting as much done at work or at home?

Never

Rarely

Sometimes

Very Often

Always

Next
Thank you for completing these questions.

Asthma Impact Survey © 2002 by Quality Metric Incorporated. All Rights Reserved.
Asthma Impact Survey is a trademark of Quality Metric Incorporated.

 

References:
1. Wechsler M, et al, for the AIR2 Trial Study Group. J Allergy Clin Immunol. 2013;132:1295-1302.