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| Q1 |
In the past 4 weeks, how much of the time did your asthma keep you from getting as much done at work, school or at home? |
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| Q2 |
During the past 4 weeks, how often have you had shortness of breath? |
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| Q3 |
During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning? |
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| Q4 |
During the past 4 weeks, how often have you used your rescue inhaler or nebulizer medication (such as albuterol)? |
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| Q5 |
How would you rate your asthma control during the past 4 weeks? |
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| Total Score | |