COPD Assessment

 

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How is your COPD? Take the COPD Assessment Test (CAT)

This questionnaire will help you and your healthcare professional to measure the impact that COPD (Chronic Obstructive Pulmonary Disease) is having on your wellbeing and daily life. Your answers and test score can be used by you and your healthcare professional to help improve the management of your COPD and gain the greatest benefit from the treatment.

Cough

0 = I never cough
5 = I cough all the time

Phlegm

0 = I have no phlegm in my chest at all
5 = My chest is completely full of phlegm

Chest Tightness

0 = My chest does not feel tight at all
5 = My chest feels very tight

Breathlesness

0 = When I walk up a hill or one flight of stairs I am not breathless
5 = When I walk up a hill or one flight of stairs I am very breathless

Activities

0 = I am not limited doing any activities at home
5 = I am very limited doing any activities at home

Confidence

0 = I am confident leaving my home despite my lung condition
5 = I am not at all confident leaving my home because of my lung condition

Sleep

0 = I sleep soundly
5 = I don’t sleep soundly because of my lung condition

Energy

0 = I have lots of energy
5 = I have no energy at all

Total Score

YOU HAVE A SCORE OF

Breathlessness on Target - Well Done

Your COPD appears to have been under control over the last 4 weeks. However, if you are experiencing symptoms your doctor or nurse may be able to help you, please add these int the comments box at the end of this form.

YOU HAVE A SCORE OF

On Target

Your COPD appears to have been under control over the last 4 weeks. However, if you are experiencing symptoms your doctor or nurse may be able to help you, please add these int the comments box at the end of this form.

YOU HAVE A SCORE OF

High Health Impact (Monitoring Needed)

Your COPD appears that it may not be under control during the past 4 weeks.
Your Doctor or nurse may recommend a COPD action plan to help improve your COPD control once you have submitted this form.

Points

Very High Health Impact (Off Target)

Your COPD may not have been controlled during the past 4 weeks.
Your Doctor or nurse will recommend a COPD action plan to help improve your COPD control once you have submitted this form.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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