Asthma Control Test (ACT)

Asthma control over the last 4 weeks — five items, 5–25

Time asthma kept you from getting things done at work, school, or home

All of the time

Most of the time

Some of the time

A little of the time

None of the time

How often you had shortness of breath

More than once a day

Once a day

3 to 6 times a week

Once or twice a week

Not at all

How often asthma symptoms woke you at night or earlier than usual

4 or more nights a week

2 to 3 nights a week

Once a week

Once or twice

Not at all

How often you used your rescue inhaler or nebuliser

3 or more times a day

1 or 2 times a day

2 or 3 times a week

Once a week or less

Not at all

How you would rate your asthma control

Not controlled at all

Poorly controlled

Somewhat controlled

Well controlled

Completely controlled

Answer all five questions to calculate

Evidence

Original publication

Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. Five self-administered items (activity limitation, dyspnoea, nocturnal symptoms, rescue-inhaler use, self-rated control), each 1–5, summed 5–25; a score ≤ 19 identified inadequately controlled asthma against specialist assessment.

Journal of Allergy and Clinical Immunology, 2004

Open source

Validation

Schatz M, Sorkness CA, Li JT, et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. A cut-point of 19 (≤ 19 = not well controlled) and 20–24 / 25 for well controlled / totally controlled performed well; a change of 3 points is clinically meaningful.

Journal of Allergy and Clinical Immunology, 2006

Open source

Guideline

GINA and the NAEPP EPR-4 update list the ACT among validated numerical control tools. The ACT is copyrighted (QualityMetric) but freely available for clinical use; bands here: ≥ 20 well controlled, 16–19 not well controlled, ≤ 15 poorly controlled.

Last reviewed: 2026-09

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