COPD Assessment

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COPD Assessment

COPD Assessment 

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.
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All questions marked with a * are mandatory

Personal Details
Please double check you've entered the correct email address
May be used to identify you
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Questions

For each of the following questions choose what best describes your health currently

Example question: Happiness

0
1
2
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4
5
I am very happy
I am very sad

This chart displays a range of 'Happiness'. A score of 1would show that you feel far closer to the “I am very happy” statement.

Cough
0
1
2
3
4
5
I never cough
I cough all the time
Phlegm
0
1
2
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4
5
I have no phlegm in my chest at all
My chest is completely full of phlegm
Chest Tightness
0
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5
My chest does not feel tight at all
My chest feels very tight
Breathlessness
0
1
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5
When I walk up a hill or one flight of stairs I am not breathless
When I walk up a hill or one flight of stairs I am very breathless
Activities
0
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4
5
I am not limited doing any activities at home
I am very limited doing any activities at home
Confidence
0
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5
I am confident leaving my home despite my lung condition
I am not at all confident leaving my home because of my lung condition
Sleep
0
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5
I sleep soundly
I don’t sleep soundly because of my lung condition
Energy
0
1
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5
I have lots of energy
I have no energy at all
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Total Score

Low Score 

You have a score of  meaning your Breathlessness is on Target - Well Done

  • Your COPD appears to have been under control over the last 4 weeks.

Caution advised

  • However, if you are experiencing symptoms your doctor or nurse may be able to help you, please add these into the comments box at the end of this form.
  • If you would like to send this assessment to the surgery please continue to the next page

Medium Score 

You have a score of  meaning your Breathlessness is on Target

  • Your COPD appears to have been under control over the last 4 weeks.

Caution advised

  • However, if you are experiencing symptoms your doctor or nurse may be able to help you, please add these into the comments box at the end of this form.
  • If you would like to send this assessment to the surgery please continue to the next page

High Score 

You have a score of  meaning a High Health Impact (Monitoring Needed)

  • Your COPD appears that it may not be under control during the past 4 weeks.

Please note

  • Your Doctor or nurse may recommend a COPD action plan to help improve your COPD control once you have submitted this form.
  • Please submit this assessment to the surgery by continuing to the next page

Very High Score

You have a score of  meaning a 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

  • Please submit this assessment to the surgery by continuing to the next page
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