To advocate for yourself with asthma or COPD means taking an active part in your care. That includes knowing the signs that your breathing is not well controlled, bringing your plan and your questions to each visit, and asking about options or a referral when what you are doing is not working. Asthma guidelines advise shared decision-making between you and your clinician. This page explains how to tell whether your asthma is under control, what to bring and ask, when to ask about a specialist, and what research does and does not show about taking part in your own care.
How can you tell whether your asthma is under control?
The Global Initiative for Asthma (GINA) asks four questions about the past 4 weeks. Have you had daytime symptoms more than twice a week? Has asthma woken you at night? Have you needed a reliever inhaler for symptoms more than twice a week? Has asthma limited your activity? Its summary guide says that none of these suggests well controlled asthma, one or two suggest partly controlled and three or four suggest uncontrolled. (GINA 2026 summary guide)
The American Lung Association has its own online assessment. Its scoring says that 20 or more means your asthma seems to be well controlled, 19 or less means it may not be, and 15 or less may mean it is very poorly controlled and a reason to contact your healthcare provider right away. (American Lung Association, My asthma control assessment) MedlinePlus adds that you should tell your provider if you use quick-relief medicine twice a week or more to control your symptoms. (MedlinePlus, Asthma quick-relief drugs) If your answers worry you, tell your clinician, and do not change your medicine on your own.
What should you bring to a visit?
- Your written action plan, if you have one, and a note on whether you are able to follow it.
- Your inhalers, spacer and other devices, so your clinician can check them and watch your technique.
- Notes on your symptoms: how often you cough, wheeze or feel short of breath, whether asthma wakes you at night, and how often you use your quick-relief inhaler.
- Peak flow readings, if your clinician asked you to track them.
- A list of the triggers you have noticed and the medicines and supplements you take.
- Your questions, written down with the most important first.
Our checklist of asthma essentials explains the action plan, quick-relief inhaler, spacer, peak flow meter and trigger plan in more detail.
What questions can you ask?
- Is my asthma or COPD well controlled, and how do you know?
- Do I have a written action plan, and can we go over it together?
- Is my inhaler technique right, and would a spacer help?
- What does it mean if I need my quick-relief inhaler more than twice a week?
- Should I use a peak flow meter?
- If my treatment is not working, what are my options, and what are the benefits and risks of each?
- Would it help to see an allergist or a lung specialist?
- Is pulmonary rehab right for me, and can you refer me?
When can it help to ask about a specialist?
GINA advises that if asthma is still uncontrolled after 3 to 6 months on step 4 treatment, a person should be referred for expert advice. (GINA 2026 summary guide) The American College of Allergy, Asthma and Immunology lists warning signs of serious asthma, including struggling to catch your breath, frequent wheezing or coughing especially at night or after exercise, frequent shortness of breath or chest tightness, and frequent asthma attacks despite medication. (ACAAI, When to see an allergist) These are reasons to ask your doctor about a specialist. They are not a diagnosis.
GINA also says asthma should generally be reviewed 1 to 3 months after starting treatment and then every 3 to 12 months. If you have not had a review in a long time, you can ask for one.
What does the research say about taking part in your own care?
A Cochrane review first published in 1998 looked at 36 randomized trials and found that self-management education improves health outcomes for adults with asthma. The programs combined education, self-monitoring of symptoms or peak flow, regular review by a health practitioner and a written action plan, and those that let people adjust their medicine using a written action plan appeared more effective than other forms of self-management. (Cochrane review, Gibson et al.) Any plan to adjust medicine has to come from your own doctor.
The evidence on written action plans alone is less certain. A 2017 Cochrane review of 15 studies with 3,062 adults found no clear added benefit or harm from personalized written action plans, and its authors said they could not be confident about the size or direction of the effects because the evidence was low or very low certainty. (Cochrane review, Gatheral et al., 2017) That describes how sure the research is. It is not a reason to skip a plan your doctor recommends.
GINA also advises shared decision-making, where you and your clinician weigh the possible benefits and risks of a treatment together. (GINA 2026 summary guide)
Speaking up if you have COPD
The same habits help with COPD. Tell your clinician when your breathlessness changes and ask what you should do during a flare-up. The 2023 American Thoracic Society guideline says that less than 5% of people with COPD who may benefit from pulmonary rehab receive it, and it recommends pulmonary rehab after a hospital stay for a COPD flare-up. (ATS guideline, 2023) If rehab has not been offered, you can ask whether it is right for you and whether your doctor can refer you. Our page on pulmonary rehab after a hospital stay explains what the numbers show and how to ask, and do you need a referral for pulmonary rehab explains what a referral includes.
How Bloom fits in
Bloom Medical Group provides one-on-one virtual pulmonary rehab by video with a licensed respiratory therapist or clinical exercise physiologist. Education covers inhaler technique, symptom management and the daily habits that protect lung function. Bloom works alongside your own doctor, and a referral from that doctor is needed to start.
Frequently asked questions
It means taking an active part in your care: knowing the signs of poor control, bringing your action plan and questions to visits, asking about options and referrals, and working with your clinician on shared decisions.
GINA asks about the past 4 weeks: daytime symptoms more than twice a week, night waking, reliever inhaler use more than twice a week and activity limits. None of these suggests well controlled asthma, one or two suggest partly controlled and three or four suggest uncontrolled. Tell your clinician if you are unsure.
Bring your written action plan, your inhalers and any spacer, notes on your symptoms and quick-relief inhaler use, peak flow readings if you track them, a list of triggers, and your questions.
The ACAAI lists warning signs such as frequent wheezing or coughing, frequent shortness of breath or chest tightness, and frequent attacks despite medication. GINA advises referral for expert advice if asthma is still uncontrolled after 3 to 6 months on step 4 treatment. Ask your doctor what makes sense for you.
A Cochrane review of 36 trials found that self-management education improves health outcomes for adults with asthma. A separate 2017 Cochrane review found no clear added benefit or harm from written action plans, with low or very low certainty evidence. Ask your doctor what plan is right for you.
Yes. You can ask whether pulmonary rehab is right for you and whether your doctor can refer you. Bloom needs a referral from your own doctor. You can call 1-866-972-8228 to check your plan.
Next step
Not sure whether rehab fits you? Take our free 2 minute lung health assessment.
Ready to find out if you qualify? Call Bloom Medical Group at 1-866-972-8228 or fill in the see if you qualify form. One-on-one virtual pulmonary rehab with licensed respiratory therapists and clinical exercise physiologists, billed to commercial insurance. Read how virtual pulmonary rehab at Bloom works.
This article is for education only and is not medical advice. Talk with your doctor about what is right for you.
Sources
- Global Initiative for Asthma. GINA 2026 Summary Guide
- American Lung Association. My Asthma Control Assessment
- MedlinePlus. Asthma, quick-relief drugs
- American College of Allergy, Asthma and Immunology. When to See an Allergist
- Gibson PG, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev
- Gatheral TL, et al. Personalised asthma action plans for adults with asthma. Cochrane Database Syst Rev. 2017
- American Thoracic Society. Pulmonary rehabilitation for adults with chronic respiratory disease, official clinical practice guideline. Am J Respir Crit Care Med. 2023;208(4):e7
