The WWHAM questions can be used when talking to a patient with asthma:
Who is it for?
What are you using the SABA for? Asthma or COPD? (if for asthma, continue)
How many canisters have you been prescribed in the last 12 months? How many puffs of SABA have you used in the past seven days? Are any night-time and/or day-time symptoms present?
Use an asthma slide-rule to indicate SABA puffs per year and the potential number of breathless moments. (For example, six SABA canisters = 1,200 puffs per year which could mean 600-1,200 breathless moments (one dose = one to two puffs of SABA)
Actions: ICS (preventer) usage: Monitor the ICS:SABA ratio in the past 12 months (e.g. two ICS:12 SABA (urgent referral). A ratio of 12:2 is an indicator of good control. If ICS adherence is good, check inhaler technique. Is a spacer required? Is a referral required for a temporary ICS dose step up and adjustment to the PAAP?
Medication: Are you on any other medication (e.g. NSAIDs, beta blockers) or exposed to triggers (e.g. tobacco smoke, damp, pollen) that can make the medication less effective?