Florey allows you to send questionnaires out to patients to gather data. The Asthma Florey Questionnaire is used to help gather data that would be useful for an annual asthma review.

Please note that there are two Asthma Florey Questionnaires: the Asthma ACT Questionnaire and the Asthma RCP Questionnaire. The ACT Questionnaire was added in 2020 to align with the 20-21 QOF requirements.

This article details:
- Asthma ACT Florey content

- Asthma RCP Florey content
- the SNOMED codes added (Codes added align to QOF requirements).

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Asthma ACT Florey content (if patient is 12 years old)

Enrolment SMS:
Hi/Dear NAME,
I'd like you to complete some questions about your asthma via the link below.
Thanks, SIGN-OFF
Please follow this link: (link will autogenerate here)
You need internet on your phone (otherwise you can open the link on a computer or contact reception).
SENDER ID

First page of questionnaire:

Hi NAME
As part of your asthma care, your GP would like to gather up-to-date information about some aspects of your asthma. It should take no longer than three minutes to complete.

Are you happy to proceed?
This survey is operated by accuRx.

The Asthma Control Test (ACT) is a trademark of QualityMetric incorporated. The Childhood Asthma Control Test was developed by GSK.

Questions
What is your date of birth?
Example 8 12 1988

  • DD MM YYYY

1. During the past 4 weeks, how often did your asthma prevent you from getting as much 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

2. During the past 4 weeks, how often have 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

3. During the past 4 weeks, how often did your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) wake you up at night or earlier than usual in the morning?

  • 4 or more nights a week
  • 2 to 3 nights a week
  • Once a week
  • Once or twice
  • Not at all

4. During the past 4 weeks, how often have you used your reliever inhaler (usually the blue inhaler) or nebuliser medication?

  • 3 or more times per day
  • 1 or 2 times per day
  • 2 or 3 times per week
  • Once a week or less
  • Not at all

5. How would you rate your asthma control during the past 4 weeks?

  • Not controlled at all
  • Poorly controlled
  • Somewhat controlled
  • Well controlled
  • Completely controlled

7 How many asthma exacerbations have you had in the past 12 months?

An exacerbation is where your symptoms got worse, your reliever did not help and you needed to seek medical attention (for more information see here)

  • Free text

8 Do you have any further information about your asthma that you feel is relevant to this review?

Please note that your answers will not be seen immediately and you should direct any urgent queries to your GP surgery

  • Free text

9 What is your smoking status?

  • Current smoker
  • Ex-smoker
  • Never smoked

10 How much do you smoke? (if answered Current smoker to previous question)

  • <1 cigarettes per day or equivalent
  • 1-9 cigarettes per day or equivalent
  • 10-19 cigarettes per day or equivalent
  • 20-30 cigarettes per day or equivalent
  • 40+ cigarettes per day or equivalent

11 Does anyone else in your household smoke? (if patient is 19 years old or younger)

  • Yes
  • No

12 Who smokes in your household? (if patient is 19 years old or younger)

  • Free text

After a patient submits their responses, they are shown:
What next?
Your practice will review this information in the next 28 days and be in touch if further action is required. Please contact reception if you need to speak to a clinician.

Inhaler technique
It is important to regularly review your inhaler technique. You can do this at the following link: www.asthma.org.uk/advice/inhaler-videos/

Quitting smoking
Smoking leads to health problems such as cancer, heart disease and strokes. The benefits of stopping smoking include: better health, more money and cleaner air for those around you!

Do you want to stop smoking? Here is some advice on ways to quit smoking, local services and general tips: www.nhs.uk/smokefree

After Completion SMS:
Thank you for completing your GP's questions. Your answers will not be seen immediately. For urgent queries, please call reception. How did you like filling out the survey? Leave feedback here: <feedback link>

Response in accuRx Inbox:
Asthma Team

@Asthma Team patient NAME has responded:

Questionnaire : Asthma ACT Questionnaire

Affecting work, school, home :

Shortness of breath :

Waking up :

Uses of reliever inhaler/nebuliser :

Rating of asthma control :

Number of exacerbations in past 12 months :

Further information :

Smoking Status :

Smoking Quantity :

Others in household smoke :

Who else smokes :

Asthma Control Test score :

Codes that are added to EMIS/SystmOne record

The codes added are in italics

The following codes are added to all Asthma Florey responses:
Asthma Control Test score /25

The following codes are also saved according to the patient's response:

"What is your smoking status?"

  • "Current smoker" - Current smoker
  • "Ex-smoker" - Ex-smoker
  • "Never smoked" - Never smoked

[if chose 'Current Smoker' above]
Smoking: "How much do you smoke?"

  • "Trivial smoker (<1 cigarettes/day or equivalent)" - Trivial smoker (<1 cigarettes/day or equivalent)
  • "Light smoker (1-9 cigarettes/day or equivalent)" - Light smoker (1-9 cigarettes/day or equivalent)
  • "Moderate smoker (10-19 cigarettes/day or equivalent)" - Moderate smoker (10-19 cigarettes/day or equivalent)
  • "Heavy smoker (20-30 cigarettes/day or equivalent)" - Heavy smoker (20-30 cigarettes/day or equivalent)
  • "Very heavy smoker (40+ cigarettes/day or equivalent)" - Very heavy smoker (40+ cigarettes/day or equivalent)

Smoking cessation advice given - This code is added for anyone who says they are a current smoker. We display a standard short bit of smoking cessation advice with link to nhs.uk/smokefree.

------------


Asthma RCP Florey content

Enrolment SMS:
Hi/Dear NAME,
I'd like you to complete some questions about your asthma via the link below.
Thanks, SIGN-OFF
Please follow this link: (link will autogenerate here)
You need internet on your phone (otherwise you can open the link on a computer or contact reception).
SENDER ID

First page of questionnaire:

Hi NAME
Your GP would like to gather some up to date information about some aspects of your asthma. It should take no longer than three minutes to complete. The questions may mention any long-term-conditions that you have.
Are you happy to proceed?
This survey is operated by accuRx.

Questions
1 What is your date of birth?
Example 8 12 1988

  • DD MM YYYY

2 Do you have asthma?

  • Yes
  • No

3 How often does your asthma cause symptoms during the day

  • Never
  • 1 to 2 times per month
  • 1 to 2 times per week
  • Most days

4 How often does your asthma cause symptoms at night?

  • Never
  • 1 to 2 times per month
  • 1 to 2 times per week
  • Most nights

5 How often does asthma limit your activities?

  • Never
  • 1 to 2 times per month
  • 1 to 2 times per week
  • Most nights

6 On average, how many times a week do you need to use your reliever inhaler?

  • Free text

7 How many asthma exacerbations have you had in the past 12 months?

An exacerbation is where your symptoms got worse, your reliever did not help and you needed to seek medical attention (for more information see here)

  • Free text

8 Do you have any further information about your asthma that you feel is relevant to this review?

Please note that your answers will not be seen immediately and you should direct any urgent queries to your GP surgery

  • Free text

9 What is your smoking status?

  • Current smoker
  • Ex-smoker
  • Never smoked

10 How much do you smoke? (if answered Current smoker to previous question)

  • <1 cigarettes per day or equivalent
  • 1-9 cigarettes per day or equivalent
  • 10-19 cigarettes per day or equivalent
  • 20-30 cigarettes per day or equivalent
  • 40+ cigarettes per day or equivalent

11 Does anyone else in your household smoke? (if patient is 19 years old or younger)

  • Yes
  • No

12 Who smokes in your household? (if patient is 19 years old or younger)

  • Free text

After a patient submits their responses, they are shown:
Thank you for completing your asthma review online. Your practice will review this information in the next 28 days and be in touch if further action is required.

It is important to regularly review your inhaler technique. You can do this at the following link: www.asthma.org.uk/advice/inhaler-videos/

Please contact reception if you need to speak to a clinician.

(if they answered current smoker, the following is also displayed)
Smoking leads to health problems such as cancer, heart disease and strokes. The benefits of stopping smoking include: better health, more money and cleaner air for those around you!

Do you want to stop smoking? Here is some advice on ways to quit smoking, local services and general tips: www.nhs.uk/smokefree

After Completion SMS:
Thank you for completing your GP's questions. Your answers will not be seen immediately. For urgent queries, please call reception.

Response in accuRx inbox:
Asthma Team

@Asthma Team patient NAME has responded:

Questionnaire : Asthma Questionnaire

Confirmed Asthma Status :

Day Symptoms :

Night Symptoms :

Limits Activities :

Uses of reliever per week :

Exacerbations in 12 months :

Additional Comments :

Smoking Status :

Smoking Quantity :

Others in household smoke:

Who else smokes:


Codes that are added

The codes added are in italics

The following codes are added to all Asthma Florey responses:
History of asthma (situation)

The following codes are also saved according to the patient's response:

Daytime symptoms: "How often does your asthma cause symptoms during the day?"

  • "Never" - Asthma never causes daytime symptoms
  • "1 to 2 times per month" - Asthma causes daytime symptoms 1 to 2 times per month
  • "1 to 2 times per week" - Asthma causes daytime symptoms 1 to 2 times per week
  • "Most days" - Asthma causes daytime symptoms most days

Nighttime symptoms: "How often does your asthma cause symptoms at night?"

  • "Never" - Asthma not disturbing sleep
  • "1 to 2 times per month" - Asthma causes night symptoms 1 to 2 times per month
  • "1 to 2 times per week" - Asthma causes night time symptoms 1 to 2 times per week
  • "Most days" - Asthma causes symptoms most nights

Limiting activities: "How often does your asthma limit your activities?"

  • "Never" - Asthma not limiting activities
  • "1 to 2 times per month" - Asthma limits activities 1 to 2 times per month
  • "1 to 2 times per week" - Asthma limits activities 1 to 2 times per week
  • "Most days" - Asthma limiting activities most days

Smoking status: "What is your smoking status?"

  • "Current smoker" - Current smoker
  • "Ex-smoker" - Ex-smoker
  • "Never smoked" - Never smoked

[if chose 'Current Smoker' above]
Smoking: "How much do you smoke?"

  • "Trivial smoker (<1 cigarettes/day or equivalent)" - Trivial smoker (<1 cigarettes/day or equivalent)
  • "Light smoker (1-9 cigarettes/day or equivalent)" - Light smoker (1-9 cigarettes/day or equivalent)
  • "Moderate smoker (10-19 cigarettes/day or equivalent)" - Moderate smoker (10-19 cigarettes/day or equivalent)
  • "Heavy smoker (20-30 cigarettes/day or equivalent)" - Heavy smoker (20-30 cigarettes/day or equivalent)
  • "Very heavy smoker (40+ cigarettes/day or equivalent)" - Very heavy smoker (40+ cigarettes/day or equivalent)

Smoking cessation advice given - This code is added for anyone who says they are a current smoker. We display a standard short bit of smoking cessation advice with link to nhs.uk/smokefree.

F.A.Q's

Why do you no longer include the 'Asthma Annual Review' SNOMED code?

We used to have this "Asthma Annual Review" code included in the asthma Florey Questionnaire but as we'd received a large amount of feedback from practices asking for this to be removed as they weren't comfortable with marking a review as completed through the questionnaire alone.

Why do you have both the RCP and the ACT questionnaires?

We have historically only had one asthma questionnaire that had RCP questions.

In the QOF year 20-21, ACT questions became a requirement so we added this.

We have left the original RCP questionnaire if practices still require it, if we find from our review that it is no longer used, it will be removed.


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