The Asthma Control Test, or ACT, is a 5 question survey developed and validated through clinical research and used in allergy and pulmonology offices around the world. The score ranges from 5 (worst control) to 25 (total control). It captures how asthma has affected your daily life over the past 4 weeks. We use it during follow-up visits to track whether a treatment change is working.
What the score actually means
A score of 19 or below is the threshold where most specialists recommend a change in treatment. Below 15 is a flag for poor control and a higher risk of an asthma exacerbation, which is the medical word for the kind of attack that lands people in urgent care. Patients commonly think their asthma is fine because they have adapted to symptoms over time. The ACT cuts through that adaptation by asking specific questions about activities, sleep, and inhaler use.
Why allergic asthma matters in Central Texas
A large portion of asthma patients have allergic asthma, where exposure to specific allergens drives airway inflammation. In our Waco clinic, the most common triggers are mountain cedar (December to February), oak and other tree pollens (March to May), grasses (May to October), ragweed (September and October), and indoor allergens like dust mites and mold year round. Treating the underlying allergy with immunotherapy can significantly reduce asthma symptoms and inhaler use over time.
When to consider biologics
For patients with severe asthma who score consistently below 15 despite high dose controller therapy, biologic medications like Xolair, Dupixent, Nucala, and Fasenra have changed outcomes substantially over the past decade. These are injection medications that target specific inflammatory pathways and are typically prescribed and managed by an allergist or pulmonologist. We administer biologics in office and have prescribing experience across all the available options.
How often to retake the test
Once at every follow-up visit. More often if you have just changed medications or started a new season. Trends matter. A score that drops from 23 to 18 over two visits is meaningful even though both numbers look acceptable individually.
