Nebulizer Questionnaire

1. Has it been easy to learn and prepare how to use the inhaler? VeryFairlySomewhatNot veryHardly at all

2. Was it easy to continue normal activities with the use of the inhaler? VeryFairlySomewhatNot veryHardly at all

3. Carrying my asthma inhaler(s) can be cumbersome (e.g. size/weight). VeryFairlySomewhatNot veryHardly at all

4. My inhaler(s) helps me feel in control of my asthma symptoms VeryFairlySomewhatNot veryHardly at all

5. When I take my medication, I feel confident that my asthma Symptoms will be controlled VeryFairlySomewhatNot veryHardly at all

6. My asthma medication leaves a bad taste in my mouth VeryFairlySomewhatNot veryHardly at all

7. My asthma medication affects my voice VeryFairlySomewhatNot veryHardly at all

8. I feel confident in using my inhaler(s). VeryFairlySomewhatNot veryHardly at all

9. I worry that my inhaler is not giving me enough medication. VeryFairlySomewhatNot veryHardly at all

10. My asthma medication provides fast relief of my asthma symptoms. VeryFairlySomewhatNot veryHardly at all

11. I would recommend my inhaler(s) to other people with asthma

12. Ability to perform daily activities; VeryFairlySomewhatNot veryHardly at all

13. Breathlessness over the past 24 hours VeryFairlySomewhatNot veryHardly at all

14. Waking at night due to respiratory symptoms VeryFairlySomewhatNot veryHardly at all

15. Cough VeryFairlySomewhatNot veryHardly at all

16. Breathlessness on arising VeryFairlySomewhatNot veryHardly at all

17. Sputum production VeryFairlySomewhatNot veryHardly at all

18. Optional: What asthma treatment do you use and how much are you paying for it?