COPD Self-assessment questionnaire
It's time to have a conversation with your healthcare professional
Your responses indicate that your symptoms may have got worse over the past three months or you have had to use medication more than usual to manage your exacerbations, or both.
This means that your COPD may not be managed as well as it could be and you could be at risk of your COPD getting worse.
Book an appointment with your healthcare professional to discuss how to better manage your COPD and exacerbations. Ask if it is appropriate to get an updated COPD review, this may help you to understand your disease better.
Before your appointment, print out this evaluation and fill out the appointment discussion guide. These tools could help you have a better conversation with your healthcare professional and get the support you need to help manage your condition.
Keep track of your COPD symptoms
Your responses indicate that you have not had worsening symptoms over the last three months or required additional medical attention for your exacerbations.
While this suggests your COPD is currently well managed, it is important to keep track of your
symptoms and speak to your healthcare professional if you experience a noticeable worsening of your symptoms.
Consider making an appointment with your healthcare professionnal to discuss how to prevent & manage exacerbation, and ask if it is appropriate to get an updated COPD review.
Print out your responses and download the COPD symptom tracker to allow you to continue to understand and monitor your COPD symptoms.
If you have any upcoming appointments, take these resources with you as they could help you to have a more informed conversation with your healthcare professional.
COPD self-assessment questionnaire
Find out about your COPD to check and keep track of your symptoms quality of life and if they are progressing and affecting you and your loved ones
In the past 3 months, have your COPD symptoms made it difficult or impossible to go about your everyday life or participate in activities that you enjoy?
In the past 3 months, have you experienced a worsening of shortness of breath, cough, and/or production of more phlegm (mucus)?
Are you currently using inhaled medications for your COPD?
In the past year, have you been to A&E or hospital due to the worsening of your COPD symptoms?
In the past month, have you needed to use your medication—like inhalers or nebulisers—more often than usual to help manage your symptoms?
In the past year, have you had to use your rescue pack (steroids or antibiotics) or been prescribed steroids for the worsening of your COPD?
In the past year have you had a review in relation to your COPD with your Healthcare Professional team, including a record of the number of exacerbations, a blood test and an assessment of your breathlessness?
Note: This tool has been developed & funded by Sanofi. This COPD self-assessment tool is to help keep track of your symptoms & disease management only and not intended to diagnose or replace advice from healthcare professional. If you have concerns about your sign, symptoms or health, please always talk to your healthcare professional for further advice.
The health information contained herein is provided for general educational purposes only. Your healthcare professional is the single best source of information regarding your health. Please consult your healthcare professional if you have any questions about your health or treatment.
MAT-SG-2600249-v1.0-10/2026