PPPAIMT-Crest/files/docs/questionnaire.md

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| Physicians’ Perspectives on Patient Adherence to Inhaled Maintenance Therapy: | |
| | |
| A Cross-Sectional Comparison of Extended-Dose and Standard Packaging | |
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| Study Questionnaire – Draft 03 (24/09/2026) | |
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| Basic Demographics / | Name ____________________________________________________ |
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| Doctor details | Qualification: MBBS / MD (Chest) / DM (Pulmo / DNB / D3CH) / MD (Med) / DNB (Med) |
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| | Any other, please specify: _________________________________________ |
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| | Years of Practice: __________________________ |
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| | Practice setting: Private Clinic / Private Hospital / Govt. Hospital |
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| | Specialization: Chest Physician / Consulting Physician / General Physician / |
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| | Other (please specify) _______________ |
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| | City _________________________________ State _____________________ |
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| Physician practice profile | - On an average how many patients do you see per month? |
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| | _______________ |
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| | - Approximately how many asthma patients do you manage per month? |
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| | - New patients: ___ |
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| | - Follow-up/old patients: ___ |
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| | - Approximately how many COPD patients do you manage per month? |
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| | - New patients: ___ |
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| | - Follow-up/old patients: ___ |
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| Foracort prescribing pattern | Approximately what proportion of your asthma patients receive Formoterol/Budesonide |
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| | - _____ % |
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| | Approximately what proportion of your COPD patients receive Formoterol/Budesonide |
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| | - ? _____ % |
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| | - Among your patients receiving Foracort, approximately what proportion do you prescribe: |
| | |
| | ------------------------------------------------------------------------ |
| | Pack type Asthma COPD |
| | ------------------------ --------------- --------------- --------------- |
| | Regular Pack¹ pMDI ___% ___% |
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| | Rotacap ___% ___% |
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| | Extended- Dose Pack² pMDI ___% ___% |
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| | Rotacap ___% ___% |
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| | Total Rotacap 100% 100% |
| | ------------------------------------------------------------------------ |
| | |
| | +--------------------------------------------------------------------------------------------------------+ |
| | | ^(1:) Regular Pack - Formoterol/Budesonide 200 & 400mcg - Rotacaps (pack of 30) & MDI (120 doses) | |
| | | | |
| | | ² : Extended-Dose Pack - Formoterol/Budesonide 200 & 400 mcg - Rotacaps (pack of 60) & MDI (180 doses) | |
| | | | |
| | | Ref: 1 : Note: The unit dose cost for DPI & MDI remains same irrespective of the pack size | |
| | +========================================================================================================+ |
| | +--------------------------------------------------------------------------------------------------------+ |
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| Physician assessment of adherence | - Based on your clinical experience, approximately what proportion of patients are adherent to their prescribed treatment? |
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| | (Please provide your estimate out of 100 patients) |
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| | ------------------------------------------------------------------------ |
| | Pack type Asthma COPD |
| | ------------------------ --------------- --------------- --------------- |
| | Regular Pack pMDI ___ / 100 ___ / 100 |
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| | Rotacap ___ / 100 ___ / 100 |
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| | Extended- Dose-Pack pMDI ___ / 100 ___ / 100 |
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| | Rotacap ___ / 100 ___ / 100 |
| | ------------------------------------------------------------------------ |
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| Physician assessment of adherence | Compared with patients receiving the regular pack, adherence among patients receiving the extended-dose pack is: |
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| | - Much better |
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| | - Somewhat better |
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| | - No difference |
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| | - Somewhat worse |
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| | - Much worse |
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| | - Unable to assess |
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| Reasons for non-adherence | - In your opinion What are the key barriers to adherence to inhaled maintenance therapy of formoterol/budesonide in your asthma and COPD patients? |
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| | - Side effects |
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| | - Lack of understanding of the need for regular treatment |
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| | - Delay in refill due to poor accessibility |
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| | - Perception that medication is not required when symptoms improve |
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| | - Fear/concerns about long-term medication |
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| | - Cost |
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| | - Difficulty remembering to take doses |
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| | - Inhaler technique difficulties |
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| | - Patient lifestyle/work-related factors |
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| | - Other (Specify): _____________________________________________ |
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| Patient characteristics associated with adherence | - Which patients, in your opinion, are most likely to benefit from an Extended dose Pack? |
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| | - Elderly patients |
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| | - Difficulty in accessing the pharmacy for a refill (e.g. Remote location) |
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| | - Patients with frequent exacerbations |
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| | - Patients frequently forgetting doses |
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| | - Patients taking multiple medications |
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| | - Patients with poor disease awareness |
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| | - All patients requiring long-term maintenance therapy |
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| | - Busy Lifestyle / working professional |
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| | - Frequent travellers |
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| | - Caregiver-dependent patients |
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| | - Other: ______ |
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| Physician perspective on the Extended-Dose Pack | - What do you consider the main advantages / disadvantages of the Extended-Dose Pack compared to Regular Pack |
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| | Advantages: ________________________________________________________ |
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| | Disadvantages: ____________________________________________________ |
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- Overall, how would you rate the Extended-Dose Pack compared with the Regular Pack with respect to:
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Attribute Strongly disagree Disagree Neither agree nor disagree Agree Strongly Agree
---------------------------------------------------------------------------------------------------------------- ------------------- ---------- ---------------------------- ------- ----------------
Using an adherence pack is more convenient for patients ○ ○ ○ ○ ○
Using an adherence pack reduces the frequency of medication refills ○ ○ ○ ○ ○
Using an adherence pack improves medication adherence ○ ○ ○ ○ ○
Using an adherence pack helps in maintaining treatment continuity ○ ○ ○ ○ ○
Using an adherence pack improves patient satisfaction ○ ○ ○ ○ ○
Using an adherence pack helps achieve better disease control ○ ○ ○ ○ ○
Using an adherence pack is more cost-beneficial for patients because it reduces the frequency of doctor visits ○ ○ ○ ○ ○
Using an adherence pack may be detrimental because it can delay follow-up visits with the doctor ○ ○ ○ ○ ○
Patients are reluctant to bear the higher initial purchase amount
Higher chance of damage to Rotacaps due to humidity in the extended-dose pack
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