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Study Questionnaire — Survey Questionnaire Version 01 (Date: 14/10/2026)

CREST Pvt. Ltd. — Confidential

Study title: Physicians' Perceptions of the Impact of an Extended-Dose Pack versus Regular Pack on Adherence to Inhaled Maintenance Medication in Asthma and COPD: A Cross-Sectional Survey

Section 1: Basic Demographics / Doctor Details

  • Name: ______
  • Qualification (single choice): MBBS / MD (Chest) / DM (Pulmo / DNB / DCH) / MD (Med) / DNB (Med) / Any other (specify): ______
  • Years of Practice: ______
  • Practice setting (multi-select): Private Clinic / Private Hospital / Govt. Hospital
  • Specialization (single choice): Chest Physician / Consulting Physician / Other (specify): ______
  • City: ______
  • State (dropdown): all Indian states and union territories

Section 2: Physician Practice Profile

  1. On an average, how many patients do you see per month? ______
  2. Approximately how many asthma patients do you manage per month?
    • New patients: ___
    • Follow-up/old patients: ___
  3. Approximately how many COPD patients do you manage per month?
    • New patients: ___
    • Follow-up/old patients: ___

Section 3: Foracort Prescribing Pattern

  1. Approximately what proportion of your asthma patients receive Formoterol/Budesonide? ___ %
  2. Approximately what proportion of your COPD patients receive Formoterol/Budesonide? ___ %
  3. For how long have you been prescribing the Extended-Dose Pack to your patients with asthma and/or COPD? (single choice)
    • Less than 6 months
    • 6 months to less than 1 year
    • More than 1 year
  4. Among your patients receiving Foracort, approximately what proportion do you prescribe (each column must total 100%):
Pack type Product Pack info Asthma COPD
Regular Pack Formoterol/Budesonide 200 & 400 mcg pMDI 120 doses (unit dose cost same for 120 and 180 dose packs) ___% ___%
Regular Pack Rotacap Pack of 30 (unit dose cost same for 30 and 60 dose pack) ___% ___%
Extended-Dose Pack Formoterol/Budesonide 200 & 400 mcg pMDI 180 doses (unit dose cost same for 120 and 180 dose packs) ___% ___%
Extended-Dose Pack Rotacap Pack of 60 (unit dose cost same for 30 and 60 dose pack) ___% ___%
Total 100% 100%

Section 4: Physician Assessment of Adherence

  1. Based on your clinical experience, approximately what proportion of patients are adherent to their prescribed treatment? (Estimate out of 100 patients.)

    Note: A patient is considered "adherent" if the physician believes the patient takes at least 75% of the prescribed inhaled maintenance medication doses during a typical month of treatment.

Pack type Product Asthma COPD
Regular Pack Formoterol/Budesonide 200 & 400 mcg pMDI (120 doses) ___ / 100 ___ / 100
Regular Pack Rotacap (pack of 30) ___ / 100 ___ / 100
Extended-Dose Pack Formoterol/Budesonide 200 & 400 mcg pMDI (180 doses) ___ / 100 ___ / 100
Extended-Dose Pack Rotacap (pack of 60) ___ / 100 ___ / 100
  1. Compared with patients receiving the regular pack, adherence among patients receiving the extended-dose pack is: (single choice)
    • Much better
    • Somewhat better
    • No difference
    • Somewhat worse
    • Much worse
    • Unable to assess

Section 5: Reasons for Non-adherence

  1. In your opinion, what are the key barriers to adherence to inhaled maintenance therapy of formoterol/budesonide in your asthma and COPD patients? (multi-select)
    • Side effects
    • Lack of understanding of the need for regular treatment
    • Delay in refill due to poor accessibility
    • Perception that medication is not required when symptoms improve
    • Fear/concerns about long-term medication
    • Cost
    • Difficulty remembering to take doses
    • Inhaler technique difficulties
    • Patient lifestyle/work-related factors
    • Other (specify): ______

Section 6: Patient Characteristics Associated with Adherence

  1. Which patients, in your opinion, are most likely to benefit from an Extended-dose pack? (multi-select)
    • Elderly patients
    • Difficulty accessing the pharmacy for a refill (e.g., remote location)
    • Patients with frequent exacerbations
    • Patients frequently forgetting doses
    • Patients taking multiple medications
    • Patients with poor disease awareness
    • All patients requiring long-term maintenance therapy
    • Busy lifestyle / working professional
    • Frequent travellers
    • Caregiver-dependent patients
    • Other: ______

Section 7: Physician Perspective on the Extended-Dose Pack

  1. What do you consider the main advantages / disadvantages of the Extended-Dose Pack compared to the Regular Pack?

    • Advantages: ______
    • Disadvantages: ______

  2. Overall, how would you rate the Extended-Dose Pack compared with the Regular Pack with respect to the following? (Likert scale per row: Strongly disagree / Disagree / Neither agree nor disagree / Agree / Strongly agree)

    1. Using an adherence pack is more convenient for patients
    2. Using an adherence pack reduces the frequency of medication refills
    3. Using an adherence pack improves medication adherence
    4. Using an adherence pack helps in maintaining treatment continuity
    5. Using an adherence pack improves patient satisfaction
    6. Using an adherence pack helps achieve better disease control
    7. Using an adherence pack is more cost-beneficial for patients because it reduces the frequency of doctor visits
    8. Using an adherence pack may be detrimental because it can delay follow-up visits with the doctor
    9. Patients are reluctant to bear the higher initial purchase amount
    10. Higher chance of damage to Rotacaps due to humidity in the extended-dose pack

    Note: In the source PDF, rows 9 and 10 appear without the rating options (the page appears cut off); they are presumably meant to use the same 5-point scale.