Protocol - Health Conditions, Medications and Health Care During COVID-19 Pandemic

READ: I would like to ask you about your other health conditions and how your health care has been impacted by the COVID-19 pandemic.

1. Do you have any of the following conditions? (Select all that apply)

(SKIP to Q2 if all No)

   1a. Specify: ___________________

   1b. Are you currently taking any medications for any of these conditions?

1[ ]Yes

0[ ]No

   1c. Are you currently taking any medications for any other health or mental health conditions?

1[ ]Yes

0[ ]No

   (SKIP to 2 if 1b and 1c are both No)

   1d. How many days’ worth of medication do you currently have at home? If you take more than one medication, choose the medication you have the lowest supply of.

   __________ days (If >30 days, skip to Q2)

   1e. Have you made arrangements to get your medication refill/s?

0[ ]No

1[ ]You have been able to arrange for some medication refills but not all

2[ ]You are waiting to hear from your physician on how to refill medications

3[ ]Yes, home delivery

4[ ]Yes, you will be picking up from the pharmacy

5[ ]Yes, someone will be picking up your medications for you

2. Since the COVID-19 pandemic (March 1, 2020), have you needed to postpone any medical procedures?

1[ ]Yes

0[ ]No

3. In the past month, have you missed any scheduled appointments with any health care provider?

1[ ]Yes

0[ ]No (SKIP to 4)

97[ ]Don’t Know (SKIP to 4)

98[ ]Refused to answer (SKIP to 4)

   3a. What is the MAIN reason you missed appointments with any healthcare provider in the past month?

1[ ]Your clinic cancelled your appointment because of COVID-19

2[ ]Your clinic is closed because of the COVID-19

3[ ]You had symptoms of COVID-19, so you stayed home

4[ ]You cancelled the appointment to avoid being around others

5[ ]You cancelled the appointment because you did not want to be in a healthcare setting

6[ ]You felt okay or good enough

7[ ]You didn’t have money or insurance

8[ ]You didn’t want to take public transportation and had no other way to get there

9[ ]You forgot to go/just missed your appointment

10[ ]You felt disrespected by the office or medical staff

12[ ]You were drinking/using drugs

12[ ]Other (specify)

97[ ]Don’t know

98[ ]Refused to answer

3a1. Specify: __________

4. In the past month, have you missed taking any medications?

1[ ]Yes

0[ ]No (SKIP to Q4)

97[ ]Don’t Know (SKIP to Q4)

98[ ]Refused to answer (SKIP to Q4)

   4a. What is the MAIN reason you missed taking medications in the past month?

1[ ]You couldn’t get your medications because the pharmacy closed

2[ ]You couldn’t get to the pharmacy because of COVID-19 shutdowns

3[ ]You couldn’t get to the pharmacy because you wanted to avoid being around others

4[ ]You felt good, didn’t need your medications

5[ ]Your doctor advised you to delay treatment

6[ ]You were worried about side effects

7[ ]You didn’t have money or insurance to get medicine

8[ ]You didn’t want to take public transport to pick up your prescription and had no other way to get there

9[ ]You were drinking or using drugs

10[ ]You forgot to take your medications

11[ ]Other (specify)

97[ ]Don’t know

98[ ]Refused to answer

       4a1. Specify: ______________