Simple Steroid replacement therapy changeover- International Survey

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* 1. In general, would you say your health is

1. Excellent

2. Very good

3. Good

4. Fair

5. Poor

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* 2. These questions are about how you feel and how things have been with you during the past 7 days. For each question, please give the one answer that comes closest to the way you have been feeling.

How much of the time during the past 7 days . . .

	1. All of the Time	2. Most of the Time	3. A Good Bit of the Time	4. Some of the Time	5. A Little of the Time	6. None of the Time
Did you feel full of pep?	Did you feel full of pep? 1. All of the Time	Did you feel full of pep? 2. Most of the Time	Did you feel full of pep? 3. A Good Bit of the Time	Did you feel full of pep? 4. Some of the Time	Did you feel full of pep? 5. A Little of the Time	Did you feel full of pep? 6. None of the Time
Have you been a very nervous person?	Have you been a very nervous person? 1. All of the Time	Have you been a very nervous person? 2. Most of the Time	Have you been a very nervous person? 3. A Good Bit of the Time	Have you been a very nervous person? 4. Some of the Time	Have you been a very nervous person? 5. A Little of the Time	Have you been a very nervous person? 6. None of the Time
Have you felt so down in the dumps that nothing could cheer you up?	Have you felt so down in the dumps that nothing could cheer you up? 1. All of the Time	Have you felt so down in the dumps that nothing could cheer you up? 2. Most of the Time	Have you felt so down in the dumps that nothing could cheer you up? 3. A Good Bit of the Time	Have you felt so down in the dumps that nothing could cheer you up? 4. Some of the Time	Have you felt so down in the dumps that nothing could cheer you up? 5. A Little of the Time	Have you felt so down in the dumps that nothing could cheer you up? 6. None of the Time
Have you felt calm and peaceful?	Have you felt calm and peaceful? 1. All of the Time	Have you felt calm and peaceful? 2. Most of the Time	Have you felt calm and peaceful? 3. A Good Bit of the Time	Have you felt calm and peaceful? 4. Some of the Time	Have you felt calm and peaceful? 5. A Little of the Time	Have you felt calm and peaceful? 6. None of the Time
Did you have a lot of energy?	Did you have a lot of energy? 1. All of the Time	Did you have a lot of energy? 2. Most of the Time	Did you have a lot of energy? 3. A Good Bit of the Time	Did you have a lot of energy? 4. Some of the Time	Did you have a lot of energy? 5. A Little of the Time	Did you have a lot of energy? 6. None of the Time
Have you felt downhearted and blue?	Have you felt downhearted and blue? 1. All of the Time	Have you felt downhearted and blue? 2. Most of the Time	Have you felt downhearted and blue? 3. A Good Bit of the Time	Have you felt downhearted and blue? 4. Some of the Time	Have you felt downhearted and blue? 5. A Little of the Time	Have you felt downhearted and blue? 6. None of the Time
Did you feel worn out?	Did you feel worn out? 1. All of the Time	Did you feel worn out? 2. Most of the Time	Did you feel worn out? 3. A Good Bit of the Time	Did you feel worn out? 4. Some of the Time	Did you feel worn out? 5. A Little of the Time	Did you feel worn out? 6. None of the Time
Have you been a happy person?	Have you been a happy person? 1. All of the Time	Have you been a happy person? 2. Most of the Time	Have you been a happy person? 3. A Good Bit of the Time	Have you been a happy person? 4. Some of the Time	Have you been a happy person? 5. A Little of the Time	Have you been a happy person? 6. None of the Time
Did you feel tired?	Did you feel tired? 1. All of the Time	Did you feel tired? 2. Most of the Time	Did you feel tired? 3. A Good Bit of the Time	Did you feel tired? 4. Some of the Time	Did you feel tired? 5. A Little of the Time	Did you feel tired? 6. None of the Time
Did you feel nauseous?	Did you feel nauseous? 1. All of the Time	Did you feel nauseous? 2. Most of the Time	Did you feel nauseous? 3. A Good Bit of the Time	Did you feel nauseous? 4. Some of the Time	Did you feel nauseous? 5. A Little of the Time	Did you feel nauseous? 6. None of the Time

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* 3. How convenient is your hydrocortisone or prednisolone replacement therapy?

1. Very convenient

2. Convenient

3. OK

4. Inconvenient

5. Very inconvenient

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* 4. I am currently on

1. Hydrocortisone

2. Prednisolone

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* 5. What dose are you taking in total each day (in mg) of hydrocortisone or prednisolone?

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* 6. I take my prednisolone or hydrocortisone

1. Once daily

2. Twice daily

3. Three times daily

4. Four times daily

I split my dose as follows (eg 10mg in the morning, 5 at lunchtime and 5 at 4pm)

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* 7. When do you take your FIRST dose in the morning

Immediately on waking before doing anything else

At least 30 minutes after waking

I make sure I have something to eat before taking my first dose

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* 8. Finally please fill in the following details

Patient Initials and number:

Centre/Location:

Date:

Doctors email address

Any other comments

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* 1. In general, would you say your health is

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* 2. These questions are about how you feel and how things have been with you during the past 7 days. For each question, please give the one answer that comes closest to the way you have been feeling.How much of the time during the past 7 days . . .

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* 3. How convenient is your hydrocortisone or prednisolone replacement therapy?

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* 4. I am currently on

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* 5. What dose are you taking in total each day (in mg) of hydrocortisone or prednisolone?

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* 6. I take my prednisolone or hydrocortisone

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* 7. When do you take your FIRST dose in the morning

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* 8. Finally please fill in the following details

* 2. These questions are about how you feel and how things have been with you during the past 7 days. For each question, please give the one answer that comes closest to the way you have been feeling.

How much of the time during the past 7 days . . .