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A0 - Please enter respondent unique id


Section A: Introduction and screening


This research is being conducted by an independent market research company called Insight Dojo and is on the topic of Opioid Induced Constipation

We are really interested to hear about your experiences in the area, and your responses will help shape the products and services that are available to people such as yourself.

Some of the questions in this survey are of a sensitive nature, but please be assured that any information you provide us with today will remain fully confidential, and none of the responses will be attributed to you personally.


In the first section we would like to ask a few basic questions about your health and medication. This section will take approximately 5 minutes to complete, but all questions must be filled in in order to progress.


Q1 - What is your gender?


Q2 - How old are you?


Q3 - Thinking specifically about your health, which of the following, if any, apply:


Q4a - Thinking about the pain for which you are currently taking medication, which of the following best describes this:


Q4b - You mentioned that you are currently taking medication to control pain. For which of these following conditions are you currently taking medication to control?


Q5 - Which of these pain conditions causes you the most severe pain i.e., the one for which you need the strongest pain treatment?


Q6 - Given below is a list of opioid drugs that people take for pain relief.
Are you currently taking any from the list below:
Yes No
1. Ossicodone/naloxone e.g Targin
2. Tapentadolo e.g. Palexia
3. Ossicodone/paracetamolo e.g. Depalgos
4. Fentanyl e.g. Durogesic, Matrifen, Effentora, Abstral, Durfenta, Alghedon, Pecfent, Actiq, Instanyl, Vollofent
5. Metadone
6. Ossicodone e.g. Oxycontin
7. Buprenorfina e.g Busette, Transtec
8. Morfina e.g. oramorph
9. Idromorfone e.g. Jurnista
1. Codeina/Paracetamolo e.g. Tachidol
2. Codeina/Ibuprofene


dOpiods - dOpiods (Auto Select)


Q6b - Which of the following formats of opioid medication are you currently taking for pain relief?


Q7 - Roughly, how long ago were you first prescribed opioid drugs for {{Q5}}?


Now we would like to ask you a few questions about your digestive health e.g., pain or discomfort related to your stomach or bowels. Let us start with your bowel movements.


Q8a - Over the past ONE week, on how many days did you have bowel movements?


Q8b - To what extent is moving your bowels bothersome for you (e.g. because you cannot use the toilet as often as you would like, or because you experience pain, discomfort, or difficulties with daily activities)?


Q10 - Thinking back to the time before you started taking opioid medications.
How was your experience of constipation then compared to the constipation you have now?


Q10b - Below is a chart that represents different types of stools.

Which of the stool types shown on the chart have you experienced in the past week? Select all that apply.


Dummy_1 - Patient has opioid induced constipation


Section B: General QoL and impact of pain on life


In this section, we would like you to ask a few questions about your life and health in recent times.
Please answer the questions below as honestly as you can.


Q11a - Please respond to each question or statement by marking one option per row.
Poor Fair Good Very good Excellent
In general, would you say your health is:


Q11e - How would you rate your pain on average? Please answer on a scale of 0 to 10, where 0 indicates ‘no pain’ and 10 indicates ‘worst pain imaginable’


Section C1: Opioids management


Thank you for your time so far. In the next section we would like to ask a few questions about your experience of using opioids to manage {{Q5}}


Q17b - Thinking about a typical week, how many times do you take/use/apply the medication you use for pain relief?


Q19 - Generally speaking, how easy or difficult do you find it to stick to the opioid regime that your doctor has prescribed?


Q31 - We would like to understand your general bowel health before you started taking opioids. To your memory, which of the following, if any, did you experience at least twice a week before you started taking opioids?


Section D: Experience of OIC


Earlier in the survey you indicated that you are currently suffering from constipation. In the next section we would like to ask you some specific questions about this.


This section is designed to measure the impact constipation has had on your daily life over the past 2 weeks.
      • Answer each question according to your experience as accurately as possible. There are no right or wrong answers.
      • Please tick the box that best represents how you feel.


Q35a - The following questions ask about your symptoms related to constipation. During the past 2 weeks, to what extent or intensity have you
Not at all A little bit Moderately Quite a bit Extremely
Felt bloated to the point of bursting?
Felt heavy because of your constipation?


Q35b - The next few questions ask about how constipation affects your daily life. During the past 2 weeks, how much of the time have you...
None of the time A little of the time Some of the time Most of the time All of the time
Felt any physical discomfort?
Felt the need to have a bowel movement but not been able to?
Been embarrassed to be with other people?
Been eating less and less because of not being able to have bowel movements?


Q35c - The next few questions ask about how constipation affects your daily life. During the past 2 weeks, to what extent or intensity have you...
Not at all A little bit Moderately Quite a bit Extremely
Had to be careful about what you eat?
Had a decreased appetite?
Been worried about not being able to choose what you eat (for example, at a friend’s house)?
Been embarrassed about staying in the bathroom for so long when you were away from home?
Been embarrassed about having to go to the bathroom so often when you were away from home?
Been worried about having to change your daily routine (for example, travelling, being away from home)?


Q35d - The next few questions ask about your feelings related to constipation. During the past 2 weeks, how much of the time have you...
None of the time A little of the time Some of the time Most of the time All of the time
Felt irritable because of your condition?
Been upset by your condition?
Felt obsessed by your condition?
Felt stressed by your condition?
Felt less self-confident because of your condition?
Felt in control of your situation?


Q35e - The next questions ask about your feelings related to constipation. During the past 2 weeks, to what extent or intensity have you...
Not at all A little bit Moderately Quite a bit Extremely
Been worried about not knowing when you are going to be able to have a bowel movement?
Been worried about not being able to have a bowel movement?
Been more and more bothered by not being able to have a bowel movement?


Q35f - The next questions ask about your life with constipation. During the past 2 weeks, how much of the time have you...
None of the time A little of the time Some of the time Most of the time All of the time
Been worried that your condition will get worse?
Felt that your body was not working properly?
Had fewer bowel movements than you would like?


Q35g - The next questions ask about your degree of satisfaction related to constipation. During the past 2 weeks, to what extent or intensity have you been...
Not at all A little bit Moderately Quite a bit Extremely
Satisfied with how often you have a bowel movement?
Satisfied with the regularity of your bowel movements?
Satisfied with the time it takes for food to pass through the intestines?
Satisfied with your treatment?


Thank you for your time. You have reached the end of the survey.




 


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