{{ $DoctorName }} @if (isset(session()->get('doctor')['vCentralCode'])) {{ session()->get('doctor')['vCentralCode'] }} @endif
@if (isset(session()->get('doctor')['vCentralCode'])) @endif

{{ $ActivityTypeName }}

{{ $ActivityName }}

@csrf
@if (isset(session()->get('doctor')['vCentralCode'])) @else
@endif
Survey Questionnaire

An observational cross-sectional survey to understand the management paradigm of bronchial asthma and role of various combination therapies of fixed-dose inhaled corticosteroids (ICS) and long acting ẞ2 agonist (LABA) in Indian settings

Questionnaire

  1. How many patients of asthma do you see every month in your practice approximately?
  2. What is the relative percentage of disease severity amongst the patients of asthma? *
  3. Percentage
    Mild
    %
    Mild to moderate
    %
    Moderate to severe
    %
    Severe
    %
  4. What are the most common symptoms that patients with asthma present in your practice? *
  5. Symptoms Tick all applicable
    Cough

    Chest Tightness

    Mucus secretion

    Breathlessness

  6. What are the cardinal signs you observe in your asthma patients? *
  7. Signs Tick all applicable
    Sputum production

    Wheezing

    Increased respiratory rate

    Dyspnea

  8. What are the most common diagnostic investigations you perform in your practice? *
  9. Tick all applicable
    Chest X-ray

    Pulmonary Function Test (PFT)

    Complete blood count for serum eosinophils

    Allergen testing

    HRCT

    High resolution compounded tomography

    FeNO

  10. Which are the most common comorbidities you observe associated with asthma in your practice? *
  11. Comorbidity Percentage of patients
    %
    %
    %
    %
  12. What is the duration of follow-up visits of patients of asthma in your practice? *
  13. Kindly mention duration in weeks
    Mild
    Mild to moderate
    Moderate to severe
    Severe
  14. Which is your preferred therapy choice for various asthma severity? *
  15. ICS, ICS + LABA, ICS+LABA+LAMA Formulation Nebulization/Inhaler Duration of therapy
    Mild
    Mild to moderate
    Moderate to severe
    Severe
  16. What are the factors determining your choice of ICS+LABA combination? *
  17. Tick all applicable
    Efficacy

    Quick onset of action

    Duration of action

    Convenient dosing for patient adherence

  18. Which is the preferred choice of ICS+LABA combination as per GINA categories of patients in your practice? *
  19. GINA Preferred ICS+LABA combination
    Step 1
    Step 2
    Step 3
    Step 4
    Step 5
  20. Which is the preferred ICS+LABA combination as per ACT score? *
  21. Preferred ICS+LABA combination
    More than 20
    16-19
    <15
  22. Which ICS+LABA combination do you prefer in your practice as maintenance/controller of asthma symptoms? *
  23. ICS+LABA Combination Dosage Form (MDI/DPI/NEB) Duration of therapy in weeks
    Formoterol + Budesonide
    Vilanterol + Fluticasone Furoate
    Salmeterol + Fluticasone Propionate
    Formoterol +Fluticasone Propionate
    Indacaterol + Mometasone
  24. Which is the preferred reliever with ICS+LABA combination? *
  25. ICS+LABA Combination Preferred Reliever
    Formoterol + Budesonide
    Vilanterol + Fluticasone Furoate
    Salmeterol + Fluticasone Propionate
    Formoterol +Fluticasone Propionate
    Indacaterol + Mometasone
  26. Do you prefer switching patients of controlled asthma from BD ICS+LABA to OD ICS+uLABA? *
  27. Which type of patients do you prefer combination therapy of VI+FF? *
  28. Percentage Dose 100 or 200 Duration of therapy in weeks
    Mild
    %
    {{-- --}}
    Mild to moderate
    %
    {{-- --}}
    Moderate to severe
    %
    {{-- --}}
    Severe
    %
    {{-- --}}
  29. VI+FF is a preferred combination in which category of patients? *
  30. VI+FF is a preferred choice in which of the following patient profiles in your practice? *
  31. Tick wherever applicable
    Maintenance therapy for controlled patients

    Patient with exacerbations

  32. What makes VI+FF a preferred choice over other BID ICS+LABA? *
  33. Do you feel OD dosing of VI+FF improves patient adherence in your practice? *
  34. In your practice, what is the percentage of patients who have been switched from BID ICS+LABA to OD ICS+LABA? *
  35. Do you prefer VI+FF in patients with cardiovascular comorbidity or high risk for cardiac diseases? *
  36. Please mention any unmet medical need that may improve patient outcome in patients with asthma *
{{-- Backend Script --}} {{-- Backend Script ends --}}