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1*
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How satisfied or dissatisfied are you with the ability of the medication to prevent or treat your condition?
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2*
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How satisfied or dissatisfied are you with the way the medication relieves your symptoms?
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3*
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How satisfied or dissatisfied are you with the amount of time it takes the medication to start working?
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4**
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As a result of taking this medication, do you currently experience any side effects at all?
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5
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How bothersome are the side effects of the medication you take to treat your condition?
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6
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To what extent do the side effects interfere with your physical health and ability to function (i.e., strength, energy levels, etc.)?
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7
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To what extent do the side effects interfere with your mental function (i.e., ability to think clearly, stay awake, etc.)?
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8
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To what degree have medication side effects affected your overall satisfaction with the medication?
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9
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How easy or difficult is it to use the medication in its current form?
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10
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How easy or difficult is it to plan when you will use the medication each time?
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11
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How convenient or inconvenient is it to take the medication as instructed?
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12
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Overall, how confident are you that taking this medication is a good thing for you?
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13
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How certain are you that the good things about your medication outweigh the bad things?
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14*
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Taking all things into account, how satisfied or dissatisfied are you with this medication?
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