1
RUSSELL RESEARCHRMR #14-01-004
ONE MEADOWLANDS PLAZA, STE. 1001January 2014
EAST RUTHERFORD, NJ 07073
(201) 528-0400
AF SURVEY PROJECT
PHYSICIANS
PROGRAMMER, DISPLAY: Please note that all answers provided by you in this survey are completely confidential and will only be analyzed in aggregate. This means all answers provided today will not be personally identifiable and cannot be linked to any of your personal information.
Please answer the questions on each screen and click the “Next” button to continue.
A.Please check your gender. (ALLOW ONE ANSWER.)
Male...... ( )1...123
Female...... ( )2
B.Please enter your age in the box below. (ASSIGN RANGES BELOW)…124-25
25 - 34...... ( )1…126
35 - 44...... ( )2
45 - 54...... ( )3
55 - 64...... ( )4
65 or older...... ( )5
IF “25OR OLDER”: Continue screening with Q. C.
OTHERWISE: Terminate and tally.
C.Which of the following best describes your specialty? (RANDOMIZE & ALLOW ONE ANSWER.)
Cardiologist(n=200)...... ( )1…127
Electrophysiologist(n=100)...... ( )2
Neurologist(n=50)...... ( )3
Primary Care Physician...... ( )4
(n=150)Internal Medicine...... ( )5
Family Practice...... ( )6
Other (Please Specify)...... TERMINATE7
IF ONE OF THE BOLDED SPECIALTIES AND NOT OVER QUOTA FOR THAT CELL: Continue screening with Q. D.
OTHERWISE: Terminate and tally.
hold_qcSpecialty…131
Cardiologist1
Electrophysiologist2
Neurologist3
PCP / Internal / Family4
D.For how many years have you been in practice since residency or fellowship? (ALLOW RANGE OF 0-99)
Number of Years...... …132-33
Less than one year( )1 …134
E.Approximately how many AFib-related stroke patients have you treated in the past year? (ALLOW RANGE OF 0-9999)
Number of Patients...... …135-38
IF NEUROLOGIST & 25 OR MORE: Ask Q.F Next.
IF OTHER SPECIALTY & 10 OR MORE: Ask Q.F Next.
OTHERWISE: Terminate and tally.
F.About what percent of your time is spent in clinical practice or direct patient care as opposed to teaching or administration? (ALLOW RANGE OF 0-100)
% of Time...... …139-41
IF 70 OR MORE: Ask Q.G Next.
OTHERWISE: Terminate and tally.
G.Are you board-certified, board-eligible, or neither in your primary specialty? (ALLOW ONE ANSWER.)
Board-certified...... ( )1...142
Board-eligible...... ( )2
Neither...... TERMINATE 3
IF “BOARD CERTIFIED/ELIGIBLE”: Continue screening with Q. G.
IF “NEITHER”: Terminate and tally.
H.Are you or anyone in your immediate household employed by a pharmaceutical manufacturer? (ALLOW ONE ANSWER.)
Yes...... TERMINATE 1...143
No...... ( )2
IF “NO”: Continue screening with Q. I
IF “YES”: Terminate and tally.
I.Do you regularly see patients with any of the following medical conditions? (ALLOW MULTIPLE ANSWERS.)
Chronic Pain...... ( )1...144
Parkinson’s...... ( )2
Atrial Fibrillation...... ( )3
Migraine headache...... ( )4
Epilepsy...... ( )5
Stroke...... ( )6
None of the above...... TERMINATE 7
IF ANY SPECIALTY OTHER THAN NEUROLOGIST AND “ATRIAL FIBRILLATION” CHECKED: Continue screening with Q.I.
IF NEUROLOGISTAND “STROKE”CHECKED: Continue screening with Q.K.
OTHERWISE: Terminate and tally.
IF “NEUROLOGIST”, INSERT “STROKE” INSTEAD OF “ATRIAL FIBRILLATION IN Q.K
J.What is the average age of your (Stroke/Atrial Fibrillation)patients? (ALLOW ONE ANSWER.)
Under 18...... TERMINATE 1...145
18 – 29...... ( )2
30 – 39...... ( )3
40 – 49...... ( )4
50 – 59...... ( )5
60 – 69...... ( )6
70 – 79...... ( )7
80 – 84...... ( )8
85 or older...... ( )9
IF “18 OR OLDER”: Respondent now qualified. Continue with main interview.
OTHERWISE: Terminate and tally.
PROGRAMMER, DISPLAY: The rest of this survey will be about Atrial Fibrillation and Strokes in general, and not anything specific about your patients. Throughout this survey, please think of your general patient population and not specific patients
1a.In an average 12 month time period, how manypatients withAtrial Fibrillation (AFib) do you see? (CHECK ONE ANSWER ONLY)
1 – 9 ...... ( ) 1...146
10 - 19...... ( ) 2
20 - 49...... ( ) 3
50 - 99...... ( ) 4
100 - 149...... ( ) 5
150 - 199...... ( ) 6
200 or more...... ( ) 7
I do not see Atrial Fibrillation patients...... ( ) 8
1b.And what percentage of your AFib patients have had a history of stroke? (ENTER PERCENTAGE)
Stroke Patient Percentage...... 147-49
2.In terms of reducing the risk of stroke in Atrial Fibrillation, what types of oral treatment options do you currently prescribe to your at-risk patients? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
Oral anticoagulant (“blood thinner”) – e.g. oral Vitamin K antagonist, oral direct thrombin inhibitor, oral Factor Xa inhibitor ( )1 …150
Antiplatelet – e.g. Aspirin, other antiplatelet...... ( )2
Other (Specify)...... ( )3
IF MORE THAN ONE OPTION CHECKED IN Q.2, ASK Q.3 NEXT. OTHERWISE, SKIP TO Q.4
3.What percentage of the time do you prescribe each of the following oral treatment options to your at-risk patients with Atrial Fibrillation to reduce their risk of stroke? (ENTER PERCENTAGE IN BOX PROVIDED. ONLY SHOW OPTIONS CHECKED IN Q.2a AND ANSWERS MUST EQUAL 100. ALLOW RANGE OF 1-100 FOR EACH)
Oral anticoagulant (“blood thinner”) – e.g. oral Vitamin K antagonist, oral direct thrombin inhibitor, oral Factor Xa inhibitor ...154-56
Antiplatelet – Aspirin, other antiplatelet...... 157
Other...... 160
ASK ALL
4.Of the following options, which best describes your primaryobjectivewhen prescribinganticoagulation therapy for patients with Atrial Fibrillation? (RANDOMIZE & CHOOSE ONE ANSWER.)
To reduce the risk ofAFib-related ischemic strokes....( )1…163
To minimize the risk of hemorrhagic strokes...... ( )2
Overall safety profile of the medication...... ( )3
To minimize potential adverse effects...... ( )4
Affordable for the patient...... ( )5
Ability to monitor anticoagulant effect...... ( )6
Other (Specify)...... ( )7
5a.When using anticoagulants to reduce the risk of stroke resultant from atrial fibrillation, what are your primary concerns? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
IF MORE THAN 1 ANSWER CHECKED IN Q.5a, ASK Q.5b NEXT.
5b.When using anticoagulants to reduce the risk of stroke resultant from atrial fibrillation, what do you see as the greatest concern? (SHOW ANSWERS GIVEN IN Q. 4a. RANDOMIZE & ALLOW ONE ANSWER.)
- 5a -- 5b –
PrimaryGreatest
ConcernsConcern
…167…172
Need for dual anti-platelet therapy...... ( )2( )2
Patient’s bleeding risk...... ( )3( )3
Overall safety profile of the medication...... ( )4( )4
Compliance...... ( )5( )5
Potential Adverse Events ...... ( )6( )6
Cost...... ( )7( )7
Patient preference...... ( )8( )8
...... …168…173
Dosing schedule for the patient...... ( )1 ( )1
Food and drug interactions...... ( )2 ( )2
Reversibility of the anticoagulant effect..... ( )3 ( )3
Minimizing the risk of hemorrhagic strokes.. ( )4 ( )4
Other (Specify)...... ( )5( )5
ASK ALL
PROGRAMMER, DISPLAY: Please read the case study below and answer the question that follows based on what you have read.
A 67 year old woman with hypertension presents with recurrent episodes of paroxysmal atrial fibrillation. She has no other past medical history.
6.Based on your experience, which of the following would you recommend for reducing this patient’s risk of stroke in atrial fibrillation? (ALLOW ONE ANSWER.)
Aspirin (low dose)...... ( )1...177
Aspirin (high dose)...... ( )2
Dual antiplatelet (low dose Aspirin and other antiplatelet)..( )3
Dual Antiplatelet therapy (high dose Aspirin and other antiplatelet)( )4
Oral anticoagulant (“blood thinner”) – oral Vitamin K antagonist, oral direct thrombin inhibitor, oral Factor Xa inhibitor ( )5
Note: This patient has a CHADS2 score of 1 (hypertension) and CHA2DS2VASc score of 3 (hypertension, woman, age >65).
7.Thinking about conversations you have had with your patients with Atrial Fibrillation about their increased risk of AFib-related stroke and available treatments, what percentage of the time would you say conversations are initiated by you versus those initiated by patients? (ENTER PERCENTAGE IN BOX PROVIDED. TOTAL MUST EQUAL 100)
Initiated by Physician...... xx-xx
Initiated by Patient...... xx-xx
8. From your experience, which of the following do you view as the greatest, second greatest and third greatest barriers when initiating therapy to reduce the risk of stroke in patients with atrial fibrillation? (RANDOMIZE & CHECK ONE ANSWER PER COLUMN)
2nd3rd
GreatestGreatestGreatest
-211-213-215
Patient risk of bleeding...... ( )1( )1( )1
Patient risk of falling...... ( )2( )2( )2
Risk of Adverse Events...... ( )3( )3( )3
Patient tolerability...... ( )4( )4( )4
Time to counsel patients on dietary restrictions...... ( )5( )5( )5
Time to counsel patients on medication risks and benefits..( )6( )6( )6
Lack of patient education resources...... ( )7( )7( )7
Dietary Restrictions...... ( )8( )8( )8
Drug-Drug Interactions...... ( )9( )9( )9
-212-214-216
Routine lab work required for monitoring...... ( )0( )0( )0
Prior authorizations or managing insurance coverage.....( )1( )1( )1
Affordability...... ( )2( )2( )2
Lack of samples...... ( )3( )3( )3
Unsure of patient’s stroke risk...... ( )4( )4( )4
Unsure of patient’s bleed risk...... ( )5( )5( )5
Patient resistance...... ( )6( )6( )6
Other (Specify)...... ( )7( )7( )7
c226-40 - NOT USED
9From your experience, what do you see as the greatest barrier to patient compliance in treatment therapy to reduce the risk ofischemic stroke due to AFib? (RANDOMIZE & ALLOW ONE ANSWER.)
Number of daily doses...... ( )1...241
Patients experiencing side effects due to the medication...( )2
Patient belief that they are at low-riskfor stroke
due to atrial fibrillation...... ( )3
Patients are more concerned about AFib symptom
management...... ()4
Patients are concerned about the risk of bleeding...... ( )5
Patients are concerned about cost...... ( )6
Monitoring anticoagulation effect (e.g. INR)...... ( )7
Dietary restrictions...... ( )8
Other (Specify)...... ( )9
10.Overall, which of the following statements accurately describes your typical patient’s understanding of how Atrial Fibrillation increases their risk ofischemic stroke? (ALLOW MORE THAN ONE ANSWER.)
My typical AFib patients are very knowledgeable about their
risk of ischemic stroke due to AFib...... ( )1...245
My average AFib patients are actively looking for ways to
reduce their risk of ischemic stroke due to AFib ...... ( )2
My average AFib patients do not usually understand their risk
of ischemic stroke due to AFib...... ( )3
11.How important do you think the following considerations are for your patients with Atrial Fibrillation? (RANDOMIZE - ALLOW ONE ANSWER FOR EACH.)
VeryNot VeryNot At All
ImportantImportantImportantImportant
-1--2--3--4-
Understanding Atrial Fibrillation and the associated risk of stroke ( )( )( )( ) …246
Learning about ways to manage Atrial Fibrillation( )( )( )( ) …247
Learning about treatment options that may reduce their risk of AFib-related ischemic stroke( )( ) ( ) ( ) …248
Reducing the symptoms of Atrial Fibrillation...( )( )( )( )…249
Reducing the risk of stroke due to
Atrial Fibrillation...... ( )( )( )( )…250
Minimizing the risk of hemorrhagic stroke....( )( )( )( )…252
Being able to afford their medication...... ( )( )( )( )…253
Being able to follow the treatment or dosing regimens( )( )( )( ) …254
c251 - NOT USED
12.In which, if any, of the following ways do you try to educate your patients with Atrial Fibrillation about the specifics of their condition and their increased risk ofAFib-related stroke? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
Give them written material to read (e.g. brochures, pamphlets, etc.) ( )1 …255
Direct them to associations or websites related specifically to heart conditions or AFib-related stroke ( )2
You personally discuss their situation with them directly ( )3
Have a nurse, educator, or other professional in my office discuss their situation with them ( )4
You give them educational CDs or DVDs...... ( )5
You direct them to download an app for a mobile phone, tablet computer or other device ( )6
Direct them to a pharmaceutical company website on the condition ( )7
Direct them to a pharmaceutical company website with information on medications to reduce risk of AFib-related stroke ( )8
Some other way (Specify)...... ( )9
13a.What do you see as barriers in terms of trying to educate your patients with Atrial Fibrillation about the specifics of their condition and their increased risk of AFib-related stroke? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
IF MORE THAN 1 ANSWER CHECKED IN Q.13a, ASK Q.13b NEXT.
13b.And what do you see as the primary barrier in terms of trying to educate your patients with Atrial Fibrillation about the specifics of their condition and their increased risk ofAFib-related stroke? (RANDOMIZE & CHECKONE ANSWER. SHOW ANSWERS CHECKED IN Q.13a)
=Q.13a==Q.13b=
BarriersPrimary
-259-264
They have trouble understanding what I am trying to explain to them (due to things such as age, cognitive issues, etc.) ( )1 ( )1
They don’t really believe that their condition is serious( )2( )2
They don’t believe that Atrial Fibrillation can cause stroke( )3( )3
They think that once their symptoms are being treated, the risk of AFib-related stroke goes away ( )4 ( )4
I don’t have enough time to fully discuss the issues with them( )5( )5
I don’t have nurses, educators, or other professionals in my office available to discuss their situation with them ( )6 ( )6
I don’t have literature to give them...... ( )7( )7
They feel the risks outweigh the benefits for medications reducing the risk of AFib-related stroke ( )8 ( )8
I don’t have any good websites to refer the patient to( )9( )9
-260-265
Other (Specify)...... ( )0( )0
14.In which, if any, of the following ways do you try to educate your patients with Atrial Fibrillation about treatment options to reduce the risk of AFib-related stroke? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
Give them written material to read (e.g. brochures, pamphlets, etc.) ( )1 …269
Direct them to associations or websites related specifically to heart conditions or AFib-related stroke ( )2
You personally discuss the treatment options with them ( )3
Have a nurse, educator, or other professional in my office discuss the treatment options with them ( )4
You give them educational CDs or DVDs...... ( )5
You direct to download an app for a mobile phone, tablet computer or other device ( )6
Direct them to a pharmaceutical company website on the condition ( )7
Direct them to a pharmaceutical company website with information on medications to reduce risk of AFib-related stroke ( )8
Some other way (Specify)...... ( )9
15a.What do you see as barriers in terms of trying to educate your patients with Atrial Fibrillation about treatment options to reduce the risk of AFib-related ischemic stroke? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
IF MORE THAN 1 ANSWER CHECKED IN Q.15a, ASK Q.15b NEXT.
15b.And what do you see as the primary barrier in terms of trying to educate your patients with Atrial Fibrillation about treatment options to reduce the risk of ischemic stroke? (RANDOMIZE & CHECK ONE ANSWER. SHOW ANSWERS CHECKED IN Q.15a)
=Q.15a==Q.15b=
BarriersPrimary
-273-278
They have trouble understanding what I am trying to explain to them (due to things such as age, cognitive issues, etc.) ( )1 ( )1
They don’t really believe that their AFib is serious and warrants medication( )2 ( )2
They don’t believe that Atrial Fibrillation can cause an ischemic stroke ( )3 ( )3
They think that once their symptoms are being treated, the risk of AFib-related stroke goes away ( )4 ( )4
I don’t have enough time to fully discuss the treatment options with them( )5 ( )5
I don’t have nurses, educators, or other professionals in my office available to discuss the treatment options with them ( )6 ( )6
I don’t have literature to give them...... ( )7( )7
They feel the risks outweigh the benefits for medications reducing the risk of AFib-related stroke ( )8 ( )8
I don’t have any good websites to refer the patient to( )9( )9
-274-279
Other (Specify)...... ( )0( )0
16.What resources would you like to have to discuss stroke risk and treatment options with your Atrial Fibrillation patients/caregivers? (RANDOMIZE & ALLOW MULTIPLE ANSWERS.)
Educational brochures/pamphlets/posters...... ( )1...311
Web-based illustrations/animations...... ( )2
Interactive videos...... ( )3
On-demand FAQs...... ( )4
Some other resources (Specify)...... ( )5
ASK ALL
17.How much do you agree or disagree with each of the following statements in terms of treatment of Atrial Fibrillation? (RANDOMIZE - ALLOW ONE ANSWER FOR EACH.)
AgreeAgreeDisagreeDisagree
StronglySomewhatSomewhatStrongly
-1--2--3--4-
I wish I had more information/educational materials to share with my Atrial Fibrillation patients that discuss stroke risk associated with Atrial Fibrillation ( ) ( ) ( ) ( ) …315
I wish I had more information/educational materials to share with my Atrial Fibrillation patients that discuss risks/benefits of treatment options to reduce the risk of stroke in Atrial Fibrillation ( ) ( ) ( ) ( ) …316
I regularly advise or remind my colleagues of the increased risk for ischemic stroke among Atrial Fibrillation patients ( ) ( ) ( ) ( ) …317
I believe many Atrial Fibrillation patients are in denial about their risk of experiencing an ischemic stroke( ) ( ) ( ) ( ) …318
I feel many of my colleagues don’t do enough to educate Atrial Fibrillation patients about the risks of AFib-related ischemic stroke ( ) ( ) ( ) ( ) …319
I have too many Atrial Fibrillation patients who underestimate the importance of adhering to their prescribed therapy for reducing the risk of AFib-related ischemic stroke ( ) ( ) ( ) ( ) …320
Many Atrial Fibrillation patients underestimate the impact anAFib-related stroke could have on their everyday lives ( ) ( ) ( ) ( ) …321
I think anticoagulants are effective stroke risk reduction treatments for the appropriate atrial fibrillation patient ( ) ( ) ( ) ( ) …322
I believe AFib-related ischemic stroke can be as debilitating as ahemorrhagic stroke( )( ) ( ) ( ) …323
I believe that AFib-related ischemic strokeis more common than hemorrhagic stroke( )( ) ( ) ( ) …324
AFib-related ischemic stroke can have devastating outcomes to my patients/caregivers( )( ) ( ) ( ) …325
PROGRAMMER, DISPLAY: And finally, just a few questions for classification purposes only.
D-1.Do you work primarily in a… (ALLOW ONE ANSWER ONLY.)
Hospital...... ( )1...326
Private Practice...... ( )2
Out-patient Rehab...... ( )3
Skilled Nursing Facility; LTAC
(Long Term Acute Care)...... ( )4
Assisted Living facility...... ( )5
Other (Specify)...... ( )6
IF “NEUROLOGIST” (Q.C), ASK Q.D-2 NEXT. OTHERWISE, SKIP TO Q. D-3.
D-2Do you practice, or are you affiliated with a… (ALLOW MULTIPLE ANSWERS.)
Joint Commission certified comprehensive strokecenter( )1 ...330
Joint Commission certified primary stroke center..( )2
CARF-certified stroke center...... ( )3
None of the above...... ( )4
EVERYONE CONTINUES FROM HERE:
D-3.In which state do you currently practice? (SHOW DROP-DOWN BOX WITH CHOICES)
State...... 331-36
D-4.What is the zip code of where you primarily practice? Please enter only the first five digits. (ENTER FIVE-DIGIT ZIP CODE)
Zip Code...... 337-41
AF Survey Project #14-01-004Final (Post-Submission): 4/10/14
Physicians Cell(online)
AFIB590113PAR