Supplementary Appendix: Patient Questionnaires a (Baseline) and B (Follow-Up Visits)

Supplementary appendix: Patient Questionnaires A (baseline) and B (follow-up visits)

PART A - BASELINE VISIT

PATIENT QUESTIONNAIRE

USE OF ANALGESIC PATCHES FOR THE TREATMENT OF CHRONIC PAIN

DEMOGRAPHICS

Sex □ Male □ Female

Age years

Height (Feet/Inches) Weight (Stone/Pound)

GENERAL INFORMATION

1. / I live in / □ a town / city
□ a village/ in the countryside
2. / I live / □ at home
□ in an assisted living facility
□ in a nursing home
3. / Do you have a caregiver? / □ Yes / □ No
4. / Do you smoke? / □ Yes / □ No

5. Nutrition (Single Answer)

□ I don’t have a special diet

□ I am on a special diet for medical reasons

□ I am vegetarian

□ Other, please specify

6. Allergies (Multiple answers possible)

□ I suffer from hay fever

□ I have asthma

□ I show skin reactions to pets

□ I show skin reactions to some foods

□ I show skin reactions to perfumes, some cosmetic products or washing powder

□ Other, please specify

7. How would you describe the current condition of your skin? (Multiple answers possible)

□ My skin is normal

□ My skin is always very dry

□ My skin is always oily

□ My skin is often reddened or inflamed

□ I am vulnerable to skin infections e.g. fungal infections

8. Body washing (Multiple answers possible):

□ For my daily wash I use regular shower gel / soap from the shops

□ For my daily wash I use special over-the-counter products e.g. hypoallergenic from the pharmacy

□ I wash with special products prescribed by my doctor

□ I do not use any products for my daily body washing

9. What else do you apply to your skin and how often?

□ No products

Product type / Frequency of use
(How many days per week?)
□ Perfume / after shave / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ Body lotion / cream / oil / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ Other, please specify / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7

10. How would you describe your daily physical activities (single answer)

□ I am very active

□ I am reasonably active

□ I am mobile

□ I am restricted in my mobility (e.g. due to sickness, pain)

11. Do you have regular activities / exercise as mentioned below? (multiple answers possible)

Activity / Frequency of activities
(How many days per week?)
□ I don’t do any sport / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ I go to a sauna / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ I go to the gym / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ I go swimming / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ I use sun-beds / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7
□ Other activities, please
specify / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7

12. Have you ever had a feeling of sickness (multiple answers possible)

From movement whilst being in a car / bus / plane / lift / □ Yes / □ No
Due to pregnancy / □ Yes / □ No
Due to chemotherapy / □ Yes / □ No
Due to chronic conditions / □ Yes / □ No
For other reasons / □ Yes / □ No

If yes, please specify

MEDICAL HISTORY PRIOR TREATMENT OF PAIN

13. General medical history

Do you suffer from any of the following? (Multiple answers possible)

I have a drug hypersensitivity (e.g. against penicillin) □ Yes □ No

I have a skin problem (e.g. neurodermitis, rash, hives)

□ No □ Yes, please specify

I have an allergy □ Yes □ No

I take regularly medication for my allergies (e.g. cortisone)

□ No □ Yes, please specify

14. Chronic pain history

Do you suffer from any of the following? (Multiple answers possible)

□ I have a constant back pain

□ I have a constant headache e.g. migraine

□ I have constant pain from arthritis or osteoporosis

□ I have constant pain from cancer

□ Other chronic pain

Please specify:

15. How long have you had chronic/long-term pain?

17. Which doctors have you been seeing specifically for your pain? (Multiple answers possible)

□ GP

□ Pain specialist

□ Hospital consultant

□ Other, please specify:

18. Within the last 12 months, what medication did you take for your chronic pain, other than patches? (Multiple answers possible)

□ Medication prescribed by my doctor, please specify

□ Over the counter medication / non-prescription medication (e.g. Paracetamol, Nurofen®, Aspirin®), please

specify

□ Homeopathy, please specify

19. If you used multiple pain relief medication, why did you switch from one pain medication to another? (Multiple answers possible)

□ Pain became worse

□ Did not like side effects

□ Effects of medication did not last long enough

□ Doctor’s recommendation

□ Other, please specify

20. How bad is your pain on a scale from 0 to 10; 0 being no pain and 10 being the worst imaginable pain (please tick)?

¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

TREATMENT WITH TRANSDERMAL ANALGESIC PATCH

21. Please estimate when did you start using transdermal analgesic patches?

Day Month Year

22. How long, on average, are you wearing one patch at a time?

|_ | Days

23. Do you take the patch off and reapply it (e.g. for showers, baths)? □ Yes □ No

24. Is the transdermal patch effective in relieving your pain over the entire application time? (Single answer)

□ Very effective

□ Effective

□ Not very effective

□ Not at all effective

25. Did you take any additional pain medication over the last year?

□ Yes □ No

If yes, which one?

For how many days did you take this additional medication? | | | Days

26. During the last 4 weeks, did you forget to apply the transdermal analgesic patch?

□ No □ Yes If yes, please provide number of days: | | |

27. During the last 4 weeks, have you applied more patches then prescribed by your doctor?

□ No □ Yes If yes, please provide number of days and number of

28. Have you ever cut your patch?

□ No □ Yes, If yes, please specify if □ Sometimes

□ Occasionally

□ Frequently

29. If you did cut your patch, what was the reason?

30. During the last 4 weeks, have you applied a transdermal analgesic patch without removing the old one?

□ No □ Yes If yes, please provide number of days: | | |

31. During the last 4 weeks, to approximately how many different skin spots have you applied a transdermal analgesic patch? | | | skin sites?

32. Please indicate the location(s) where you applied the last three patches (Mark with a cross as shown in the example below):

Please mark with crosses as shown in the example above:

SATISFACTION WITH THE

TRANSDERMAL ANALGESIC PATCH

33. In the previous week, how easy was the analgesic transdermal patch to use:

a) Opening the package

□ Very easy □ Easy □ Difficult □ Very difficult

b) / Putting on the patch
□ Very easy / □ Easy / □ Difficult / □ Very difficult
c) / Taking off the patch
□ Very easy / □ Easy / □ Difficult / □ Very difficult
d) / Disposal of the patch
□ Very easy / □ Easy / □ Difficult / □ Very difficult

e) Using the patch, in general

□ Very easy □ Easy □ Difficult □ Very difficult

34. How do you dispose of your patch? (Multiple answers possible)

□ I put it into the bin

□ I put it down the toilet

□ I give it to my caregiver

□ I return it to my pharmacist

□ Other, please specify

35. Patch adhesiveness (Single answer)

□ Normally, my patch remains completely on

□ Most days the edge(s) of the patch lift off

□ Most days the patch lifts half off

□ Most days the patch is just hanging on

□ Most days the patch falls off

36. If the patch does not remain completely on, what do you do? (Multiple answers possible)

□ I do nothing and leave it as it is

□ I take the patch off and apply a new one

□ I take the patch off and do not apply a new one

□ I try to stick the patch back on e.g. using tape

37. If the patch does not remain completely on, why do you think it comes off? (Multiple answers possible)

□ It comes off because I sweat a lot

□ I have applied body lotion or another product to my skin prior to sticking the patch on

□ It comes off because there is too much body hair on the application site

□ Other (please specify):

38. How satisfied are you with your transdermal analgesic patch?

Item measured / 1 = I strongly disagree
5 = I fully agree
The patch is easy to use / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5
The patch normally sticks well / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5
My skin tolerates the patch well / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5
The patch is comfortable to wear / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5
Overall I am satisfied with my patch / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5
I am satisfied compared to previous chronic pain
medication / ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5

39. If you could design a transdermal patch, what would you do to make the patch better?

40. I would like my patch to be (multiple answers possible):

□ Transparent

□ Silky smooth in texture

□ Stretchy/ flexible

□ Smaller

□ Larger

□ Different in colour, please specify

□ Different in shape, please specify

□ I would like to be able to write on my patch (e.g. date of application)

□ Other, please specify

SHORT PAIN ANALYSIS

41. Please rate your level of pain:

0 being no pain and 10 being the worst pain imaginable

a. The strongest pain that I felt during the last 7 days I would rate as:

¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

b. The least pain that I felt during the last 7 days I would rate as:

¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

c. The average pain I felt during the last 7 days I would rate as:

¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

d. The pain I feel right now I would rate as:

¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

42. In the last 7 days, how much did the pain affect you;

0 being you were not affected at all and 10 being you were affected very much

My general activities are affected / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
The pain affects my mood / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
The pain affects my ability to walk / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
The pain affects my ordinary housework and work outside the home / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
The pain affects my relationship with other people / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
I do not sleep well because of pain / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10
The pain affects my social activities / ¨ 0 - ¨ 1 - ¨ 2 - ¨ 3 - ¨ 4 - ¨ 5 - ¨ 6 - ¨ 7 - ¨ 8 - ¨ 9 - ¨ 10

SIDE EFFECTS

43. Since you have used the transdermal analgesic patch, have you noticed any of the following

(please tick if and as many as apply)?

□ I have not noticed anything unusual

Side effect / Please specify
□ I have had problems going to the
toilet (Constipation) / Maximum intensity:
□ Mild □ Moderate □ Severe
Duration: | | | Days
Current intensity:
□ Mild □ Moderate □ Severe
Duration: | | | Days
□ I have felt sick (Nausea) / Maximum intensity:
□ Mild □ Moderate □ Severe
Duration: | | | Days
Current intensity:
□ Mild □ Moderate □ Severe
Duration: | | | Days
□ I have been sick (Vomiting) / Maximum intensity:
□ 1-2 times/day □ 3-4 times/day
□ more than 4 times/day
Duration: | | | Days
Current intensity:
□ 1-2 times/day □ 3-4 times/day
□ more than 4 times/day
Duration: | | | Days
□ I have had problems sleeping / □ Mild □ Moderate □ Severe
□ I have felt dizzy / □ Mild □ Moderate □ Severe
□ I have had skin problems / Questions referring to skin problems will follow later.
□ Other, please
specify / □ Mild □ Moderate □ Severe

44. Do you take any medication for the above mentioned side effects? If yes, please specify: