46 Recalling I will now ask Yesterday, Day 1: NOTE: taking pill about taking pills 1. Yes Repeat in the past 7 days, 2. No going not including 98. Don’t remember backwards today. I will ask 7 days Day 2: about each of the starting 1. Yes past seven days, with 2. No starting with yesterday. 98. Don’t remember yesterday (x-day). Day 3 We are most 1. Yes interested in 2. No knowing on how 98. Don’t remember many days you took the pill. Soif Day 4 you cannot 1. Yes remember which 2. No day(s) exactly 98. Don’t remember you did or did not take the pill, Day 5 please guess. If 1. Yes you missed some 2. No days, we prefer 98. Don’t remember that you indicate this even if you Day 6 cannot remember 1. Yes exactly which 2. No days you missed. 98. Don’t remember Yesterday (x-day) Day 7 did you take a pill? 1. Yes 2. No 98. Don’t remember 47 Pill Does taking pills 1. Yes interfere with any 2. No with of your regular regular daily activities? activities 48 Time of In the past month, 1. Morning pill what time of day 2. Afternoon do you typically 3. Evening take your pill? 96. Other, specify ____________ 49 Frequency In the past month, Always of pill how often did you Sometimes take your pill at Never about the same time each day?
46 Recalling taking pill I will now ask about taking pills in the past 7 days, not including today. I will ask about each of the past seven days, starting with yesterday (x-day). We are most interested in knowing on how many days you took the pill. Soif you cannot remember which day(s) exactly you did or did not take the pill, please guess. If you missed some days, we prefer that you indicate this even if you cannot remember exactly which days you missed. Yesterday (x-day) did you take a pill? Yesterday, Day 1: 1. Yes 2. No 98. Don’t remember Day 2: 1. Yes 2. No 98. Don’t remember Day 3 1. Yes 2. No 98. Don’t remember Day 4 1. Yes 2. No 98. Don’t remember Day 5 1. Yes 2. No 98. Don’t remember Day 6 1. Yes 2. No 98. Don’t remember Day 7 1. Yes 2. No 98. Don’t remember NOTE: Repeat going backwards 7 days starting with yesterday. 47 Pill with regular activities Does taking pills interfere with any of your regular daily activities? 1. Yes 2. No 48 Time of pill In the past month, what time of day do you typically take your pill? 1. Morning 2. Afternoon 3. Evening 96. Other, specify ____________ 49 Frequency of pill In the past month, how often did you take your pill at about the same time each day? Always Sometimes Never
Ashodaya_exit-questionnaire.docx