COVID-19 Survey for the Adrenal Disease Community
1.
Please choose your state of residence from the drop-down.
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia (DC)
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
2.
Please check all that apply to you.
I have
primary adrenal insufficiency
or am the caregiver for someone with it.
I have
secondary adrenal insufficiency
or am the caregiver for someone with it.
Other adrenal disease (please specify)
3.
Please select the age group of the individual with adrenal disease from the ranges shown below.
Under 18
18-24
25-34
35-44
45-54
55-64
65+
4.
Have you experienced any challenges obtaining medication for your adrenal disease?
Yes
No
5.
If yes, what was the challenge to get the medication?
I am unable to or afraid to travel to the pharmacy and my pharmacy does not deliver.
I am unable to reach my physician to refill my prescription.
Pharmacy is unable to fill do to a shortage or backorder.
My insurance won't let me fill more than the standard 30-day or 90 day supply.
I am unable to afford the medication due to a loss of income as a result of COVID-19.
6.
If your pharmacy indicated that your medication was not available, please check which drug you could not obtain.
Greenstone Hydrocortisone 5 mg
Greenstone Hydrocortisone 10 mg
Greenstone Hydrocortisone 20 mg
Pfizer Cortef 5 mg
Pfizer Cortef 10 mg
Pfizer Cortef 20 mg
Vensun Hydrocortisone 5 mg
Vensun Hydrocortisone 10 mg
Vensun Hydrocortisone 20 mg
Amneal Hydrocortisone 5mg
Amneal Hydrocortisone 10 mg
Amneal Hydrocortisone 20 mg
Fludrocortisone (any)
Other (please specify)
7.
If your pharmacy replaced your usual hydrocortisone brand, what did they replace it with?
8.
If your usual brand of hydrocortisone was replaced, how is it working for you?
The replacement is working fine.
The replacement is not working as well as my prior brand.
I was able to obtain my usual brand so have not had an issue.
If it is not working as well as your prior brand, please describe the issue.
9.
Are you concerned with future medication shortages?
Yes
No
10.
What steps are you taking to protect yourself from contracting COVID-19? (Check all that apply)
Social distancing - 6 feet or more
Washing hands often
Avoiding touching eyes, nose and mouth
Staying at home
Cleaning and disinfecting frequently touched surfaces
Covering coughs and sneezes
Having a plan to prevent and treat symptoms of low cortisol
Other (please specify)
11.
Have you had any symptoms of COVID-19?
Yes
No
12.
If yes, what were your symptoms? (Check all that apply)
Fever
Dry Cough
Shortness of Breath
Other (please specify)
13.
Please tell us if you have been tested for coronavirus (COVID-19).
Yes
No
14.
If tested for COVID-19, were you positive or negative?
Positive
Negative
Please add your email address (or phone number) if you've tested positive. This will allow NADF to contact you for any questions regarding your experience with COVID-19.
15.
If you were tested positive, were you hospitalized?
Yes
No
16.
If you were hospitalized for COVID-19 did medical staff need to administer steroid dosing via IV hydrocortisone?
Yes
No
Other (please specify)
17.
What else do you think we should know about your experience with COVID-19.
18.
Please tell us what sources you are using for information about COVID-19 and adrenal insufficiency. (Check all that apply)
National Adrenal Disease Foundation (NADF) Website
NADF Facebook Page
NADF Twitter
NADF Instagram
NADF Support Groups
Other (please specify)
19.
How helpful are the updates from the National Adrenal Disease Foundation (NADF) regarding COVID-19 for those with adrenal insufficiency.
Extremely helpful
Very helpful
Somewhat helpful
Not so helpful
Not at all helpful
20.
What questions do you have about COVID-19 with respect to adrenal insufficiency that you would you like answered?
21.
We want you to stay safe during this pandemic. If there is anything else you'd want to share, please provide it here. Please note: this is an anonymous survey and will not have your contact information unless you provide it.
22.
Important Research on Adrenal Insufficiency and COVID-19:
NADF Board Member, Elizabeth Regan MD, PhD is a principal investigator for
The Adrenal Insufficiency (AI) Study
, and is coordinating with several other patient cohort studies to collect detailed information about who gets sick, what symptoms do they experience and what are the long-term outcomes. If you are interested in participating in this more detailed study, please use this link. Thank you!
https://redcap.njhealth.org/redcap/surveys/?s=P3DLE9D479
