1. | In which region of the country do you practice? |
(Southwest; Northwest; Midwest; Southeast; Mid-Atlantic; Northeast; Alaska/Hawaii; International) |
2. | What is your gender? |
(male/female) |
3. | In which type of practice do you work? |
(academic; hospital-based; solo private practice; group specialty practice; other) |
4. | Including fellowship, for how many years have you been practicing rheumatology? |
(< 5 yrs; 5–10 yrs; 10–15 yrs; 15–20 yrs; > 20 yrs) |
5. | On average, approximately how many patients with a rheumatologic diagnosis do you see each week? |
(< 5 pts; 5–10 pts; 10–15 pts; > 20 pts) |
6. | Approximately what percentage of the patients you care for are managed on chronic glucocorticoids? |
(< 10%; 10–25%; 25–50%; 50–75%; 75–90%; > 70%) |
7. | Approximately what percentage of the patients you care for are managed on other immunosuppressive agents, including cyclophosphamide, methotrexate, azathioprine, and mycophenolate? |
(< 10%; 10–25%, 25–50%; 50–75%; 75–90%; > 90%) |
8. | Have any of your patients ever developed Pneumocystis jirovecii pneumonia (PCP)? |
(no; yes; if yes, please specify how many) |
9. | Do you prescribe chemoprophylaxis for PCP? If yes, please specify what prophylaxis method you prefer. |
(no; yes – with trimethoprim/sulfamethoxazole once daily; yes – with trimethoprim/sulfamethoxazole 3 times per week; yes – with aerosolized pentamidine; yes – with another prophylactic medication. Please specify) |
10. | For which underlying conditions are you most likely to prescribe PCP chemoprophylaxis? (mark all that apply) |
(systemic lupus erythematosus; rheumatoid arthritis; psoriatic arthritis; Wegener’s granulomatosis; polyarteritis nodosa; microscopic polyangiitis; other systemic vasculitides; scleroderma; dermatomyositis; polymyositis; other myositis; other. Please specify; rheumatologic diagnosis does not affect my decision to prescribe or not prescribe PCP chemoprophylaxis; I do not prescribe PCP chemoprophylaxis) |
11. | With which treatment regimens are you likely to prescribe PCP chemoprophylaxis? (mark all that apply) |
(prednisone alone; prednisone in combination with another immunosuppressant agent; methotrexate; cyclophosphamide; azathioprine; mycophenolate; TNF-alpha inhibitors; cyclosporine; 6-mercaptopurine; rituximab; other. Please specify; treatment regimen does not affect my decision to prescribe or not prescribe PCP chemoprophylaxis) |
12. | At what dose of prednisone are you likely to prescribe PCP chemoprophylaxis? |
(≥ 5 mg/day; ≥ 10 mg/day; ≥ 15 mg/day; ≥ 20 mg/day; ≥ 30 mg/day; ≥ 40 mg/day; ≥ 50 mg/day; other. Please specify; prednisone dosage does not affect my decision to prescribe or not prescribe PCP chemoprophylaxis; I do not prescribe PCP chemoprophylaxis) |
13. | What laboratory data do you use when deciding whether to prescribe PCP chemoprophylaxis? (please mark all that apply) |
(peripheral blood absolute lymphocyte count; peripheral blood CD4 T cell count; other. Please specify; laboratory data does not affect my decision to prescribe or not prescribe PCP chemoprophylaxis; I do not prescribe PCP chemoprophylaxis) |
14. | What other clinical data not mentioned above makes you more likely to prescribe PCP chemoprophylaxis? (please mark all that apply) |
(history of PCP; history of other opportunistic infection; history of interstitial pulmonary fibrosis; other. Please specify; other clinical data does not affect my decision to prescribe or not prescribe PCP chemoprophylaxis; I do not prescribe PCP chemoprophylaxis) |
15. | What is the most important factor in your decision as to whether or not to prescribe PCP chemoprophylaxis? |
(underlying condition; treatment regimen; dose of medication; laboratory data; history of PCP; history of other opportunistic infections; history of interstitial pulmonary fibrosis; other. Please specify; I do not prescribe PCP chemoprophylaxis) |