Adrenal Disease Quality of Life Survey
The Adrenal Alternatives Foundation is a patient empowerment organization that encourages, educates and advocates for sufferers of all adrenal diseases and is registered with the IRS as a 501(c)3 nonprofit organization. We are working on creating clinical trials and research. The information gleaned from this survey is completely confidential and will be used to further advancements in adrenal disease care.   For more information please visit our website at adrenalalternatives.com
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What form of adrenal disease were you diagnosed with?
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Were you diagnosed prior to having an adrenal crisis?
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What cortisol replacement steroid medication do you currently take?
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What is your current cortisol replacement dose of your steroid medication? (What is your daily mg)
How many times a day are you taking your steroid medication?
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Which, if any, of the following side effects do you experience from your steroid medication?
How many different steroids have you tried to manage your adrenal disease?
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How would you rate your quality of life on your current steroid replacement?
Low Quality of life
Optimal Quality of life
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How would you rate your willingness to try a new steroid replacement to improve your quality of life?
Unwilling
Very Willing
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If you could change anything about your current steroid replacement, what would it be?
Has your doctor explained multiple steroid options to you?
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How often do you updose your steroid?
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Check all of the options below you would updose your steroid for
Does your insurance cover your current steroid medication?
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Does your steroid dosing schedule impact your sleep or other activities of daily life?
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Would you be willing to participate in a research study regarding steroid medications in the management of adrenal disease?
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Do you feel your doctor is knowledgeable about managing adrenal disease?
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Have you been prescribed an emergency cortisol injection?
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Did your doctor prescribe your emergency cortisol injection or did you have to request it?
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Did your doctor explain updosing and the need for extra steroid during times of physical or emotional stress?
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Have you ever experienced an adrenal crisis?
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How often do you experience low cortisol symptoms?
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What low cortisol symptoms do you experience?
How many adrenal crisis have you experienced?
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Did the emergency department know how to treat your adrenal crisis?
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What is one thing you wish people understood about living with adrenal insufficiency?
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