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Survey of the American Consumer - GfK MRI

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ailments/DOCTOR VISITS<br />

Page 16<br />

AILMENTS/<br />

REMEDIES<br />

You Personally:<br />

How treated in <strong>the</strong> last 12 months?<br />

Have/ Used a prescription Used a Used a<br />

Had in remedy non- home/<br />

last 12 prescription herbal<br />

months Branded Generic remedy remedy<br />

Have not<br />

treated<br />

107 1 2 3 4 5 6<br />

AILMENTS<br />

Acne ........................ 01<br />

ADD/ADHD. .................. 02<br />

Allergy/Hay Fever .............. 03<br />

Anxiety/Panic ................. 04<br />

Arthritis/Rheumatoid arthritis (RA) . 05<br />

Arthritis/Osteoarthritis. .......... 06<br />

Asthma ...................... 07<br />

Athlete’s Foot ................. 08<br />

Backache/Back Pain. ........... 09<br />

Bipolar Disorder ............... 10<br />

Cancer ...................... 11<br />

Chronic/Severe Pain. ........... 12<br />

Cold Sores ................... 13<br />

Constipation .................. 14<br />

Dandruff/Dry Scalp ............. 15<br />

Depression ................... 16<br />

Diabetes (Insulin Dependent). .... 17<br />

Diabetes (Non-Insulin Dependent) . 18<br />

Dry Eyes. .................... 19<br />

Eczema/Skin Itch/Rash ......... 20<br />

Epilepsy/Seizures. ............. 21<br />

Erectile Dysfunction (ED) ........ 22<br />

Fibromyalgia .................. 23<br />

Hair Loss .................... 24<br />

Hearing Loss ................. 25<br />

Heart Attack/Heart Disease ...... 26<br />

Heartburn/Acid Reflux .......... 27<br />

High Cholesterol. .............. 28<br />

Hypertension/High Blood<br />

Pressure ................... 29<br />

Insomnia. .................... 30<br />

Irritable Bowel Syndrome (IBS) ... 31<br />

Kidney Ailments ............... 32<br />

Macular Degeneration .......... 33<br />

Menopause/Hormone Replacement 34<br />

Migraine Headaches. ........... 35<br />

Multiple Sclerosis (MS). ......... 36<br />

Muscle Strain/Sprain ........... 37<br />

Nail Fungus .................. 38<br />

Obesity/Overweight ............ 39<br />

Osteoporosis ................. 40<br />

Overactive Bladder ............. 41<br />

Prostate ..................... 42<br />

Restless Legs Syndrome ........ 43<br />

Rosacea or Skin Disease ........ 44<br />

Sinus Congestion/Headache ..... 45<br />

Sleep Apnea. ................. 46<br />

Snoring ...................... 47<br />

Ulcer ........................ 48<br />

Urinary Tract Infection (UTI) ...... 49<br />

Wrinkles ..................... 50<br />

Yeast Infection ................ 51<br />

In <strong>the</strong> last 12 months, how did you obtain information about an ailment or prescription drug?<br />

15A-0<br />

Television Advertisement ........ 1 Patient support group ........... 7<br />

Magazine Advertisement ........ 2 Pharmacist ................... 8<br />

O<strong>the</strong>r Advertisement ........... 3 Pharmaceutical company ........ 9<br />

Doctor or Health care pr<strong>of</strong>essional . 4 Medical journals ............... 0<br />

Friends/Family ................ <br />

Online/Internet site ............. X<br />

5<br />

O<strong>the</strong>r. ....................... Y<br />

Pamphlets/Brochures. .......... 6<br />

DOCTOR<br />

VISITS<br />

094<br />

You Personally:<br />

Visited Times/<br />

in last 12 last 12<br />

months months<br />

TOTAL: ................ 00<br />

TYPES:<br />

Acupuncturist ........... 01<br />

Allergist ............... 02<br />

Cardiologist ............ 03<br />

Chiropractor ............ 04<br />

Dentist ................ 05<br />

Dermatologist. .......... 06<br />

Ear, Nose & Throat. ...... 07<br />

Eye Doctor . . . . . . . . . . . . . . 08<br />

Gastroenterologist ....... 09<br />

General/Family Practitioner . 10<br />

Internist ............... 11<br />

Nurse Practitioner. ....... 12<br />

OB/Gyn ............... 13<br />

Osteopath. ............. 14<br />

Pediatrician (with child) ... 15<br />

Physical Therapist ....... 16<br />

Plastic Surgeon ......... 17<br />

Podiatrist .............. 18<br />

Psychiatrist. ............ 19<br />

Urologist ............... 20<br />

999<br />

OTHER (Write In)<br />

CAREGIVER/<br />

CARETAKER<br />

Are you, personally, <strong>the</strong> primary caregiver for<br />

someone with a medical condition? Yes 1 15L-0<br />

If yes, what services/support do you provide?<br />

15N-0<br />

Assist with chores ........... 1<br />

Assist with personal care ...... 2<br />

Give medication ............. 3<br />

Make doctor’s appointments. ... 4<br />

Provide transportation ........ 5<br />

Research medical information .. 6<br />

O<strong>the</strong>r ..................... 7<br />

Age <strong>of</strong> patient(s): 15W-0<br />

Less than 18 years old ..... 1<br />

18-64 years old. .......... 2<br />

65 years or older ......... 3<br />

Patient’s relationship to you: 15Y-0<br />

Relative ................ 1<br />

Friend .................. 2<br />

O<strong>the</strong>r .................. 3<br />

HEALTHCARE<br />

ADVERTISING<br />

ACTIONS TAKEN<br />

14B-0<br />

Actions you took as a result <strong>of</strong> seeing or<br />

hearing healthcare advertising, in <strong>the</strong> last<br />

12 months:<br />

Bought a non-prescription product ..... 1<br />

Refilled a prescription. .............. 2<br />

Made an appointment to see a doctor . . 3<br />

Discussed an ad with your doctor ..... 4<br />

Discussed an ad with a friend or<br />

relative ......................... 5<br />

Asked your doctor to prescribe a<br />

specific drug ..................... 6<br />

Consulted a pharmacist ............. 7<br />

Visited a product or drug website ...... 8<br />

Visited ano<strong>the</strong>r website ............. 9<br />

Requested a free sample ............ 0<br />

Called a toll-free number for information . . X<br />

O<strong>the</strong>r ........................... Y

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