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Language:
English
WESSQL6.MEPS_V2
Spec Label:
This is the cover page. Additional contents currently project specific.
PM - Page 1 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_00
Route Details:
(PM1000)
Item Type: Route
Type Class: If Then
01 Box = BOX_10, BOX_20, BOX_30, BOX_40, BOX_50, BOX_60, BOX_70, BOX_
80, BOX_90, BOX_100, BOX_110
02 Loop = LOOP_10
03 End Loop = END_LP10
04 S ingle S elect = PM20, PM40, PM50, PM70, PM90, PM110, PM190
05 S ingle S elect with Display Roster = PM180
06 S ingle S elect with Fill in Answer Text = PM10
07_S ingle S elect with Add/Edit/Delete = PM200
11 Multiple S elect with Add/Edit/Delete = PM30, PM60, PM80, PM100, PM120
12 Address - Newly Collected = PM170_01, PM170_02, PM170_03, PM170_04,
PM170_05, PM170_06, PM170_07
15 Regular Date Entry with S kips = PM130_01, PM130_02
19 Numeric Field = PM140, PM150
28 Trigram Lookup = PM160LU
Roster 3 = PM30, PM60, PM80, PM100, PM120, PM160LU, PM200
BOX_05
Route Details:
(PM1005)
Item Type: Route
Type Class: If Then
All sections starting with and including PM that precede Employment in rounds 1, 3, 5 or
precede Access in rounds 2 and 4, function as a single person level loop (e.g., ask PM, OM,
AH, and CS, for person 1, then loop through those sections for person 2, then person 3, and
person N.) CAPI will allow the interviewer to select CTRL-S at any time during the person
loop, and select another RU member to loop on (including starting with someone other than
the respondent/reference person).
For sections PM, OM, and AH, all current RU members, including those who are deceased
and institutionalized should be asked these sections.
For the CS section, all RU members < or = 17 years of age including those who are
institutionalized, but excluding those RU members that are deceased.
The order of these sections follows the same ones specified in the GL section;
respondent/reference person if the respondent is a proxy followed by RU members in PID
order.
PM - Page 2 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
PMIntro
Item Type:
(PM1006)
Question
Type Class:
Enumerated
Answer Type:
TContinue
Help Available (
BLAISE NAME: PMIntro
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
)
Show Card (
ArrayMax:
Max value:
)
Look Up File (
Question Text:
PRESCRIBED MEDICINES (PM), OTHER MEDICAL (OM), {AND} ADDITIONAL HEALTHCARE (AH){,
AND CHILD HEALTH (CS)} SECTIONS – ASKED FOR EACH RU MEMBER AS A LOOP.
CTRL-S: SWITCH TO A DIFFERENT RU MEMBER.
PRESS 1 AND ENTER TO CONTINUE.
Responses:
CONTINUE
Programmer
Instructions:
This item is presented only for the first person that goes through the PM, OM, AH and CS
loop. Skip PMIntroduction for all other RU members.
Display
Instructions:
BOX_10
(PM1010)
Display “AND” if rounds 1, 3, or 5. Otherwise, use a null display.
Display “, AND CHILD HEALTH (CS)” if round 2 or round 4. Otherwise, use a null
display.
Testing/Editing
Notes:
BOX_10
Route Details:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
(PM1010)
Item Type: Route
Type Class: If Then
Context header display instructions:
Display PERS .FULLNAME, PRND.BEGREFMM,DD,YY and
PRND.ENDREFMM,DD,YY.
Continue with PM10 (even if PM10 is prefilled with a response).
PM - Page 3 of 40
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM10
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1020)
Question
Enumerated
BLAISE NAME: HasPmedRecords
Field kind: Datafield
Field Size:
THASPRESCPTNRE Answers allowed: 1
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
{Earlier you mentioned that {you/{PERSON}} had prescription medicine bottles, containers, tubes, or bags available.} For
these next questions, please have any bottles, containers, tubes, or bags, a pharmacy print out or patient portal information
available for each of {your/PERSON}'s medicines we will be talking about.
Responses:
Programmer
Instructions:
HAS PRESCRIPTION MEDICINE
BOTTLES/RECORDS FOR {PERSON}
DOES NOT HAVE ANY PRESCRIPTION
MEDICINE BOTTLES/RECORDS FOR
{PERSON}
REFUSED TO USE ANY PRESCRIPTION
MEDICINE BOTTLES/RECORDS FOR
{PERSON}
1
BOX_20
(PM1030)
2
BOX_20
(PM1030)
3
BOX_20
(PM1030)
Refused and Don't Know are disallowed.
If CA30_05 is coded '1' (YES, HAS PRESCRIPTION RECORDS/MEDICINE BOTTLES
FOR {PERSON}), prefill the response entry field with '1' (HAS PRESCRIPTION
MEDICINE BOTTLES/RECORDS) as selected, but the field should be editable.
Display
Instructions:
Testing/Editing
Notes:
Display 'Earlier you mentioned that {you/{PERSON}} had prescription medicine bottles, containers,
tubes, or bags available.' If CA30_5 is coded '1' (YES, HAS PRESCRIPTION RECORDS/MEDICINE
BOTTLES FOR {PERSON}. Otherwise, use a null display.
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 4 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_20
Route Details:
(PM1030)
Item Type: Route
Type Class: If Then
If person has 'DIABETES' on Persons-Medical-Conditions-Roster, created in PE in any
round, continue with PM20.
Otherwise, go to BOX_30.
PM20
Item Type:
(PM1040)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (PmedDiabHelp)
Context Header:
BLAISE NAME: PmedDiab
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
{Since {START DATE}/Between {START DATE} and {END DATE}}, {have/has} {you/{PERSON}} obtained insulin or
any other prescribed medicines related to {your/his/her} diabetes?
HELP:F1
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM - Page 5 of 40
PM30
PM40
PM40
PM40
(PM1050)
(PM1060)
(PM1060)
(PM1060)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
Display 'since {START DATE}' if not round 5. Display 'between {START DATE} and {END DATE}'
if round 5.
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
BLAISE NAME: PmedDiabRoster
PM30
Item Type:
(PM1050)
Question
Type Class:
Enumerated
Answer Type:
TPRESCRIBEDMED Answers allowed: 110 ArrayMax:
Help Available (
Context Header:
)
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Show Card (
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
What are the names of these medicines related to {your/his/her} diabetes?
PROBE: Any other medicines related to {your/his/her} diabetes?
ENTER ALL THAT APPLY.
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
Responses:
{PRESCRIBED MEDICINE}1
{PRESCRIBED MEDICINE}2
{PRESCRIBED MEDICINE}3
{PRESCRIBED MEDICINE}4
{PRESCRIBED MEDICINE}N
1
2
3
4
5
PM - Page 6 of 40
PM40
PM40
PM40
PM40
PM40
(PM1060)
(PM1060)
(PM1060)
(PM1060)
(PM1060)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Roster Behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a medicine added at this item as long as
CAPI has not created a link between this medicine and an event. If a medicine, added in
PMed section, is never linked to an event, that medicine can be deleted until the end of
interview.
4. Limited edit allowed. Interviewer may edit medicines added at this item at this item as
long as CAPI has not created a link between this medicine and an event. If a medicine, added
in PMed section, is never linked to an event, that medicine can be edited until the end of
interview.
NOTE: In order for the columns to display properly, 35 allowable characters for the
medicines will be accepted for display on the roster.
When adding a medicine in the pop-up manipula, a maximum of 60 characters will be
allowed.
When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60
characters for the medicine name.
General flag rules for medicines:
-Round medicine first created (by definition a medicine is selected the same time it is
created)
-Question number medicine first created
-Round medicine selected
Display
Instructions:
Roster 3- Add/Edit/Delete Allowed.
Roster Definition:
This item displays the person’s-prescribed-medicines-roster for selection/addition. Display name of
prescribed medicine (DRUG.DRUGNAME).
Roster Filter:
Display all; no filter.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 7 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM40
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1060)
Question
Enumerated
TYESNO
)
BLAISE NAME: DiabEquip
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
{Other than what we just listed, did/Did} {you/{PERSON}} obtain any other diabetic equipment or supplies, typically
prescribed by a physician; for example, syringes, a blood glucose monitor machine, glucose meter, insulin pumps, lancets,
alcohol swabs or control solution {since {START DATE}/between {START DATE} and {END DATE}}?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
BOX_30
BOX_30
BOX_30
BOX_30
(PM1070)
(PM1070)
(PM1070)
(PM1070)
Programmer
Instructions:
If PM40 is coded ‘1’ (YES), automatically select the entry ‘OTHER DIABETIC
EQUIPMENT/SUPPLIES’ on person’s-prescribed-medicines-roster. If ‘OTHER DIABETIC
EQUIPMENT/SUPPLIES’ is not already on roster, create the entry and select it.
General flag rules for medicines:
- Round medicine first created (by definition a medicine is selected the same time it is
created)
- Question number medicine first created
- Round medicine selected
Display
Instructions:
Display ‘Other than what we just listed, did’ if PM20 was coded ‘1’ (YES). Otherwise, display ‘Did’.
Display ‘since {START DATE}’ if not round 5. Display ‘between {START DATE} and {END
DATE}’ if round 5.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 8 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_30
Route Details:
(PM1070)
Item Type: Route
Type Class: If Then
If person has ‘AS THMA’ on Persons -Medical-Conditions-Roster, created in PE in any
round, continue with PM50.
Otherwise, go to PM70.
PM50
Item Type:
(PM1080)
Question
Type Class:
Enumerated
Answer Type:
TYESNO
Help Available (MEDPRESHelp)
Context Header:
BLAISE NAME: PmedAsthma
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size:
Answers allowed: 1
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
Including any medicines for quick relief of asthma symptoms, such as inhalers, and those that prevent symptoms over the long
term, {have/has} {you/{PERSON}} obtained any prescribed medicines related to {your/his/her} asthma {since {START
DATE}/between {START DATE} and {END DATE}}?
HELP:F1
Responses:
Display
Instructions:
Testing/Editing
Notes:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM60
PM70
PM70
PM70
(PM1090)
(PM1100)
(PM1100)
(PM1100)
Display ‘since {START DATE}’ if not round 5. Display ‘between {START DATE} and
{END DATE}’ if round 5.
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 9 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM60
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1090)
Question
Enumerated
BLAISE NAME: PmedAsthmaRoster
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
TPRESCRIBEDMED Answers allowed: 110 ArrayMax:
)
Show Card (
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
What are the names of these medicines related to {your/his/her} asthma?
PROBE: Any other medicines related to {your/his/her} asthma?
ENTER ALL THAT APPLY
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
Responses:
{PRESCRIBED MEDICINE}1
{PRESCRIBED MEDICINE}2
{PRESCRIBED MEDICINE}3
{PRESCRIBED MEDICINE}4
{PRESCRIBED MEDICINE}N
1
2
3
4
5
PM - Page 10 of 40
PM70
PM70
PM70
PM70
PM70
(PM1100)
(PM1100)
(PM1100)
(PM1100)
(PM1100)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Roster Behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a medicine added at this item as long as
CAPI has not created a link between this medicine and an event. If a medicine, added in
PMed section, is never linked to an event, that medicine can be deleted until the end of
interview.
4. Limited edit allowed. Interviewer may edit medicines added at this item at this item as
long as CAPI has not created a link between this medicine and an event. If a medicine, added
in PMed section, is never linked to an event, that medicine can be edited until the end of
interview.
NOTE: In order for the columns to display properly, 35 allowable characters for the
medicines will be accepted for display on the roster.
When adding a medicine in the pop-up manipula, a maximum of 60 characters will be
allowed.
When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60
characters for the medicine name.
General flag rules for medicines:
-Round medicine first created (by definition a medicine is selected the same time it is
created)
-Question number medicine first created
-Round medicine selected
Display
Instructions:
Roster 3- Add/Edit/Delete Allowed.
Roster Definition:
This item displays the person’s-prescribed-medicines-roster for selection/addition. Display name of
prescribed medicine (DRUG.DRUGNAME).
Roster Filter:
Display all; no filter.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 11 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM70
Item Type:
Type Class:
Answer Type:
(PM1100)
Question
Enumerated
TYESNO
Help Available (PmedAsNeeded)
Context Header:
BLAISE NAME: NewMeds
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
In answering the next couple of questions, remember to think about prescriptions obtained at any pharmacy,
including mail-order or on-line. {Since {START DATE}/Between {START DATE} and {END DATE}}, {have/has}
{you/{PERSON}} obtained any new prescription medicines or any refills {we have not yet talked about}?
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM80
PM90
PM90
PM90
(PM1110)
(PM1120)
(PM1120)
(PM1120)
DISPLAY ‘Since {START DATE}’ IF NOT ROUND 5. DISPLAY ‘Between {START DATE} and
{END DATE}’ IF ROUND 5.
Display "we have not yet talked about" if 1 or more medicines have been selected during this round.
Otherwise use a null display.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 12 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM80
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1110)
Question
Enumerated
BLAISE NAME: NewMedsRoster
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
TPRESCRIBEDMED Answers allowed: 110 ArrayMax:
)
Show Card (
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
What were the names of these medicines?
PROBE: Any other medicines?
ENTER ALL THAT APPLY
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
Responses:
{PRESCRIBED MEDICINE}1
{PRESCRIBED MEDICINE}2
{PRESCRIBED MEDICINE}3
{PRESCRIBED MEDICINE}4
{PRESCRIBED MEDICINE}N
1
2
3
4
5
PM - Page 13 of 40
PM90
PM90
PM90
PM90
PM90
(PM1120)
(PM1120)
(PM1120)
(PM1120)
(PM1120)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Roster Behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a medicine added at this item as long as
CAPI has not created a link between this medicine and an event. If a medicine, added in
PMed section, is never linked to an event, that medicine can be deleted until the end of
interview.
4. Limited edit allowed. Interviewer may edit medicines added at this item at this item as
long as CAPI has not created a link between this medicine and an event. If a medicine, added
in PMed section, is never linked to an event, that medicine can be edited until the end of
interview.
NOTE: In order for the columns to display properly, 35 allowable characters for the
medicines will be accepted for display on the roster.
When adding a medicine in the pop-up manipula, a maximum of 60 characters will be
allowed.
When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60
characters for the medicine name.
General flag rules for medicines:
- Round medicine first created (by definition a medicine is selected the same time it is
created)
- Question number medicine first created
- Round medicine selected
Display
Instructions:
Roster 3- Add/Edit/Delete Allowed.
Roster Definition:
This item displays the person’s-prescribed-medicines-roster for selection/addition. Display name of
prescribed medicine (DRUG.DRUGNAME).
Roster Filter:
Display all; no filter.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 14 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM90
Item Type:
Type Class:
Answer Type:
(PM1120)
Question
Enumerated
TYESNO
Help Available (MEDPRESHelp)
Context Header:
BLAISE NAME: PmedAsNeeded
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
{Since {START DATE}/Between {START DATE} and {END DATE}}, did {you/{PERSON}} obtain any {other}
prescriptions, even if {you/{PERSON}} {are/is} no longer taking the medicine or only take it as-needed?
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM100
BOX_40
BOX_40
BOX_40
(PM1130)
(PM1140)
(PM1140)
(PM1140)
Display ‘Since {START DATE}’ if not round 5. Display ‘Between {START DATE} and {END
DATE}’ if round 5.
Display ‘other’ if at least one medicine is flagged as selected for the current round (that is, at least one
medicine was selected at HS100, ER70, OP100, MV120, PM30, PM60, or PM80 in the current round
or PM40 was coded ‘1’ (YES) in the current round). Otherwise, use a null display.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 15 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM100
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1130)
Question
Enumerated
BLAISE NAME: PmedAsNeededRoster
Field kind: Datafield
ArrayMin:
Field Size:
TPRESCRIBEDMED Answers allowed: 110 ArrayMax:
)
Show Card (
Min value:
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
What were the names of these medicines?
PROBE: Any other medicines?
ENTER ALL THAT APPLY.
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
Responses:
{PRESCRIBED MEDICINE}1
{PRESCRIBED MEDICINE}2
{PRESCRIBED MEDICINE}3
{PRESCRIBED MEDICINE}4
{PRESCRIBED MEDICINE}N
1
2
3
4
5
PM - Page 16 of 40
BOX_40
BOX_40
BOX_40
BOX_40
BOX_40
(PM1140)
(PM1140)
(PM1140)
(PM1140)
(PM1140)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Roster Behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a medicine added at this item as long as
CAPI has not created a link between this medicine and an event. If a medicine, added in
PMed section, is never linked to an event, that medicine can be deleted until the end of
interview.
4. Limited edit allowed. Interviewer may edit medicines added at this item at this item as
long as CAPI has not created a link between this medicine and an event. If a medicine, added
in PMed section, is never linked to an event, that medicine can be edited until the end of
interview.
NOTE: In order for the columns to display properly, 35 allowable characters for the
medicines will be accepted for display on the roster.
When adding a medicine in the pop-up manipula, a maximum of 60 characters will be
allowed.
When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60
characters for the medicine name.
General flag rules for medicines:
- Round medicine first created (by definition a medicine is selected the same time it is
created)
- Question number medicine first created
- Round medicine selected
Display
Instructions:
Roster 3- Add/Edit/Delete Allowed.
Roster Definition:
This item displays the person’s-prescribed-medicines-roster for selection/addition. Display name of
prescribed medicine (DRUG.DRUGNAME).
Roster Filter:
Display all; no filter.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 17 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_40
(PM1140)
Item Type: Route
Type Class: If Then
Context Header:
Route Details:
Check person’s-prescribed-medicines-roster for selections. If at least one medicine is
flagged as selected for the current round (that is, at least one medicine was selected at
HS 100, ER70, OP100, MV120, PM30, PM60, PM80 or PM100 in the current round or
PM40 was coded ‘1’ (YES ) in the current round), continue with LOOP_10.
Otherwise, go to BOX_110.
LOOP_10
(PM1150)
Item Type: Route
Type Class: Begin Loop
Context Header:
Route Details:
For each element in person’s-prescribed-medicines-roster flagged as selected, ask
BOX_50 -END_LP10.
Loop Definition: LOOP_10 collects information about each prescribed medicine
selected during the current round. This loop cycles on prescribed medicines that meet
one of the following conditions:
- Prescribed medicine was selected at HS 100, ER70, OP100, MV120, PM30, PM60,
PM80 or PM100 in the current round for this person
or
- PM40 is coded ‘1’ (YES ) and “OTHER DIABETIC EQUIPMENT/S UPPLIES ’ is
flagged as selected for the current round
PM - Page 18 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_50
(PM1180)
Route Details:
Item Type: Route
Type Class: If Then
If medicine being looped on was linked to a condition in a prior round
(preload.PrescribedMed.PMedS pecCondFlag=Yes), go to BOX_60.
If medicine being looped on was selected at PM30 in the current round, autocode
PM110 to ‘1’ (YES ) and autocode ‘DIABETES ’ at PM120 and then go to BOX_60.
If looping on “OTHER DIABETIC EQUIPMENT/S UPPLIES ”, autocode PM110 to ‘1’
(YES ) and autocode ‘DIABETES ’ at PM120 and then go to PM140.
If medicine being looped on was selected at PM60 in the current roundautocode
PM110 to ‘1’ (YES ) and autocode ‘AS THMA’ at PM120 and then go to BOX_60.
Otherwise (medicine created this round and related to neither diabetes nor asthma),
continue with PM110.
PM110
Item Type:
Type Class:
(PM1190)
Question
Enumerated
Answer Type:
TYESNO
Help Available (
Context Header:
BLAISE NAME: PmedSpecCond
Field kind: Datafield
Field Size:
Answers allowed: 1
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF PRESCRIPTION
MEDICINE.} {STR-DT}
{END-DT}
Question Text:
Now, let's talk about {MEDICINE}.
Is {MEDICINE} used for a specific health problem?
Responses:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM - Page 19 of 40
PM120
BOX_60
BOX_60
BOX_60
(PM1200)
(PM1210)
(PM1210)
(PM1210)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Display
Instructions:
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
PM120
Item Type:
(PM1200)
Question
Type Class:
Enumerated
Answer Type:
TCONDITION
BLAISE NAME: PmedCondRoster
Field kind: Datafield
Min value:
Field Size:
Answers allowed: 110 ArrayMax:
Help Available (SpecCondHelp)
Context Header:
ArrayMin:
Show Card (
Max value:
)
Look Up File (
)
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF PRESCRIPTION
MEDICINE.} {STR-DT}
{END-DT}
Question Text:
{Now, let's talk about {MEDICINE}.}
What health problem is {MEDICINE} prescribed for?
PROBE: Any other health problems?
ENTER ALL THAT APPLY
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
HELP:F1
Responses:
{MEDICAL CONDITION} 1
{MEDICAL CONDITION} 2
{MEDICAL CONDITION} 3
{MEDICAL CONDITION} 4
{MEDICAL CONDITION}N
1
2
3
4
5
PM - Page 20 of 40
BOX_60
BOX_60
BOX_60
BOX_60
BOX_60
(PM1210)
(PM1210)
(PM1210)
(PM1210)
(PM1210)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Roster Behavior:
1. Multiple select allowed. Selection should not impact the round flag of the condition.
2. Multiple add allowed. Interviewer should record condition name.
3. Limited delete allowed. Interviewer may delete a condition added at this item as long as
CAPI has not created a link between this condition and an event. If a condition, added in
PMed section, is never linked to an event, that condition can be deleted until a link is made
between the condition and the medicine. The link between condition and the medicine is
created at END_LP10 (the end of the cuycle for the medicine being asked about).
4. Limited edit allowed. Interviewer may edit a condition name added at this item as long as
CAPI has not created a link between this condition and an event. If a condition, added in
PMed section, is never linked to an event, that condition can be edited until a link is made
between the condition and the medicine. The link between the condition and the medicine is
created at END_LP10 (the end of the cycle for the medicine being asked about).
Roster 3- Add/Edit/Delete allowed.
Roster Definition:
Display the person-medical-conditions-roster for the selection and addition of one or many medical
condition(s) associated with this medicine.
Roster Filter:
Display all conditions on person's roster; no filter.
Display ‘Now let’s talk about {MEDICINE}.’ if this is the first question presented in LOOP_10,
otherwise, use a null display.
Testing/Editing
Notes:
BOX_60
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
(PM1210)
Item Type: Route
Type Class: If Then
Context Header:
Route Details:
If medicine being asked about is flagged as 'CREATED' during the current round,
continue with PM130_01.
Otherwise, go to PM140.
PM - Page 21 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM130_01
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1220)
Question
String
BLAISE NAME: PMedStartYYYY
Field kind: Datafield
Field Size: 4
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF PRESCRIPTION
MEDICINE.} {STR-DT}
{END-DT}
Question Text:
{Now, let's talk about {MEDICINE}.}
In what year did {you/{PERSON} first use {MEDICINE}?
ENTER ' XXXX' IF PERSON HAS NOT YET TAKEN/USED MEDICINE.
ENTER 4- DIGIT YEAR
Responses:
REFUSED
DON'T KNOW
RF
DK
PM - Page 22 of 40
PM140
PM140
(PM1240)
(PM1240)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
If ' XXXX' (HAS NOT YET TAKEN/USED) entered, go to PM140.
If Rounds 1-3 and year entered is equal to or greater than person's begin reference period year
or FirstPanYear minus 1, continue with PM130_02.
If Rounds 4-5 and year entered is equal to or greater than person's begin reference period year
or SecondPanYear minus 1, continue with PM130_02.
Otherwise, go to PM140.
Range Check: Year = 1900 - 2100.
Display
Instructions:
Display PM130_01 and PM130_02, on the same form pane.
Display ‘Now let’s talk about {MEDICINE}.’ if this is the first question presented in LOOP_10,
otherwise, use a null display.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
BLAISE NAME: PMedStartMM
PM130_02
Item Type:
(PM1230)
Question
Type Class:
Answer Type:
Field Size: 2
Integer
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
)
Field kind: Datafield
Show Card (
ArrayMin:
Min value: 1
ArrayMax:
Max value: 12
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT} {NAME OF PRESCRIPTION MEDICINE.}
Question Text:
[In what year did {you/{PERSON} first use {MEDICINE}?]
What month did {you/he/she} first use {MEDICINE}?
ENTER MONTH
Responses:
REFUSED
DON'T KNOW
RF
DK
PM - Page 23 of 40
PM140
(PM1240)
PM140
PM140
(PM1240)
(PM1240)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
For specifications purposes only (CAPI handles automatically): allowable values for month
are 1-12.
The complete date cannot be before the person's date of birth or after the reference period end
date for this person.
Display
Instructions:
Display PM130_01 and PM130_02, on the same form pane.
Display bracketed question text in lighter "grayed-out" text.
Testing/Editing
Notes:
PM140
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
(PM1240)
Question
Integer
BLAISE NAME: PmedXFill
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value: 1
ArrayMax:
Max value: 99
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF PRESCRIPTION
MEDICINE.} {STR-DT}
{END-DT}
Question Text:
{Now, let's talk about {MEDICINE}.}
How many times was {MEDICINE} obtained or purchased for {you/{PERSON}} {since {START DATE} /between
{START DATE} and {END DATE}}?
ENTER NUMBER OF TIMES
Responses:
REFUSED
DON'T KNOW
RF
DK
PM - Page 24 of 40
BOX_70
(PM1250)
BOX_70
BOX_70
(PM1250)
(PM1250)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Display
Instructions:
DISPLAY 'since {START DATE}' if not Round 5.
DISPLAY 'between {START DATE} and {END DATE}' if Round 5.
Display ‘Now let’s talk about {MEDICINE}.’ if this is the first question presented in LOOP_10,
otherwise, use a null display.
Testing/Editing
Notes:
BOX_70
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
(PM1250)
Item Type: Route
Type Class: If Then
Context Header:
Route Details:
If Round 3 and PM140 is not RF or DK, continue with BOX_80.
Otherwise, go to END_LP10.
BOX_80
Route Details:
(PM1260)
Item Type: Route
Type Class: If Then
If person being looped on has a be gin reference period date of YEAR 2, auto-code
PM150 with ‘0’ and then go to END_LP10.
If person being looped on has an e nd reference period date of YEAR 1, auto-code
PM150 with the response entered at PM140 and then go to END_LP10.
Otherwise, continue with PM150.
PM - Page 25 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM150
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1270)
Question
Integer
BLAISE NAME: PmedXFillLYr
Field kind: Datafield
Field Size: 3
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value: -99
ArrayMax:
Max value: 999
)
Look Up File (
{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF PRESCRIPTION
MEDICINE.} {STR-DT}
{END-DT}
Question Text:
NUMBER OF TIMES OBTAINED/PURCHASED SINCE {START DATE}: {NUMBER OF TIMES}
Of these times, how many were in {YEAR}?
ENTER NUMBER OF TIMES
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
RF
DK
END_LP10
END_LP10
END_LP10
(PM1280)
(PM1280)
(PM1280)
Display the first year of the panel for 'YEAR'.
Hard Check:
Number of times must be <= number of times obtained/purchased at PM140 (PmedXFill).
Display
Instructions:
Testing/Editing
Notes:
For 'NUMBER OF TIMES,' display the number entered at PM140 (PmedXFill).
Variable collected at MEPSSpring2018.PM_Main.PM_Loop10[1..110]
Variable stored at MEPSSpring2018_PersSect.PM_Main.PM_Loop10[1..110]
PM - Page 26 of 40
)
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
END_LP10
(PM1280)
Item Type: Route
Type Class: End Loop
Context Header:
Route Details:
Cycle on next medicine in person’s-prescribed-medicines-roster that meets the
conditions stated in the loop definition.
If no other medicines meet the stated conditions, end LOOP_10 and continue with
PM160LU.
PM160LU
Item Type:
(PM1290)
Question
Type Class:
Enumerated
Answer Type:
TP
Help Available (PharmRosterHelp)
Context Header:
BLAISE NAME: PharmRoster
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 110 ArrayMax:
Show Card (
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}
{END-DT}
Question Text:
Please tell me the name of the pharmacy or pharmacies that filled the prescription(s) for {you/{PERSON}} {since {START
DATE}/between {START DATE} and {END DATE}}
PROBE: Any other pharmacy?
PRESS ENTER WHEN DONE SELECTING OR ADDING PHARMACIES.
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
HELP:F1
Responses:
{{PHARMACY}, {STREET ADDRESS},
{CITY}, {ST}}1
{{PHARMACY}, {STREET ADDRESS },
{CITY}, {ST}}2
{{PHARMACY}, {STREET ADDRESS},
{CITY}, {ST}}3
{{PHARMACY}, {STREET ADDRESS},
{CITY}, {ST}}4
{{PHARMACY}, {STREET ADDRESS},
{CITY}, {ST}}N
PHARMACY NOT IN LOOKUP
1
BOX_90
(PM1300)
2
BOX_90
(PM1300)
3
BOX_90
(PM1300)
4
BOX_90
(PM1300)
5
BOX_90
(PM1300)
91
BOX_90
(PM1300)
PM - Page 27 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Roster behavior:
1. Multiple select allowed.
2. Multiple add allowed. Interviewer adds one pharmacy at a time; interviewer uses CTRL-A
to begin the add process for the each new pharmacy.
3. Limited delete allowed.
4. Limited edit allowed.
5. CTRL-A launches the pharmacy look-up. Whether a pharmacy is added through the lookup or via PM170, CAPI will return to PM160LU to allow the interviewer to add or select
another pharmacy.
General flag rules for pharmacies:
- Round pharmacy first created (by definition a pharmacy is selected the same time it is
created)
- Round pharmacy selected for this RU member
- RU member pharmacy is linked to (however, this is known by virtue that the medicine was
selected at PM160 for this person).
NOTE: The round flag and which RU member the pharmacy is linked to, also known as
a person-pharmacy-pair, is key for the collection of pharmacy authorization forms.
Display
Instructions:
Roster 3- add/edit/delete allowed.
Roster Definition:
This item displays the RU-pharmacies-roster for selection/addition. Display pharmacy name
(PHAR.PHARNAME), street address, city, and state.
Roster Filter:
Display all; no filter.
Display the roster in non-proportional text.
The allowable characters for each field should be as follow before truncation:
Pharmacy: 40 characters
Street Address: 35 characters
City: 23 characters
State: 2 characters
Phone: 10 characters - stored with pharmacy info but not displayed at PM160LU.
NOTE: When a pharmacy is selected from the lookup, the name of the pharmacy saved to
the pharmacy array and will display on this roster under the 'Pharmacy' column header be
pulled from the PharmName1 column in the NPI database.
DISPLAY 'since {START DATE}' if not Round 5.
DISPLAY 'between {START DATE} and {END DATE}' if Round 5.
Display only one column of pharmacy response option categories. Each response category should have
pharmacy name, address, city, and state separated by commas.
Upon return to PM160LU, after CTRL-A has been launched at least once, display the question text
“Please tell me the name of the pharmacy or pharmacies that filled the prescription(s) for
{you/{PERSON}} {since {START DATE}/between {START DATE} and {END DATE}}” in
brackets and “grayed out” text. The instruction “PROBE: Any other pharmacy?” remains in bold black
PM - Page 28 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
text.
Testing/Editing
Notes:
BOX_90
Route Details:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
(PM1300)
Item Type: Route
Type Class: If Then
If ‘PHARMACY NOT IN LOOKUP’ selected, continue with PM170_01.
If a pharmacy is selected from the look-up, add that pharmacy to the roster at
PM160LU and select it. Return to PM160LU for interviewer to continue to select
pharmacies.
Otherwise, go to BOX_100.
BLAISE NAME: PharmName
PM170_01
Item Type:
(PM1310)
Question
Type Class:
String
Answer Type:
{Continuous Answer.} Answers allowed: 1
Field kind: Datafield
Min value:
ArrayMax:
Max value:
Field Size: 70
Help Available (PharmRosterHelp)
Context Header:
ArrayMin:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?
ENTER COMPLETE NAME AND ADDRESS AND VERIFY SPELLING. IF PHARMACY HAS MORE THAN ONE
LOCATION, RECORD LOCATION WHERE PERSON HAD PRESCRIPTION FILLED.
ENTER WEB ADDRESS ON STREET ADDRESS LINE(S).
[What is the pharmacy name?]
HELP:F1
PM170_02
Responses:
PM - Page 29 of 40
(PM1320)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
Refused and Don’t Know are disallowed.
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
BLAISE NAME: PharmStrt1
Field kind: Datafield
ArrayMin:
PM170_02
Item Type:
(PM1320)
Question
Type Class:
String
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
)
Min value:
Field Size: 40
Show Card (
ArrayMax:
Max value:
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
ENTER COMPLETE NAME AND ADDRESS AND VERIFY SPELLING. IF PHARMACY HAS MORE THAN ONE
LOCATION, RECORD LOCATION WHERE PERSON HAD PRESCRIPTION FILLED.
ENTER WEB ADDRESS ON STREET ADDRESS LINE(S).
What is the address?
Responses:
REFUSED
DON'T KNOW
RF
DK
PM - Page 30 of 40
PM170_03
(PM1330)
PM170_03
PM170_03
(PM1330)
(PM1330)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Display
Instructions:
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Display question text "[What is the name...{you/{PERSON}}?]" and interviewer instruction “ENTER
COMPLETE NAME AND ADDRESS AND VERIFY SPELLING. IF PHARMACY HAS MORE
THAN ONE LOCATION, RECORD LOCATION WHERE PERSON HAD PRESCRIPTION
FILLED.” in lighter "grayed-out" text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
BLAISE NAME: PharmStrt2
Field kind: Datafield
ArrayMin:
PM170_03
Item Type:
(PM1330)
Question
Type Class:
String
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
)
Min value:
Field Size: 40
Show Card (
ArrayMax:
Max value:
)
Look Up File (
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
ENTER COMPLETE NAME AND ADDRESS AND VERIFY SPELLING. IF PHARMACY HAS MORE THAN ONE
LOCATION, RECORD LOCATION WHERE PERSON HAD PRESCRIPTION FILLED.
ENTER WEB ADDRESS ON STREET ADDRESS LINE(S).
ENTER SECOND STREET ADDRESS, IF AVAILABLE. IF NONE, PRESS ENTER TO CONTINUE.
Responses:
EMPTY
REFUSED
DON'T KNOW
Empty
RF
DK
PM - Page 31 of 40
PM170_04
(PM1340)
PM170_04
PM170_04
PM170_04
(PM1340)
(PM1340)
(PM1340)
)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Display
Instructions:
Testing/Editing
Notes:
Allow empty.
Display question text "[What is the name...{you/{PERSON}}?]" and interviewer instruction “ENTER
COMPLETE NAME AND ADDRESS AND VERIFY SPELLING. IF PHARMACY HAS MORE
THAN ONE LOCATION, RECORD LOCATION WHERE PERSON HAD PRESCRIPTION
FILLED.” in lighter "grayed-out" text.
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
BLAISE NAME: PharmCity
PM170_04
Item Type:
(PM1340)
Question
Type Class:
String
Answer Type:
{Continuous Answer.} Answers allowed: 1
Help Available (
Context Header:
)
Field kind: Datafield
ArrayMin:
Min value:
ArrayMax:
Max value:
Field Size: 35
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
What is the city?
Responses:
REFUSED
DON'T KNOW
Display
Instructions:
RF
DK
PM170_05
PM170_05
PM170_05
(PM1350)
(PM1350)
(PM1350)
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Display question text "[What is the name...{you/{PERSON}}?]" in lighter "grayed-out" text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 32 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM170_05
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1350)
Question
String
BLAISE NAME: PharmSt
Field kind: Datafield
Field Size: 2
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
What is the state?
TYPE THE FIRST LETTER OF THE STATE, THEN USE ARROW KEYS IF NEEDED TO LOCATE STATE, AND
PRESS ENTER TO SELECT.
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
RF
DK
PM170_06
(PM1360)
PM170_06
PM170_06
(PM1360)
(PM1360)
Use state look-up file.
NOTE: The entry Foreign Country (FC) is allowed.
Display
Instructions:
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Display question text "[What is the name...{you/{PERSON}}?]" in lighter "grayed-out" text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 33 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM170_06
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1360)
Question
String
BLAISE NAME: PharmZip
Field kind: Datafield
Field Size: 5
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
What is the zip code?
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
Display
Instructions:
RF
DK
PM170_07
(PM1370)
PM170_07
PM170_07
(PM1370)
(PM1370)
Hard check: Exactly 5 digit numeric entry required. If less than 5 numeric
digits entered in PM170_06 (PharmZip) or any characters entered that are not
numeric, display the following message: "ZIP CODE ENTRY REQUIRES
EXACTLY 5 NUMBERS. PROBE AND RE-ENTER OR ENTER F5
(DON'T KNOW) IF FULL ZIP CODE IS NOT KNOWN."
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Display question text "[What is the name...{you/{PERSON}}?]" in lighter "grayed-out" text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 34 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM170_07
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:
(PM1370)
Question
Integer
BLAISE NAME: PharmPhone
Field kind: Datafield
Field Size: 10
{Continuous Answer.} Answers allowed: 1
)
Show Card (
ArrayMin:
Min value: 0000000000
ArrayMax:
Max value: 9999999999
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
[What is the name and address of the pharmacy that filled the prescription(s) for {you/{PERSON}}?]
What is the telephone number?
IF NO TELEPHONE, ENTER DK.
Responses:
REFUSED
DON'T KNOW
Programmer
Instructions:
RF
DK
Ten digit entry required for this field.
Display hard check if less than 10 digits are entered in PM170_07 (PharmPhone) : “PHONE
ENTRY REQUIRES EXACTLY 10 NUMBERS. PROBE AND RE-ENTER OR ENTER F5 (DON’T
KNOW) IF FULL PHONE NUMBER IS NOT KNOWN.”
Use number input mask (XXX-XXX-XXXX) in the response field.
Add the pharmacy created at PM170_01 through PM170_07 to the roster at PM160LU and
select it. Return to PM160LU for interviewer to continue to select pharmacies.
Display
Instructions:
Display PM170_01, PM170_02, PM170_03, PM170_04, PM170_05, PM170_06 and PM170_07 on
the same form pane.
Display question text "[What is the name...{you/{PERSON}}?]" in lighter "grayed-out" text.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 35 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Rout
Full Detail Spec
BOX_100
(PM1380)
Type Class: If Then
Item Type: Route
Context Header:
Route Details:
If at least one pharmacy selected at PM160LUfor this person where PharmTp is missing
[(Preload.PharmTp=RF, DK, or Empty) and (PharmTp=Empty for the current round)],
continue with PM180.
Otherwise, go to PM190.
PM180
Item Type:
Type Class:
(PM1390)
Question
Answer Type:
TPHARTYPE
Enumerated
BLAISE NAME: PharmTp
Field kind: Datafield
ArrayMin:
Field Size:
Answers allowed: 1
Help Available (PharmTpHelp)
Context Header:
Min value:
ArrayMax:
Show Card (
)
Max value:
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {PHARMACY NAME} {STR-DT}
{END-DT}
Question Text:
What type of pharmacy is {PHARMACY}? Is it a mail-order pharmacy; a pharmacy located in another store such as a grocery
or department store; a pharmacy located in an HMO, clinic, or hospital; a drug store that is not located within another facility;
or is it an on-line pharmacy?
HELP: F1
Responses:
MAIL-ORDER
IN ANOTHER STORE
IN HMO/CLINIC/HOSPITAL
DRUG STORE
ON-LINE
REFUSED
DON'T KNOW
1
2
3
4
5
RF
DK
PM - Page 36 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Preloaded Grid Type 1 including question PM180.
Continue with PM190 once grid is complete.
Display
Instructions:
Roster 1 – Report
Roster Definition:
This item displays the RU-pharmacies-roster as the first two columns of the grid. Display only
pharmacy name and first street address in these columns. These columns are protected and cannot be
changed.
Roster Filter:
Display only pharmacies that are newly added to the roster (do not have a pharmacy type associated
with them).
When on grid rows, 2-n, display the text “Is it a mail-order…on-line pharmacy?” in grayed out text.
The question “What type of pharmacy is {PHARMACY}?” will stay in bold black when on every row
of the grid. Display the actual pharmacy name for the row the cursor is on for “PHARMACY”.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 37 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM190
Item Type:
Type Class:
Answer Type:
(PM1400)
Question
Enumerated
BLAISE NAME: PMed3Part
TYESNO
Help Available (PMed3PartHelp)
Context Header:
Field kind: Datafield
ArrayMin:
Min value:
Field Size:
Answers allowed: 1
ArrayMax:
Max value:
Show Card (
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
Now I’d like to ask you about the charges for {your/{PERSON}’s} prescription medicine(s).
Has {your/{PERSON}’s} health insurance or another source of coverage helped pay for any of {your/his/her} prescription
medications {since {START DATE}/between {START DATE} and {END DATE}}?
SELECT ‘NO’ IF PERSON REPORTS NO HEALTH INSURANCE OR ANOTHER SOURCE OF COVERAGE.
HELP: F1
Responses:
Display
Instructions:
YES
NO
REFUSED
DON'T KNOW
1
2
RF
DK
PM200
BOX_110
BOX_110
BOX_110
Display Instructions:
DISPLAY ‘since {START DATE}’ IF NOT ROUND 5.
DISPLAY ‘between {START DATE} and {END DATE}’ IF ROUND 5.
Testing/Editing
Notes:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
PM - Page 38 of 40
(PM1410)
(PM1420)
(PM1420)
(PM1420)
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
PM200
Item Type:
Type Class:
Answer Type:
(PM1410)
Question
Enumerated
BLAISE NAME: PMed3Roster
Field kind: Datafield
Field Size:
TNAMSRCEDIRPAY Answers allowed: 1
Help Available (
Context Header:
)
Show Card (
ArrayMin:
Min value:
ArrayMax:
Max value:
)
Look Up File (
)
{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
Question Text:
Who usually helps pay?
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
Responses:
{NAME OF SOURCE OF DIRECT
PAYMENT}1
{NAME OF SOURCE OF DIRECT
PAYMENT}2
{NAME OF SOURCE OF DIRECT
PAYMENT}3
{NAME OF SOURCE OF DIRECT
PAYMENT}4
{NAME OF SOURCE OF DIRECT
PAYMENT}N
1
BOX_110
(PM1420)
2
BOX_110
(PM1420)
3
BOX_110
(PM1420)
4
BOX_110
(PM1420)
5
BOX_110
(PM1420)
PM - Page 39 of 40
MEPS_V2
Prescribed Medicines (PM) Section
(Que
Full Detail Spec
Programmer
Instructions:
Write sources selected to the sources-of-payment roster.
If at least one source is added or selected during the current round, the flag SOPFlag should
be set to YES.
Roster Behavior:
1. Add one only or select one only.
2. Add allowed. Selecting CTRL-A displays a pop-up with a text entry field and a selectable
list of 15 common sources of payment. (See BOX_20 in the Charge/Payment (CP) Section
Specifications for a detailed list). The interviewer can type a new source or select one from
the list. Upon return to PM200, the added source will appear on the roster as selected.
3. Limited delete allowed. If interviewer adds a source of payment, delete is possible for that
source only, as long as the interviewer has not left the screen. If delete is attempted when it is
not allowed, CAPI displays the following error message: ‘Delete Allowed only when source
of payment is first entered.’
4. Limited edit allowed. If interviewer adds a source of payment, editing is possible for that
source only, as long as the interviewer has not left the screen. If edit is attempted when it is
not allowed, CAPI displays the following error message: ‘Edit allowed only when source of
payment first entered.’
Display
Instructions:
Roster 3 – Add/Edit/Delete allowed
Roster Definition:
Display the RU-Sources-Of-Payment-Roster for selection.
Roster Filter:
Display all sources of payment that are not "PERSON/FAMILY".
Testing/Editing
Notes:
BOX_110
Route Details:
Variable collected at MEPSSpring2018.PM_Main
Variable stored at MEPSSpring2018_PersSect.PM_Main
(PM1420)
Item Type: Route
Type Class: If Then
Go to next questionnaire section.
[End of PM]
PM - Page 40 of 40
| File Type | application/pdf |
| File Modified | 2018-02-21 |
| File Created | 2017-09-22 |