CMS-P-0015A Prescribed Medicine Utilization

2023 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

PMQ-PRESCRIBED MEDICINE UTILIZATION

Question Text/Description

Code List

Routing

PRESCRIBED MEDICINE UTILIZATION QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C007, C010
SPALIVE=ALL
SEASON=ALL
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
If INTTYPE in(C001, C002, C004, C005, C006, C007) AND SEASON=WINTER, administer after ACQ.
If INTTYPE in(C001, C002, C004, C005, C006, C010) AND SEASON =SUMMER/FALL, administer after MPQ.

[Now let’s talk about prescribed medicines [you have/(SP) has] obtained since (REFERENCE DATE/UTILDATE).]
PMINTA

PMINTROA

no entry

[While talking about medical visits, you mentioned some medicine(s): [READ MEDICINE NAME(S) BELOW.]]

PM1 - PMFILLED

[Now I’d like to talk about prescribed medicines.]

PMFILLED

PM1PMMEDS

PM1

yes/no

BOX PM1

routing

GETPMMEDS

no entry

[Besides that medicine, /Besides those medicines, ] [(Since/since) (REFERENCE
DATE/UTILDATE)/(Between/between) (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION/ENDUTILD)] [have you had/has (SP) had/did (SP) have] any (other) prescriptions filled?
[COUNT A MEDICINE AS "FILLED" REGARDLESS OF WHO OBTAINED IT FOR THE RESPONDENT, WHEN IT
WAS OBTAINED, WHETHER OR NOT THE PRESCRIPTION COST ANYTHING, AND WHETHER OR NOT THE
RESPONDENT ACTUALLY TOOK THE MEDICINE.]

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

(01) BOX PM1
(02) PM3 - PMREFILL
(-8) PM3 - PMREFILL
(-9) PM3 - PMREFILL

IF THE PROBE FOR PRESCRIPTION MEDICINE BOTTLES HAS NOT BEEN ASKED IN THE CURRENT ROUND,
GO TO GETPMMEDS - PM1PMMEDS.
ELSE GO TO PM2 - MEDICINE_PM1.

It would be helpful if I could look at any medicine bottle(s), container(s), or bag(s) that you have so that I can spell
the medicine name correctly and enter the strength of the medicine. [Also, please take out [your/(SP's)]
(MEDICARE PRESCRIPTION DRUG PLAN NAME) medicine statements, which should have that same information
on them.]

BOX PM2

[IF RESPONDENT HAS BOTTLE, ASK:] I’ll need that same information for all of the medicines [you/(SP)] obtained
since the last interview, if you’d like to get those bottles, too.

BOX PM2

routing

IF THERE IS AT LEAST ONE MEDICINE FROM A PRIOR ROUND ON THE EVENT TABLE FOR THIS CASE, GO
TO MEDICINE_PM1-MEDICINE_PM1.
ELSE GO TO PM2B-PMBOTTLE.

Page 1 of 8

2023 MCBS Community Questionnaire

Variable Name

MEDICINE_PM1

MR Screen Name

Question Type

PMQ-PRESCRIBED MEDICINE UTILIZATION

Question Text/Description

Code List

Routing

[DISPLAY MEDICINE ROSTER AS RESPONSE
OPTIONS:
1. [MEDICINE 1]
2. [MEDICINE 2]
…
N. [MEDICINE N]
N+1. ADD ANOTHER
[DISPLAY MEDICINE NAME, STRENGTH, FORM, AND
QUANTITY FOR EACH.

BOX PM3

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

BOX PM4

(01) YES
(02) NO
(03) NO BUT R CAN ANSWER QUESTIONS
(-8) DON'T KNOW
(-9) REFUSED

(01) MED-PMEDNAME
(02) PMKNWNM-PMKNWNM
(03) MED-PMEDNAME
(-8) PMKNWNM-PMKNWNM
(-9) PMKNWNM-PMKNWNM

MEDICINE_PM1

code one

What is the name of the medicine?

BOX PM3

routing

IF THIS MEDICINE HAS AN EXACT MATCH TO THE FDB LIST ( PMEDID^=.), THEN GO TO PM2A-SAMEFSAM.
ELSE GO TO PMBOTTLE-PMBOTTLE.

CODE "YES" WITHOUT ASKING IF STATEMENT, RECEIPT, BOTTLE OR BAG IS PRESENT AND FORM,
STRENGTH AND AMOUNT ARE EXACTLY THE SAME AS IN THE PREVIOUS INTERVIEW.
At the time of the last interview, [you/(SP)] purchased (MEDICINE NAME) in the form of (MEDICINE FORM).
SAMEFSAM

SAMEFSAM

yes/no

The strength was [MEDICINE STRENGTH].
The amount in the container when it was obtained was (PREVIOUS ROUND MEDICINE AMOUNT).
Is this medicine in the same strength, form and amount?
CODE "NO" UNLESS FORM, STRENGTH, AND AMOUNT EXACTLY MATCH PREVIOUS ROUND.

BOX PM4

PMBOTTLE

PMBOTTLE

routing

IF SAMEFSAM=1/YES, THEN DO NOT CREATE A NEW EVENT FOR THIS MEDICINE AND GO TO GETNUMGETNUM.
ELSE, CREATE A NEW EVENT FOR THIS MEDICINE AND GO TO PM2B-PMBOTTLE.

code one

CODE “YES” WITHOUT ASKING IF BOTTLE, CONTAINER, BAG, STATEMENT, OR RECEIPT IS PRESENT.
Do you have the medicine bottle, container or bag, or Prescription Drug Plan Statement available?
IF R DOES NOT HAVE DOCUMENTATION, PROBE TO DETERMINE IF R CAN ANSWER QUESTIONS ABOUT
THE FORM, STRENGTH, AND QUANTITY OF THE MEDICINE.

TO USE THE MEDICINE LOOKUP, START TYPING THE MEDICINE NAME IN THE PRESCRIBED MEDICINE
LOOKUP BOX. CHECK STATEMENT OR MEDICINE BOTTLE FOR SPELLING.
PMEDNAME

MED

lookup

ONCE YOU HAVE ENTERED ALL DETAILS FOR A MEDICINE, IF YOU NEED TO GO BACK AND CORRECT,
USE THE GREEN “RETURN TO PRESCRIBED MEDICINE LOOKUP” BUTTON.

[MEDICINE NAME SELECTED FROM LOOKUP OR
MANUALLY TYPED]

[PRESCRIBED MEDICINE LOOKUP TOOL]

PMBRNAME

MED

lookup

[PM BRAND NAME]

Page 2 of 8

2023 MCBS Community Questionnaire

PMQ-PRESCRIBED MEDICINE UTILIZATION

Variable Name

MR Screen Name

Question Type

Question Text/Description

PMGNNAME

MED

lookup

[PM GENERIC NAME]

PMFORMFD

MED

lookup

Medicine Form [FDB LIST FORM NAME]

Code List

Routing

(01)-(12) MED-PMSTRNFD
(91) MED-PMFORMOS
(-8) MED-PMSTRNFD
(-9) MED-PMSTRNFD

PMFORMMC

MED

code one

Medicine Form [MCBS FORM]

(01) PILLS (TABLETS, CAPSULES)
(02) LIQUID (TO BE TAKEN ORALLY)
(03) DROPS (EYE/EAR/NOSE)
(04) OINTMENT, CREAM, LOTION (TOPICAL OR
INTERNAL)
(05) SUPPOSITORIES
(06) AEROSOL/SPRAY, INHALANT, SOLUTIONS,
DISKUS
(07) SHAMPOO, SOAP
(08) INJECTION
(09) IV INJECTION
(10 PATCHES
(11) GEL OR JELLY (TOPICAL OR INTERNAL)
(12) POWDER, GRANULES
(91) OTHER
(-8) Don't Know
(-9) Refused

PMFORMOS

MED

verbatim

[MEDICINE FORM OTHER SPECIFY]

(01) CONTINUOUS ANSWER

PMFORMFN

MED

verbatim

[FINAL CONCATENATED MEDICINE FORM]

PMSTRNFD

MED

verbatim

Medicine Strength

(01) [MEDICINE FORM SELECTED FROM LOOKUP]
(-7) NOT FOUND
(-8) DON'T KNOW

STRNNUMBB

MED

numeric

Medicine strength number

(01) CONTINUOUS ANSWER

STRNUNIT

MED

code one

PMSTRNOS

MED

verbatim

Medicine strength unit

(01) MICROGRAMS (mcg, mc)
(02) MILLIGRAMS (mg)
(03) GRAINS (gr)
(04) MILLIEQUIVALENTS (meq)
(05) GRAMS (g, gm)
(06) PERCENT (%)
(07) INTERNATIONAL UNITS (IU)
(08) UNITS (U)
(91) OTHER
(-8) Don't Know
(-9) Refused

(01)-(08) MED-MEDID
(91) MED-PMSTRNOS
(-8) MED-PMEDID
(-9) MED-PMEDID

[MEDICINE STRENGTH UNIT OTHER SPECIFY]

Page 3 of 8

2023 MCBS Community Questionnaire

PMQ-PRESCRIBED MEDICINE UTILIZATION

Variable Name

MR Screen Name

Question Type

Question Text/Description

PMSTRUNI

MED

ookup

[FINAL CONCATENATED MEDICINE STRENGTH]

PMEDID

MED

numeric

[THIS VARIABLE STORES THE UNIQUE IDENTIFIER FOR PRESCRIBED MEDICINES ADDED THROUGH THE
LOOKUP. IT IS HIDDEN ON SCREEN.]

FAMILYID

MED

numeric

[THIS VARIABLE STORES THE UNIQUE IDENTIFIER FOR PRESCRIBED MEDICINES BY NAME ONLY,
EXCLUDING STRENGTH AND FORM, THROUGH THE LOOKUP. IT IS HIDDEN ON SCREEN.]

PMKNWNM

PMKNWNM

code one

DOES THE RESPONDENT KNOW THE NAME OF THE MEDICINE?

PMCOND

PMCOND

code one

PMCONDOS

PMCOND

verbatim

GETNUM

GETNUM

BOX PM5

numeric

routing

What condition is this medicine prescribed for or what is its primary use?
IF THIS MEDICINE IS TAKEN FOR MORE THAN ONE CONDITION, SELECT ONLY ONE.

OTHER (SPECIFY)

How many times [since (REFERENCE DATE)/between (REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)] did [(you/(SP)] obtain (MEDICINE NAME)]]?

Code List

Routing

(01) YES
(02) NO
(-9) REFUSED

(01) MED-PMEDNAME
(02) PMCOND-PMCOND
(-9) PMCOND-PMCOND

(01) ALLERGY MEDICINE
(02) ALZHEIMERS
(03) ANTIBIOTICS
(04) ANTIPSYCHOTIC
(05) ASTHMA OR COPD
(06) BLOOD PRESSURE
(07) CHOLESTEROL
(08) COUGH AND COLD MEDICINE
(09) DEPRESSION
(10) DIABETES
(11) DIURETICS (WATER PILLS)
(12) EAR DROPS
(13) ESTROGEN
(14) EYE DROPS OR PREPARATION
(15) NASAL SPRAY/DROPS
(16) OSTEOPOROSIS (BONE LOSS)
(17) PAIN MEDICINE
(18) STEROID (GLUCOCORTICOID)
(19) STOMACH ACID OR ULCER
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

(01)-(19) GETNUM-GETNUM
(91) PMCOND-PMCONDOS
(-8) GETNUM-GETNUM
(-9) GETNUM-GETNUM

(01) CONTINUOUS ANSWER
(-8) DON'T KNOW
(-9) REFUSED

(01) continuous answer
(996) EVENT ENTERED IN ERROR
(-8) Don't Know
[IF THE MEDICINE WAS ENTERED IN ERROR AND WAS NOT OBTAINED IN THE CURRENT ROUND, CHECK
(-9) Refused
“ENTERED IN ERROR” AND LEAVE THE BOX BLANK WHERE YOU ENTER THE NUMBER OF REFILLS.]

BOX PM5

IF GETNUM=996/EVENT ENTERED IN ERROR OR PMKNWNM=02/NO, GO TO PMMORE-PMMORE;
IF SAMEFSAM=1/YES AND PMFORMFN=pills (tablets, capsules), GO TO PM12-TABSADAY;
ELSE IF MEDICINE FORM IS PILLS, TABLETS OR CAPSULES [PMFORMMC=1 OR PMFORMFD CONTAINS
("PILL", "TAB", "CAP") GO TO TABNUM-TABNUM;
ELSE GO TO PM16-AMTUNIT.

Page 4 of 8

2023 MCBS Community Questionnaire

PMQ-PRESCRIBED MEDICINE UTILIZATION

Variable Name

MR Screen Name

Question Type

Question Text/Description

Code List

Routing

TABNUM

TABNUM

numeric

HOW MANY PILLS, TABLETS, OR CAPSULES WERE IN THE CONTAINER WHEN IT WAS OBTAINED?

(01) CONTINUOUS ANSWER
(-8) DON'T KNOW

BOX PM6

(01) PM16 - AMTNUM
(02) PM16 - AMTNUM
(03) PM16 - AMTNUM
(04) PM16 - AMTNUM
(05) PM16 - AMTNUM
(06) PM16 - AMTNUM
(07) PM16 - AMTNUM
(91) PM16 - AMTUNOS
(-8) PM16 - AMTNUM
(-9) PM16 - AMTNUM

AMTUNIT

PM16

quantity unit

HOW MUCH MEDICINE WAS IN THE CONTAINER WHEN IT WAS OBTAINED?
[PLEASE ENTER THE AMOUNT IN THE CONTAINER, NOT THE STRENGTH OF THE MEDICINE.]

(01) OUNCES (oz)
(02) GRAMS (g, gm)
(03) MILLILITERS (ml, cc)
(04) MILLIEQUIVALENTS (meq)
(05) MILLIGRAMS (mg)
(06) MICROGRAMS (mcg)
(07) PUFFS, DOSES, BLISTERS
(91) OTHER
(-8) DON'T KNOW
(-9) REFUSED

AMTUNOS

PM16

text

OTHER (SPECIFY)

(01) CONTINUOUS ANSWER

PM16 - AMTNUM

AMTNUM

PM16

numeric

(01) CONTINUOUS ANSWER

BOX PM6

BOX PM6

routing

IF PRESCRIPTION MEDICINE FORM IS PILLS, TABLETS OR CAPSULES, GO TO PM12 - TABSADAY.
ELSE GO TO BOX PM7.

HOW MANY PILLS, TABLETS, OR CAPSULES ARE PRESCRIBED TO BE TAKEN IN A DAY?

TABSADAY

PM12

numeric

TABSADAY95

PM12

code one

IF LESS THAN ONE UNIT IS TO BE TAKEN PER DAY, ENTER THE APPROPRIATE DECIMAL VALUE (EX: HALF
A PILL SHOULD BE ENTERED AS "0.5")
FOR MEDICINES TO BE TAKEN “AS NEEDED,” ENTER THE MAXIMUM AMOUNT THAT IS TO BE TAKEN IN A (01) CONTINUOUS ANSWER
DAY AND SELECT "TAKE AS NEEDED".
FOR MEDICINES TO BE TAKEN ON AN IRREGULAR SCHEDULE OR THAT VARY BY DAY, SELECT "OTHER
DOSING INSTRUCTIONS".
IF THE AMOUNT TO BE TAKEN PER DAY IS NOT CLEAR OR NOT INDICATED, SELECT "DON'T KNOW".

PM12 - TABSADAY95

(02) TAKE AS NEEDED
(03) OTHER DOSING INSTRUCTIONS
(-7) Empty

PM13-TABTAKE

(01) CONTINUOUS ANSWER
(-7) EMPTY
(-8) DON'T KNOW

PM13 - TABTAKE96

How many pills, tablets, or capsules (do/did/does) [you/(SP)] usually take in a day?
[READ IF NECESSARY: This question is asking about how often you actually take the medicine, not how often the
medicine is prescribed to be taken.]
TABTAKE

PM13

numeric
IF LESS THAN ONE UNIT IS TAKEN PER DAY, ENTER THE APPROPRIATE DECIMAL VALUE (EX: HALF A PILL
SHOULD BE ENTERED AS "0.5")
FOR MEDICINES TAKEN “AS NEEDED,” SELECT "TAKE AS NEEDED".
FOR MEDICINES TAKEN ON AN IRREGULAR SCHEDULE OR THAT VARY BY DAY, SELECT "OTHER DOSING
INSTRUCTIONS".

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2023 MCBS Community Questionnaire

Variable Name

TABTAKE96

MR Screen Name

PM13

BOX PM7

PMSATVA

PMSATVA

BOX PM8

PMSATHMO

PMSATHMO

Question Type

PMQ-PRESCRIBED MEDICINE UTILIZATION

Question Text/Description

code one

routing

IF (SP REPORTED RECEIVING HEALTH CARE SERVICES THROUGH V.A. IN THE CURRENT ROUND OR ANY
PREVIOUS ROUND), GO TO PMSATVA - PMSATVA.
ELSE GO TO BOX PM8.

yes/no

Did [you/(SP)] obtain (this purchase/any of these purchases) of (MEDICINE NAME) through the Department of
Veterans Affairs or V.A.?

routing

IF SP COVERED BY A MEDICARE MANAGED CARE PLAN OR A PRIVATE MANAGED CARE PLAN ANYTIME
DURING THE CURRENT ROUND, GO TO PMSATHMO - PMSATHMO.
ELSE GO TO PMMORE-PMMORE.

yes/no

Did [you/(SP)] obtain (this purchase/any of these purchases) of (MEDICINE NAME) at [READ MANAGED CARE
PLAN NAME(S) BELOW] or through a service or discount offered through [READ MANAGED CARE PLAN
NAME(S) BELOW]?
[PROBE: This could include obtaining the purchases at a plan pharmacy; at a pharmacy that honors [your/(SP’s)]
plan card; or through a mail order service that the managed care plan referred [you/(SP)] to.]

([NO MEDICINES HAVE BEEN REPORTED FOR (SP) FOR THE CURRENT REFERENCE PERIOD/THE NAMES
OF ALL MEDICINES REPORTED FOR THE CURRENT REFERENCE PERIOD ARE DISPLAYED BELOW.])
PMMORE

PMREFILL

PMDRPHON

PM17

PMREFILL

PMDRPHON

yes/no

yes/no

yes/no

[REVIEW THE INFORMATION BELOW WITH THE RESPONDENT. ASK, OR CODE AS APPROPRIATE IF R
ALREADY INDICATED: Are there any (more) medicines since (REFERENCE DATE/UTILDATE) that we haven't
talked about?]

Code List

Routing

(01) DON'T TAKE EVERY DAY
(02) TAKE AS NEEDED
(03) OTHER DOSING INSTRUCTIONS
(-7) EMPTY

BOX PM7

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

BOX PM8

(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED

PMMORE-PMMORE

(01) ADD ANOTHER
(02) ALL DONE

(01) BOX PM2
(02) PMREFILL - PMREFILL

People sometimes forget to mention refills of earlier prescriptions. (In addition to what you’ve told me about,
did/Did) [you/(SP)] have any prescriptions refilled [since (REFERENCE DATE/UTILDATE)/between (REFERENCE
DATE) and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD)]?

(01) YES
(02) NO
(-8) DON'T KNOW
[COUNT A MEDICINE AS "REFILLED" REGARDLESS OF WHO OBTAINED IT FOR THE RESPONDENT, WHEN
(-9) REFUSED
IT WAS OBTAINED, WHETHER OR NOT THE PRESCRIPTION COST ANYTHING, AND WHETHER OR NOT
THE RESPONDENT ACTUALLY TOOK THE MEDICINE.]

People sometimes forget to mention prescriptions that were phoned in by a doctor. (In addition to what you’ve told
me about, did/Did) [you/(SP)] get any medicine prescribed by a doctor or other health professional in a telephone
call to a drugstore or pharmacy [since (REFERENCE DATE/UTILDATE)/between (REFERENCE DATE) and (DATE (01) YES
OF DEATH/DATE OF INSTITUTIONALIZATION/ENDUTILD)]?
(02) NO
(-8) DON'T KNOW
[INLCUDE ALL PRESCRIBED MEDICINES REGARDLESS OF WHO OBTAINED IT FOR THE RESPONDENT,
(-9) REFUSED
WHEN IT WAS OBTAINED, WHETHER OR NOT THE PRESCRIPTION COST ANYTHING, AND WHETHER OR
NOT THE RESPONDENT ACTUALLY TOOK THE MEDICINE.]

(01) BOX PM2
(02) PMDRPHON - PMDRPHON
(-8) PMDRPHON - PMDRPHON
(-9) PMDRPHON - PMDRPHON

(01) BOX PM2
(02) BOX PM4A
(-8) BOX PM4A
(-9) BOX PM4A

Page 6 of 8

2023 MCBS Community Questionnaire

Variable Name

PMNOTGET

PMQ-PRESCRIBED MEDICINE UTILIZATION

MR Screen Name

Question Type

Question Text/Description

BOX PM4A

routing

IF SPALIVE=1 (ALIVE) AND SEASON=WINTER GO TO PMNOTGET-PMNOTGET. ELSE GO TO BOX PMEND.

yes/no

(01) YES
Now thinking about all of last year, that is calendar year [ROUND YEAR – 1], were any medicines prescribed for
(02) NO
[you/(SP)] that [you/(SP)] did not get? Please include refills of earlier prescriptions as well as prescriptions that were
(-8) Don't Know
written or phoned in by a doctor or other health professional.
(-9) Refused

PMNOTGET

Code List

Routing

(01) SC16 - TEMPMED1
(02) BOX PMEND
(-8) BOX PMEND
(-9) BOX PMEND

[DISPLAY MEDICINE ROSTER]
TEMPMED1

SC16

text

(01) [Continuous answer.]

SC16 - TEMPMED2

TEMPMED2

SC16

text

What were the names of those medicines?
ENTER ALL MEDICINES.

(01) [Continuous answer.]

(01) SC16 - TEMPMED3
(-7) SCPMCODS -SCPMCODS

TEMPMED3

SC16

text

What were the names of those medicines?
ENTER ALL MEDICINES.

(01) [Continuous answer.]

(01) SC16 - TEMPMED4
(-7) SCPMCODS -SCPMCODS

TEMPMED4

SC16

text

What were the names of those medicines?
ENTER ALL MEDICINES.

(01) [Continuous answer.]

(01) SC16 - TEMPMED5
(-7)SCPMCODS -SCPMCODS

TEMPMED5

SC16

text

What were the names of those medicines?
ENTER ALL MEDICINES.

(01) [Continuous answer.]

SCPMCODS -SCPMCODS

(01) THOUGHT IT WOULD COST TOO MUCH
(02) DIDN'T THINK MEDICINE WOULD HELP
CONDITION
(03) WAS AFRAID OF MEDICINE
REACTIONS/CONTRAINDICATIONS
(04) DON'T LIKE TO TAKE MEDICINE
(05) DIDN'T THINK MEDICINE WAS NECESSARY
(06) NOT COVERED BY INSURANCE/NOT ON PLAN
FORMULARY
(07) TROUBLE OBTAINING MEDICINE
(08) OBTAINED/USED SAMPLES
(09) USED ANOTHER MEDICINE AS A SUBSTITUTION
(91) (OTHER/SC17A - SCPMOTOS OTHER SPECIFY
TEXT)
(-8) Don't Know
(-9) Refused

(01) BOX SC2
(02) BOX SC2
(03) BOX SC2
(04) BOX SC2
(05) BOX SC2
(06) BOX SC2
(07) BOX SC2
(08) BOX SC2
(09) BOX SC2
(91) SCPMOTOS - SCPMOTOS
(-8) BOX PMEND
(-9) BOX PMEND

(01) [Continuous answer.]

BOX SC2

What were the names of those medicines?
ENTER ALL MEDICINES.

SHOW CARD PM1
This card lists some reasons people have given for not having prescriptions filled or refilled.
Which of these reasons explains why [you/(SP)] did not obtain the [READ MEDICINE(S) BELOW]?
SCPMCODS

SCPMCODS

code all

[MEDICINE 1 FROM SC16]
[MEDICINE 2 FROM SC16]
[MEDICINE 3 FROM SC16]
[MEDICINE 4 FROM SC16]
[MEDICINE 5 FROM SC16]
[PROBE: Any other reason?]
CHECK ALL THAT APPLY.

SCPMOTOS

SCPMOTOS

verbatim text

OTHER (SPECIFY)

BOX SC2

routing

IF SCPMCODS - SCPMCODS INCLUDES MORE THAN ONE RESPONSE, GO TO SCPMMAIN - SCPMMAIN.
ELSE GO TO BOX PMEND.

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2023 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

PMQ-PRESCRIBED MEDICINE UTILIZATION

Question Text/Description

Which of these was the main reason [you/(SP)] did not obtain [this medicine/these medicines] during (ROUND
YEAR – 1)?
[READ REASONS BELOW IF NECESSARY.]
SCPMMAIN

SCPMMAIN

code 1

[MEDICINE 1 FROM SC16]
[MEDICINE 2 FROM SC16]
[MEDICINE 3 FROM SC16]
[MEDICINE 4 FROM SC16]
[MEDICINE 5 FROM SC16]

BOX PMEND

routing

GO TO OMQ.

Code List

Routing

(01) THOUGHT IT WOULD COST TOO MUCH
(02) DIDN'T THINK MEDICINE WOULD HELP
CONDITION
(03) WAS AFRAID OF MEDICINE
REACTIONS/CONTRAINDICATIONS
(04) DON'T LIKE TO TAKE MEDICINE
(05) DIDN'T THINK MEDICINE WAS NECESSARY
(06) NOT COVERED BY INSURANCE/NOT ON PLAN
BOX PMEND
FORMULARY
(07) TROUBLE OBTAINING MEDICINE
(08) OBTAINED/USED SAMPLES
(09) USED ANOTHER MEDICINE AS A SUBSTITUTION
(91) (OTHER/SC17A - SCPMOTOS OTHER SPECIFY
TEXT)
(-8) Don't Know
(-9) Refused

Page 8 of 8