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Pre-intervention survey

1. What are the most recent recommendations for daily hydroxychloroquine dosing? (Marmor, M.F., et al., Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision). Ophthalmology, 2016. 123(6): p. 1386-94.)

a. ≤ 5.0mg/kg b. 5-6 mg/kg c. ≤ 6.5 mg/kg

2. Should the calculation in question #1 be based on actual body weight or ideal body weight?

a. Actual b. Ideal

3. Do you use these 2016 guidelines when prescribing hydroxychloroquine to your patients?

a. Yes

b. No

4. Do you feel that these 2016 guidelines accurately balance the risk of retinal toxicity with the therapeutic benefit of hydroxychloroquine?

a. Yes

b. No

5. Are you concerned that changing your patients’ dose based on these guidelines might lead to non-adherence in your patients?

a. Yes

b. No

6. Are you concerned that changing your patients’ dose based on these guidelines might lead to flares of their auto-immune disease?

a. Yes

b. No

7. Would you find it helpful if your electronic medical record (EMR) automatically calculated a weight-based dose when prescribing or refilling hydroxychloroquine?

a. Yes

b. No

8. If your EMR automatically calculated a weight-based dose when prescribing or refilling hydroxychloroquine, would this change your clinical practice?

a. Yes

b. No

9. Are you a member of the rheumatology team or dermatology team?

a. Rheumatology b. Dermatology

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