Platform Randomised trial of INterventions against COVID-19 In older peoPLE - PRINCIPLE
Participant Registration
Screening Form
Thank you for considering participating in the PRINCIPLE trial.
If you have not already read the Participant Information Leaflet you can download it by clicking the link below.
Click here to download the PRINCIPLE Participant Information Leaflet
There is also an illustrated summary of the Participant Information Leaflet that you can download by clicking the link below:
Click here to download an illustrated summary of the PRINCIPLE Participant Information Leaflet
Click here to access translated versions of the PRINCIPLE Participant Information Leaflet
To start your registration, please complete this screening form.
After you have answered all the questions on this form
please click the "Submit" button at the bottom of the page to proceed to your Consent Form
Are you willing to give informed consent for participation in the study?
Do you have a new continuous cough or high temperature which have been present for less than 15 days?

Defined:
A new continuous cough - this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)
and/or
A high temperature - this means you feel hot to touch on your chest or back
(you do not need to take your temperature)

What date did you start to feel unwell with this illness?
- -
Are you feeling almost recovered from this illness (i.e. generally much improved and your symptoms are now mild or almost absent)?
Have you had a positive test for COVID-19 infection?
What date was this COVID-19 test taken?
- -
Are you unwell with symptoms of COVID-19?
These symptoms may include, but are not limited to, shortness of breath, general feeling of being unwell, muscle pain, diarrhoea and vomiting.
What date did you start to feel unwell with this illness?
- -
Are you feeling almost recovered from this illness
(i.e. generally much improved and your symptoms are now mild or almost absent)?
Are you aged 65 years old or over?

Are you aged 50 to 64 years old with at least one of the comorbidities/conditions listed below?

  • weakened immune system due to a serious illness or medication (e.g. chemotherapy)
  • heart disease or high blood pressure
  • asthma or lung disease
  • known diabetes
  • liver disease
  • stroke or neurological problem
Are you pregnant or planning on becoming pregnant within the next few weeks?
Are you breastfeeding or planning on starting during the course of the trial?
Do you have myasthenia gravis?
Are you currently admitted in hospital?
Do you have a specific heart rhythm abnormality called "prolonged QT syndrome" or condition that prolongs the heart QT interval?
Have you previously participated in the PRINCIPLE trial?
Are you currently taking antibiotics for a recently diagnosed illness?
Do you have an allergy to soya or peanuts?
Have you had a previous adverse reaction to, or are you currently taking Azithromycin?

Are you currently taking any of the following drugs:

  • Amiodarone
  • Bromocriptine
  • Cabergoline
  • Ciclosporin
  • Digoxin
  • Ergotamine
  • Ergometrine
  • Hydroxychloroquine or Chloroquine
  • Methysergide
  • Sotalol
After you have answered all the questions on this form and clicked "I'm not a robot" below
please click the "Submit" button at the bottom of the page to proceed to your Consent Form
PRINCIPLE Participant Registration v4.5 11-06-2020
REC Number: 20/SC/058, IRAS Number: 281958, EudraCT Number: 2020-001209-22, Chief Investigator: Professor Christopher Butler