Any Previous or Concomitant Medication
Item
Is there any previous medication and/or concomitant medication to record?
boolean
Medication
Item
Medication
text
CL Item
Intramuscular (6)
CL Item
Ear/Auricular (7)
CL Item
Continuous Inhalation (11)
CL Item
Swish & Split / Swallow (12)
CL Item
Intra-articular (19)
CL Item
Peri-articular (20)
CL Item
Intraperitoneal (21)
CL Item
Intra-arterial (23)
CL Item
Intra-urethral (24)
Start Date
Item
Start Date
date
Stop Date
Item
Stop Date
date
Ongoing
Item
Ongoing
boolean
Dose Units
Item
Dose Units
text
Frequency
Item
Frequency
text
Indication
Item
Indication
text
Reason for Use: For Primary Diagnosis
Item
Reason for Use: For Primary Diagnosis
boolean
Reason for Use: For Medical History
Item
Reason for Use: For Medical History
boolean
Reason for Use: For AE
Item
Reason for Use: For AE
boolean
Reason for Use: Prophylaxis
Item
Reason for Use: Prophylaxis
boolean
Reason for Use: Other
Item
Reason for Use: Other
boolean
WHO Code
Item
WHO Code
text
ATC Code
Item
ATC Code
text
Level 1 ATC
Item
Level 1 ATC
text
Level 2 ATC
Item
Level 2 ATC
text
Level 3 ATC
Item
Level 3 ATC
text
Level 4 ATC
Item
Level 4 ATC
text