Beskrivning

Please complete the study medication record in the Study Medication and Compliance Section at the back of this module.

Datatyp

text

Alias

UMLS CUI [1,1]

C2734539

UMLS CUI [1,2]

C0008972

Beskrivning

Please complete the appropriate RLS Rating Scale from the RLS Rating Scale Book

Datatyp

text

Alias

UMLS CUI [1,1]

C0681889

UMLS CUI [1,2]

C0035258

Beskrivning

after 5min sitting

Datatyp

integer

Måttenheter

• betas/min

Alias

UMLS CUI [1]

C0232117

Beskrivning

after 5 minutes sitting

Datatyp

integer

Måttenheter

• mmHg

Alias

UMLS CUI [1,1]

C0871470

UMLS CUI [1,2]

C0277814

Beskrivning

Sitting diastolic blood pressure

Datatyp

integer

Måttenheter

• mmHg

Alias

UMLS CUI [1,1]

C0428883

UMLS CUI [1,2]

C0277814

Beskrivning

Please record any medical procedures performed since the last visit in the Medical Procedures section at the back of this module

Datatyp

text

Alias

UMLS CUI [1]

C0199171

Beskrivning

Please record any changes in concomitant medication since the last visit in the Concomitant Medication section at the back of this module

Datatyp

text

Alias

UMLS CUI [1]

C2347852

Beskrivning

Please record any adverse experiences observed or elicited by the following direct question to the patient: "Have you felt different in any way since the last visit?" in the Adverse Experience section at the back of this module

Datatyp

text

Alias

UMLS CUI [1]

C0559546

Beskrivning

Guided by the CGI Efficacy Index (below) determine dose level to be dispensed and dispense Weeks 9 - 12 study medication. Complete the Study Medication and Compliance Section at the back of the next module (book 2). If the patient’s dose has been increased at this clinic visit: a) Instruct the patient to return to the clinic this evening or remain to perform orthostatic vital signs*: - 2 sets of pre-dose orthostatic blood pressure and pulse - Patient takes evening dose in the clinic - One set of 2 hour post-dose orthostatic blood pressure and pulse Instruct the patient to take the appropriate number of tablet(s), at the same time, no earlier than 3 hours prior to and no later than one hour prior to bedtime (except on the first night of each new dose increase). Patient must return the bottle(s) with any unused medication at the next visit. Arrange for the patient to return in 28 days (plus or minus 3 days) for the Week 12 clinic visit. * Where possible this visit should be performed in the evening with dosing approximately 8:00 P.M. However, for scheduling convenience, this visit (including dosing) may occur during the afternoon hours (as late in the day as possible) to accomodate the collection of orthostatic blood pressure/pulse assessments during the normal clinic hours.

Datatyp

text

Alias

UMLS CUI [1,1]

C0302828

UMLS CUI [1,2]

C0035173

Beskrivning

This section contained Clinical Outcome Assessment data collection questionnaires or indices, which are protected by copyright laws and therefore have been excluded.

Datatyp

text

Alias

UMLS CUI [1]

C3639708

Beskrivning

If the patient requires a dose change between this and the next visit please complete Dose Changes Due To Adverse Experiences pages at the back of the next module (Book 2).

Datatyp

text

Alias

UMLS CUI [1]

C1707811