ID

32496

Descripción

Study ID: 106837 Clinical Study ID: HZA106837 Study Title: A Long-Term, Randomized, Double-Blind, Parallel Group Study of Fluticasone Furoate/GW642444 Inhalation Powder Once-Daily and Fluticasone Furoate Inhalation Powder Once-Daily in Subjects with Asthma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT01086384 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completed Generic Name: fluticasone furoate/vilanterol Trade Name: Relvar Study Indication: Asthma

Palabras clave

Versiones (4)
  1. 5/11/18 5/11/18 -
  2. 5/11/18 5/11/18 -
  3. 4/12/18 4/12/18 -
  4. 30/10/19 30/10/19 - Sarah Riepenhausen
Titular de derechos de autor

GSK group of companies

Subido en

5 de noviembre de 2018

DOI

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Licencia

Creative Commons BY-NC 3.0
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A Parallel Group Study of Fluticasone Furoate/Vilanterol in Subjects with Asthma - 106837

Inglés

Concomitant Medications Form

1 formularios  
Concomitant Medication Details
Descripción

Concomitant Medication Details

Sequence Number
Descripción

Sequence Number

Tipo de datos

text

Drug Name
Descripción

Trade Name Preferred

Tipo de datos

text

Unit Dose
Descripción

Unit Dose

Tipo de datos

integer

Units
Descripción

Units

Tipo de datos

text

Frequency
Descripción

Frequency

Tipo de datos

text

Route
Descripción

Route

Tipo de datos

text

Reason for Medication
Descripción

Reason for Medication

Tipo de datos

text

Generic dispensed?
Descripción

Generic dispensed?

Tipo de datos

boolean

Prescription or OTC?
Descripción

Prescription or OTC?

Tipo de datos

text

Start Date
Descripción

Start Date

Tipo de datos

date

Taken prior to study?
Descripción

Taken prior to study?

Tipo de datos

boolean

Ongoing?
Descripción

Ongoing?

Tipo de datos

boolean

If NO, record the End Date
Descripción

If NO, record the End Date

Tipo de datos

date

Device Used to Administer Medication
Descripción

Device Used to Administer Medication

Tipo de datos

text

Total Daily Dose
Descripción

Total Daily Dose

Tipo de datos

text

Was drug administered for an exacerbation?
Descripción

Was drug administered for an exacerbation?

Tipo de datos

boolean

Was drug administered as a rescue medication?
Descripción

Was drug administered as a rescue medication?

Tipo de datos

boolean

Cumulative Dose Used?
Descripción

Cumulative Dose Used?

Tipo de datos

text

Was drug ever used?
Descripción

Was drug ever used?

Tipo de datos

boolean

Total duration
Descripción

Total duration

Tipo de datos

text

Duration Unit
Descripción

Duration Unit

Tipo de datos

text

Medication Type
Descripción

Medication Type

Tipo de datos

text

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Similar models

Concomitant Medications Form

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Concomitant Medication Details
Sequence Number
Item
Sequence Number
text
Drug Name
Item
Drug Name
text
Unit Dose
Item
Unit Dose
integer
Units
Item
Units
text
Frequency
Item
Frequency
text
Route
Item
Route
text
Reason for Medication
Item
Reason for Medication
text
Generic dispensed?
Item
Generic dispensed?
boolean
Item
Prescription or OTC?
text
Prescription of OTC?
Code List
Prescription or OTC?
CL Item
Prescription (1)
CL Item
OTC (2)
Start Date
Item
Start Date
date
Taken prior to study?
Item
Taken prior to study?
boolean
Ongoing?
Item
Ongoing?
boolean
If NO, record the End Date
Item
If NO, record the End Date
date
Device Used to Administer Medication
Item
Device Used to Administer Medication
text
Total Daily Dose
Item
Total Daily Dose
text
Was drug administered for an exacerbation?
Item
Was drug administered for an exacerbation?
boolean
Was drug administered as a rescue medication?
Item
Was drug administered as a rescue medication?
boolean
Cumulative Dose Used?
Item
Cumulative Dose Used?
text
Was drug ever used?
Item
Was drug ever used?
boolean
Total duration
Item
Total duration
text
Item
Duration Unit
text
Duration Unit
Code List
Duration Unit
CL Item
Days (1)
CL Item
Months (2)
CL Item
Weeks (3)
CL Item
Years (4)
Item
Medication Type
text
Medication Type
Code List
Medication Type
CL Item
Non-Asthma (1)
CL Item
Asthma (2)
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