ID

32496

Beschrijving

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

Trefwoorden

Versies (4)
  1. 05-11-18 05-11-18 -
  2. 05-11-18 05-11-18 -
  3. 04-12-18 04-12-18 -
  4. 30-10-19 30-10-19 - Sarah Riepenhausen
Houder van rechten

GSK group of companies

Geüploaded op

5 november 2018

DOI

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Licentie

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

Engels

Concomitant Medications Form

1 Formulieren  
Concomitant Medication Details
Beschrijving

Concomitant Medication Details

Sequence Number
Beschrijving

Sequence Number

Datatype

text

Drug Name
Beschrijving

Trade Name Preferred

Datatype

text

Unit Dose
Beschrijving

Unit Dose

Datatype

integer

Units
Beschrijving

Units

Datatype

text

Frequency
Beschrijving

Frequency

Datatype

text

Route
Beschrijving

Route

Datatype

text

Reason for Medication
Beschrijving

Reason for Medication

Datatype

text

Generic dispensed?
Beschrijving

Generic dispensed?

Datatype

boolean

Prescription or OTC?
Beschrijving

Prescription or OTC?

Datatype

text

Start Date
Beschrijving

Start Date

Datatype

date

Taken prior to study?
Beschrijving

Taken prior to study?

Datatype

boolean

Ongoing?
Beschrijving

Ongoing?

Datatype

boolean

If NO, record the End Date
Beschrijving

If NO, record the End Date

Datatype

date

Device Used to Administer Medication
Beschrijving

Device Used to Administer Medication

Datatype

text

Total Daily Dose
Beschrijving

Total Daily Dose

Datatype

text

Was drug administered for an exacerbation?
Beschrijving

Was drug administered for an exacerbation?

Datatype

boolean

Was drug administered as a rescue medication?
Beschrijving

Was drug administered as a rescue medication?

Datatype

boolean

Cumulative Dose Used?
Beschrijving

Cumulative Dose Used?

Datatype

text

Was drug ever used?
Beschrijving

Was drug ever used?

Datatype

boolean

Total duration
Beschrijving

Total duration

Datatype

text

Duration Unit
Beschrijving

Duration Unit

Datatype

text

Medication Type
Beschrijving

Medication Type

Datatype

text

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Similar models

Concomitant Medications Form

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
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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