Sequence Number
Item
Sequence Number
text
Drug Name
Item
Drug Name
text
Unit Dose
Item
Unit Dose
integer
Frequency
Item
Frequency
text
Reason for Medication
Item
Reason for Medication
text
Generic dispensed?
Item
Generic dispensed?
boolean
Item
Prescription or OTC?
text
Code List
Prescription or OTC?
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
Medication Type
text
Code List
Medication Type