German English

Follow Up Medication Change

9 forms  
Medication change
Description

Medication change

Alias
UMLS CUI-1
C0580105
Which changes in the MS therapy have been carried out since the last visit?
Description

VerlModChange

Data type

integer

Alias
UMLS CUI [1]
C2169461
The active ingredient has been stopped?
Description

Abgesetzter Wirkstoff

Data type

text

Alias
UMLS CUI [1]
C2169646
If other, what?
Description

Anderer abgesetzter Wirkstoff

Data type

text

Alias
UMLS CUI [1,1]
C2169646
UMLS CUI [1,2]
C1115771
What change? (Please enter.)
Description

Andere

Data type

text

Alias
UMLS CUI [1,1]
C2169461
UMLS CUI [1,2]
C0205394
Reason for change of medication
Description

Reason for change of medication

Alias
UMLS CUI-1
C2133636
Reason for cancellation
Description

GrundAbbruch

Data type

integer

Alias
UMLS CUI [1]
C2133636
Please specify other reason
Description

Text Anderer Grund

Data type

text

Alias
UMLS CUI [1,1]
C2133636
UMLS CUI [1,2]
C0205394
Current therapy
Description

Current therapy

Alias
UMLS CUI-1
C2827774
UMLS CUI-2
C0026769
Active ingredient
Description

Wirkstoff

Data type

text

Alias
UMLS CUI [1,1]
C2827774
UMLS CUI [1,2]
C0026769
If other active ingredient, please describe
Description

curth1a

Data type

text

Alias
UMLS CUI [1,1]
C2827774
UMLS CUI [1,2]
C0026769
UMLS CUI [1,3]
C0205394
Start: Month/year
Description

Please select a day of the respective month. It is applied to only the month and year

Data type

date

Alias
UMLS CUI [1]
C3173309
UMLS CUI [1]-2
C2827774
UMLS CUI [1]-3
C0026769
Regimen
Description

Therapieschema

Data type

integer

Alias
UMLS CUI [1]
C1276413
Please specify the dose and method of administration
Description

andere

Data type

text

Alias
UMLS CUI [1]
C0001555
Back to the top of the page

Similar models

Follow Up Medication Change

9 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Medication change
C0580105 (UMLS CUI-1)
Item
Which changes in the MS therapy have been carried out since the last visit?
integer
C2169461 (UMLS CUI [1])
VerlModChange
Code List
Which changes in the MS therapy have been carried out since the last visit?
CL Item
The drug dosage has been increased (1)
CL Item
The drug dose was reduced (2)
CL Item
The therapy was deposed and started new (3)
CL Item
The therapy was discontinued without replacement (4)
CL Item
Another change has been performed (99)
Item
The active ingredient has been stopped?
text
C2169646 (UMLS CUI [1])
curth1
Code List
The active ingredient has been stopped?
CL Item
Alemtuzumab (Lemtrada) (22)
C0383429 (UMLS CUI-1)
CL Item
Azathioprine (2)
C0004482 (UMLS CUI-1)
CL Item
Cyclophosphamide (4)
C0010583 (UMLS CUI-1)
CL Item
Fingolimod (Gilenya) (18)
C1699926 (UMLS CUI-1)
CL Item
Fumarate (BG-12; Tecfidera) (24)
C0058218 (UMLS CUI-1)
CL Item
COPAXONE (Copaxone) (6)
C0289884 (UMLS CUI-1)
CL Item
Immune Globulins (7)
C0021027 (UMLS CUI-1)
CL Item
Interferon ß-1A (Avonex) (19)
C0254119 (UMLS CUI-1)
C0021492 (UMLS CUI-2)
CL Item
Interferon ß-1A SC (Rebif 22 µg, Rebif 44 µg) (20)
C0254119 (UMLS CUI-1)
CL Item
Interferon ß 1SC (Betaseron, Extavia) (21)
C0244713 (UMLS CUI-1)
CL Item
* Medication from a MS study (8)
C0013175 (UMLS CUI-1)
C0013227 (UMLS CUI-2)
CL Item
Methotrexate (9)
C0025677 (UMLS CUI-1)
CL Item
Mitoxantrone (10)
C0026259 (UMLS CUI-1)
CL Item
Natalizumab (Tysabri) (11)
C1172734 (UMLS CUI-1)
CL Item
Rituximab (14)
C0393022 (UMLS CUI-1)
CL Item
Teriflunomide (Aubagio) (23)
C1718383 (UMLS CUI-1)
CL Item
Cortisone (25)
C0010137 (UMLS CUI-1)
CL Item
Others... (99)
C1115771 (UMLS CUI-1)
Anderer abgesetzter Wirkstoff
Item
If other, what?
text
C2169646 (UMLS CUI [1,1])
C1115771 (UMLS CUI [1,2])
Andere
Item
What change? (Please enter.)
text
C2169461 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item Group
Reason for change of medication
C2133636 (UMLS CUI-1)
Item
Reason for cancellation
integer
C2133636 (UMLS CUI [1])
Therapieende
Code List
Reason for cancellation
CL Item
Side effects (1)
C0559546 (UMLS CUI-1)
(Comment:en)
CL Item
Lack effectiveness (2)
C0235828 (UMLS CUI-1)
(Comment:en)
CL Item
Another reason (99)
C3840932 (UMLS CUI-1)
C0850893 (UMLS CUI-2)
(Comment:en)
Text Anderer Grund
Item
Please specify other reason
text
C2133636 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Item Group
Current therapy
C2827774 (UMLS CUI-1)
C0026769 (UMLS CUI-2)
Item
Active ingredient
text
C2827774 (UMLS CUI [1,1])
C0026769 (UMLS CUI [1,2])
curth1
Code List
Active ingredient
CL Item
Alemtuzumab (Lemtrada) (22)
C0383429 (UMLS CUI-1)
CL Item
Azathioprine (2)
C0004482 (UMLS CUI-1)
CL Item
Cyclophosphamide (4)
C0010583 (UMLS CUI-1)
CL Item
Fingolimod (Gilenya) (18)
C1699926 (UMLS CUI-1)
CL Item
Fumarate (BG-12; Tecfidera) (24)
C0058218 (UMLS CUI-1)
CL Item
COPAXONE (Copaxone) (6)
C0289884 (UMLS CUI-1)
CL Item
Immune Globulins (7)
C0021027 (UMLS CUI-1)
CL Item
Interferon ß-1A (Avonex) (19)
C0254119 (UMLS CUI-1)
C0021492 (UMLS CUI-2)
CL Item
Interferon ß-1A SC (Rebif 22 µg, Rebif 44 µg) (20)
C0254119 (UMLS CUI-1)
CL Item
Interferon ß 1SC (Betaseron, Extavia) (21)
C0244713 (UMLS CUI-1)
CL Item
* Medication from a MS study (8)
C0013175 (UMLS CUI-1)
C0013227 (UMLS CUI-2)
CL Item
Methotrexate (9)
C0025677 (UMLS CUI-1)
CL Item
Mitoxantrone (10)
C0026259 (UMLS CUI-1)
CL Item
Natalizumab (Tysabri) (11)
C1172734 (UMLS CUI-1)
CL Item
Rituximab (14)
C0393022 (UMLS CUI-1)
CL Item
Teriflunomide (Aubagio) (23)
C1718383 (UMLS CUI-1)
CL Item
Cortisone (25)
C0010137 (UMLS CUI-1)
CL Item
Others... (99)
C1115771 (UMLS CUI-1)
curth1a
Item
If other active ingredient, please describe
text
C2827774 (UMLS CUI [1,1])
C0026769 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
curth1ab
Item
Start: Month/year
date
C3173309 (UMLS CUI [1])
C2827774 (UMLS CUI [1]-2)
C0026769 (UMLS CUI [1]-3)
Item
Regimen
integer
C1276413 (UMLS CUI [1])
TherapieSchema
Code List
Regimen
CL Item
Standard (1)
CL Item
Others (99)
andere
Item
Please specify the dose and method of administration
text
C0001555 (UMLS CUI [1])
Back to the top of the page