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Follow-Up GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

- 18.10.17 - 1 Formular, 8 Itemgruppen, 14 Datenelemente, 1 Sprache
Itemgruppen: General Information, RLS RATING SCALE, VITAL SIGNS, MEDICAL PROCEDURES, CONCOMITANT MEDICATION, ADVERSE EXPERIENCES, LABORATORY EVALUATION, URINE DIPSTICK
Study ID: 101468/190 Clinical Study ID: SKF-101468/190 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome This is the mandatory 7 day follow-up assessment form.

Anxiety And Depression Scale (HADS) Ropinirole Restless Legs Syndrom NCT00355641 - Anxiety And Depression Scale

- 27.09.21 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: Hospital anxiety and depression scale
Study part: Anxiety And Depression Scale. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Profile of Mood State Brief Form (POMSB) Ropinirole Restless Legs Syndrom NCT00355641 - Profile of Mood State Brief Form

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: score psychological
Study part: Profile of Mood State Brief Form. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Work Productivity And Activity Impairment- Specific Health Problem (WPAI) Ropinirole Restless Legs Syndrom NCT00355641 - Work Productivity And Activity Impairment- Specific Health Problem

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: score activity
Study part: Work Productivity And Activity Impairment- Specific Health Problem. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Johns Hopkins RLS QOL Questionnaire (RLSQOL) Ropinirole Restless Legs Syndrom NCT00355641 - Johns Hopkins RLS QOL Questionnaire

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: Assessment of quality of life
Study part: Johns Hopkins RLS QOL Questionnaire. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Medical Outcomes Study Sleep Scale (MOS) Ropinirole Restless Legs Syndrom NCT00355641 - Medical Outcomes Study Sleep Scale

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: score sleep
Study part: Medical Outcomes Study Sleep Scale. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Augmentation Severity Rating Scale (ASRS) Ropinirole Restless Legs Syndrom NCT00355641 - Augmentation Severity Rating Scale

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: Severity score
Study part: Augmentation Severity Rating Scale. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

CGI- Severity Of Illness (CGI-S) Ropinirole Restless Legs Syndrom NCT00355641 - CGI- Severity Of Illness

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: CGI- Severity Of Illness
Study part: CGI- Severity Of Illness. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

International RLS Rating Scale (IRLSRS) Ropinirole Restless Legs Syndrom NCT00355641 - International RLS Rating Scale

- 05.08.17 - 1 Formular, 1 Itemgruppe, 1 Datenelement, 1 Sprache
Itemgruppe: score Restless Legs Syndrome
Study part: International RLS Rating Scale. A 52-Week, Open-Label Study to Assess the Long-Term Safety of Ropinirole Extended Release (XR) in Patients with Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com. Clinicaltrials.gov Identifier: NCT00355641. Phase: phase 3. Study Recruitment Status: Completed. Generic Name: ropinirole. Trade Name Modutab, ZIPEREVE, ZEPREVE, REPREVE, ADARTREL, REQUIP, Zygara; Zygara, ZIPEREVE, ZEPREVE, Requip Depot, REQUIP, REPREVE, Modutab, ADARTREL. Study Indication : Restless Legs Syndrome. Study ID: 101468/206. Clinical Study ID: 101468/206.

Week 2 GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

- 18.10.17 - 1 Formular, 12 Itemgruppen, 15 Datenelemente, 1 Sprache
Itemgruppen: STUDY MEDICATION RECORD SINCE LAST VISIT, CHECK FOR STUDY CONTINUATION, RLS RATING SCALE, WPAI, VITAL SIGNS, MEDICAL PROCEDURES, CONCOMITANT MEDICATION, ADVERSE EXPERIENCES, CLINICAL GLOBAL IMPRESSION (CGI): EFFICACY INDEX, CLINICAL GLOBAL IMPRESSION, DOSE REDUCTION BETWEEN SCHEDULED VISITS, RAMOS RANDOMISATION AND DISPENSING
Study ID: 101468/190 Clinical Study ID: SKF-101468/190 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome This is the Week 2 form.

Week 1 GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

- 18.10.17 - 1 Formular, 12 Itemgruppen, 15 Datenelemente, 1 Sprache
Itemgruppen: STUDY MEDICATION RECORD SINCE LAST VISIT, CHECK FOR STUDY CONTINUATION, RLS RATING SCALE, WPAI, VITAL SIGNS, MEDICAL PROCEDURES, CONCOMITANT MEDICATION, ADVERSE EXPERIENCES, CLINICAL GLOBAL IMPRESSION (CGI): EFFICACY INDEX, CLINICAL GLOBAL IMPRESSION, DOSE REDUCTION BETWEEN SCHEDULED VISITS, RAMOS RANDOMISATION AND DISPENSING
Study ID: 101468/190 Clinical Study ID: SKF-101468/190 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome This is the Week 1 form.

Week 3 GSK Ropinirole in Patients Suffering from Restless Legs Syndrome 101468/190

- 18.10.17 - 1 Formular, 12 Itemgruppen, 15 Datenelemente, 1 Sprache
Itemgruppen: STUDY MEDICATION RECORD SINCE LAST VISIT, CHECK FOR STUDY CONTINUATION, RLS RATING SCALE, WPAI, VITAL SIGNS, MEDICAL PROCEDURES, CONCOMITANT MEDICATION, ADVERSE EXPERIENCES, CLINICAL GLOBAL IMPRESSION (CGI): EFFICACY INDEX, CLINICAL GLOBAL IMPRESSION, DOSE REDUCTION BETWEEN SCHEDULED VISITS, RAMOS RANDOMISATION AND DISPENSING
Study ID: 101468/190 Clinical Study ID: SKF-101468/190 Study Title:A 12 Week, Double-Blind, Placebo-Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS). Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: phase 3 Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Requip Study Indication: Restless Legs Syndrome This is the Week 3 form.

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