CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Treatment/Intervention Data
CRF: PhenX Toolkit: Medication Inventory

12 results.
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type Source Form Set Form Field
C59569 Medication number prescribed directed count MedicatnNumPrescribDrctdCt Count of units of the medication that are prescribed or otherwise directed to be taken. Count of units of the medication that are prescribed or otherwise directed to be taken. Number prescribed Numeric Values PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 09:48:13.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

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1 unit PhenX Core Tier 2 Medication Inventory Number Prescribed
C59570 Medication number prescribed directed frequency unit of measure MedicatnNumPrescribDrctdFrqUOM Unit of measure of frequency with which the count of units of medication specified in 'Medication number prescribed directed count' are to be taken Unit of measure of frequency with which the count of units of medication specified in 'Medication number prescribed directed count' are to be taken Day, Week, Month D;W;M day;week;month Alphanumeric PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 09:48:13.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Single Pre-Defined Value Selected

PhenX Core Tier 2 Medication Inventory Number Prescribed
C59571 Medication pro re nata as needed indicator MedPRNAsNeedInd Indicator of whether the specified medication is prescribed or otherwise directed to be taken pro re nata (PRN) or as needed Indicator of whether the specified medication is prescribed or otherwise directed to be taken pro re nata (PRN) or as needed PRN Medicine? No;Yes No;Yes Alphanumeric PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 10:04:55.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Single Pre-Defined Value Selected

PhenX Core Tier 2 Medication Inventory PRN Medicine
C59572 Medication pro re nata as needed number taken past 2 weeks count MedPRNAsNeedNumTakPst2WkCt Count of the units of the pro re nata (PRN) or as needed medication that were taken over the past two weeks at the frequency specified in 'Medication pro re nata as needed taken past 2 weeks frequency unit of measure' Count of the units of the pro re nata (PRN) or as needed medication that were taken over the past two weeks at the frequency specified in 'Medication pro re nata as needed taken past 2 weeks frequency unit of measure' On the average during the last two weeks, how many of these pills did you take a day/week/month Numeric Values PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 10:10:02.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

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0 unit PhenX Core Tier 2 Medication Inventory n/a
C59573 Medication pro re nata as needed taken past 2 weeks frequency unit of measure MedPRNAsNeedTakPst2WkFqUOM Unit of measurement of the frequency over the past 2 weeks that the pro re nata (PRN) or as needed medication was taken Unit of measurement of the frequency over the past 2 weeks that the pro re nata (PRN) or as needed medication was taken day/week/month D;W;M day;week;month Alphanumeric PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 10:10:02.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Single Pre-Defined Value Selected

PhenX Core Tier 2 Medication Inventory n/a
C59574 Medication prescription unable transcribe count MedRxUnableTranscribeCt Count of prescription medications that were unable to be transcribed into the medication inventory Count of prescription medications that were unable to be transcribed into the medication inventory Prescription medications number unable to transcribe Numeric Values PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 10:20:59.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

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0 99 medication PhenX Core Tier 2 Medication Inventory Number unable to transcribe
C18027 Comment text CmmntTxt Provide any additional information that pertains to the question. Provide any additional information that pertains to the question. Comments Alphanumeric PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 3.00 2013-07-16 14:01:43.01 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs 4000

Free-Form Entry

DeBaun Forms
C59575 Medication over the counter unable transcribe count MedOTCUnableTranscribeCt Count of over the counter medications that were unable to be transcribed into the medication inventory Count of over the counter medications that were unable to be transcribed into the medication inventory` Over-the-Counter medications number unable to transcribe Numeric Values PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 10:20:59.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Free-Form Entry

0 99 medication PhenX Core Tier 2 Medication Inventory Number unable to transcribe
C59565 Medication past 2 week received indicator MedPast2WkRecvdInd Indicator of whether medications taken during the past 2 weeks were received Indicator of whether medications taken during the past 2 weeks were received As you know, the XX Study will be describing all medications its participants are using, both prescription and over-the-counter. These include pills, liquid medications; skin patches, eye drops, creams, salves, inhalers and injections, as well as cold or allergy medications, vitamins, herbal remedies and other supplements. The letter you received about this appointment included a plastic medications bag for all your current medications and asked you to bring them to the clinic. Have you brought this bag with you? Are these all the medications that you have taken in the past two weeks? Yes;No;Refused;Took no medicines Yes;No;Refused;Took no medicines Alphanumeric

Copy the name of the medicine, the strength (include units), and the total number of doses prescribed per day/week/month. Include all pills, skin patches, eye drops, creams, salves, and injections.

PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 09:32:49.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Single Pre-Defined Value Selected

PhenX Core Tier 2 Medication Inventory Medication Reception
C59566 Medication prescription over the counter type MedRxOTCTyp Type of medication to indicate whether prescription or over the counter medication. Type of medication to indicate whether prescription or over the counter medication. Prescription/Over-The-Counter Medications Prescription;Over the counter medicine Prescription;Over the counter medicine Alphanumeric Adult;Pediatric Proposed 1.00 2019-04-12 09:38:39.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs

Single Pre-Defined Value Selected

PhenX Core Tier 2 Medicaton Inventory n/a
C59567 Medicaton name MedicationName Name of the medication Name of the medication Medication Name Alphanumeric

Print the first 20 letters only

PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 09:42:40.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs 20

Free-Form Entry

PhenX Core Tier 2 Medication Inventory Medication Name
C59568 Medication strength text MedicationStrengthTxt Text field capturing the medication strength Text field capturing the medication strength Strength (mg, IU, etc.) Alphanumeric

Write the decimal as one of the digits. Include units.

PhenX Protocol: Medication Inventory (#140301) Adult;Pediatric Proposed 1.00 2019-04-12 09:44:51.0 PhenX Toolkit: Medication Inventory Treatment/Intervention Data Drugs 25

Free-Form Entry

PhenX Core Tier 2 Medication Inventory Strength
12 results.
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