CDE Detailed Report

Disease: Parkinson's Disease
Subdomain Name: Drugs
CRF: Parkinson's Disease Medication Log

Displaying 1 - 12 of 12
CDE ID CDE Name Variable Name Definition Short Description 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 / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C02016 Medication prior or concomitant start date and time MedctnPriorOrConcmStrtDateTime The date (and time, if applicable and known) on which the prior/concomitant medication usage began The date (and time, if applicable and known) on which the prior/concomitant medication usage began. Start Date Date or Date & Time

Record the date (and time) the participant/subject started taking the medication. The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.) and in the format acceptable to the study database. Start Date can be used to distinguish between prior medications and concomitant medications.

ISO 8601 -<br />https://www.iso.org/iso-8601-date-and-time-format.html Adult Supplemental-Highly Recommended 3.10 2022-08-02 16:58:56.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

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C02022 Medication prior or concomitant dose unit of measure MedctnPriorOrConcomDoseUOM Dosage unit of measure of the prior or concomitant medication administered Dosage unit of measure of the prior or concomitant medication administered Units (mg, grams, etc.) g;mcg;mcL;mg;mL;oz;Other, specify;Unknown;gr;gtt;mg/mL;Tbsp;tsp;U gram;microgram;microliter;milligram;milliliter;ounce;Other, specify;Unknown;grain;drop;milligrams per milliliter;tablespoon;teaspoon;unit Alphanumeric

Record the units for the dosage of medication the participant/subject is taking

Unified Code for Units of Measure (UCUM): https://ucum.org/trac Adult Supplemental-Highly Recommended 3.10 2022-08-02 14:36:00.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

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C18736 Medication prior or concomitant dose unit of measure other text MedctnPriorOrConcomDoseUoMOTH The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administered The free-text field related to 'Medication prior or concomitant dose unit of measure', specifying other text. Dosage unit of measure of the prior or concomitant medication administere Other, specify Alphanumeric

Record the units for the dosage of medication the participant/subject is taking

Unified Code for Units of Measure (UCUM): https://ucum.org/trac Adult Supplemental-Highly Recommended 2.10 2022-08-02 14:27:44.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

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C18737 Medication prior or concomitant route type other text MedctnPriorOrConcomRteTypOTH The free-text field related to 'Medication prior or concomitant route type', specifying other text. Type of access route for the administration of the prior/concomitant medication The free-text field related to 'Medication prior or concomitant route type', specifying other text. Type of access route for the administration of the prior/concomitant medication Other, specify Alphanumeric

Record the route of administration. The code list displays the most common options

No references available Adult Supplemental-Highly Recommended 2.00 2022-08-02 16:52:05.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

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C59179 Medication prior or concomitant suppository route type MedctnPriorConcomSuppostRteTyp Type of access route for the administration of the prior/concomitant medication in suppository dosage form Type of access route for the administration of the prior/concomitant medication in suppository dosage form Suppository, specify Rectal suppository;Vaginal suppository;Urethral suppository Rectal suppository;Vaginal suppository;Urethral suppository Alphanumeric

Record the route of administration. The code list displays the most common options

No references available Adult Supplemental-Highly Recommended 1.00 2022-08-02 14:15:31.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

C59180 Medication prior or concomitant daily dose frequency MedctnPriorConcomDlyDoseFreq Frequency of use of a prior/concomitant medication daily Frequency of use of a prior/concomitant medication daily Dose Frequency Per Day (numeric only; do not use TID, etc.) Numeric Values

Record how often the medication is being taken per day as a numerical value

No references available Adult Supplemental-Highly Recommended 1.00 2022-08-02 14:18:07.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

C02006 Medication prior or concomitant dose MedctnPriorOrConcomDose Dose of prior/concomitant medication taken per administration Dose of prior/concomitant medication taken per administration Dose Strength Numeric Values

Record the strength of the medication the participant/subject is taking

No references available Adult Supplemental-Highly Recommended 3.10 2022-08-02 14:33:32.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

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C59181 Medication prior or concomitant total daily intake text MedctnPriorConcomTtlDlyIntkTxt The free-text field related to the total daily intake of the prior/concomitant medication The free-text field related to the total daily intake of the prior/concomitant medication Total Daily Intake (# pills, 24 hour infusion dose, etc.) Alphanumeric

Record the total daily intake of prior or concomitant medication, e.g., number of pills or 24-hour infusion dose

No references available Adult Supplemental-Highly Recommended 1.00 2022-08-02 14:18:57.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data 255

Free-Form Entry

C02008 Medication prior or concomitant end date and time MedctnPriorOrConcomEndDateTime The date (and time, if applicable and known) the administration of the prior/concomitant medication ended The date (and time, if applicable and known) the administration of the prior/concomitant medication ended. Stop Date Date or Date & Time

Record the date (and time) the participant/subject stopped taking the medication. The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.) and in the format acceptable to the study database. Stop Date should be recorded if participant/subject has stopped taking the medication. Conversely, Stop Date should remain blank if the participant/subject is still taking the medication.

ISO 8601 -<br />https://www.iso.org/iso-8601-date-and-time-format.html Adult Supplemental-Highly Recommended 3.10 2022-08-02 16:59:51.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Free-Form Entry

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C02013 Medication prior or concomitant dose unit of measure UCUM code MedctnPriorOrConDseUOMUCUMCode Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) Code that represents the dosage unit of measure of the prior or concomitant medication administered. Unified Code for Units of Measure (UCUM) UCUM code Alphanumeric

No instructions available

Unified Code for Units of Measure (UCUM): https://ucum.org/trac Adult Supplemental-Highly Recommended 3.10 2022-08-02 14:42:09.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data 255

Free-Form Entry

C02014 Medication prior or concomitant name MedctnPriorConcomName Name of the prior/concomitant agent or drug administered Name of the prior/concomitant agent or drug administere Medication Name (generic preferred) Alphanumeric

Enter the verbatim name (generic preferred) of the prior or concomitant medication, including formulation, if applicable.
The PD Medication Log should be utilized to record ONLY medications used for management of PD motor symptoms. Medications used for management of PD non-motor disability (e.g., mood, cognitive, sleep, autonomic dysfunction) should be recorded in the Non-Parkinson's Disease Medication Log.

No references available Adult Supplemental-Highly Recommended 3.00 2013-08-28 16:08:00.453 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data 4000

Free-Form Entry

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C02015 Medication prior or concomitant route type MedctnPriorOrConcomRteTyp Type of access route for the administration of the prior/concomitant medication Type of access route for the administration of the prior/concomitant medication Route of Administration (PO, SL, SC, etc.) Inhaled;Intramuscular;Intradermal;Intravenous;Nasal;Oral;Subcutaneous;Topical;Buccal;Both ears;Right ear;Left ear;Rectal;Sublingual;Transdermal;Spray/squirt;Suppository, specify;Rapid Dissolve;Other, specify;Unknown Inhaled;Intramuscular;Intradermal;Intravenous;Nasal;Oral;Subcutaneous;Topical;Buccal;Both ears;Right ear;Left ear;Rectal;Sublingual;Transdermal;Spray/squirt;Suppository, specify;Rapid Dissolve;Other, specify;Unknown Alphanumeric

Record the route of administration. The code list displays the most common options

No references available Adult Supplemental-Highly Recommended 3.10 2022-08-02 14:44:16.0 Parkinson's Disease Medication Log Drugs Treatment/Intervention Data

Single Pre-Defined Value Selected

3162743
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