Protocol  Medication Inventory
Related Protocols:
Protocol Name from Source:
2000 MultiEthnic Study of Arthrosclerosis (MESA), Medications
Availability:
Description:
Participants are asked to bring all their current medications with them at the time of their appointment. For prescription medications, the interviewer records the name of the medications, the strength, the number prescribed, and the actual amount taken during the last 2 weeks. For overthecounter medications (including vitamins and supplements), the interviewer records the name, strength, and actual amount consumed in the previous 2 weeks.
Protocol:
Medication Reception
As you know, the XXX Study will be describing all medications its participants are using, both prescription and overthecounter. 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 2 weeks?
[ ] Yes → May I see them? Continue with Section B
[ ] No → Make arrangements to obtain
[ ] Refused → Record reason for refusal in Comments Section
[ ] Took No MEDICINES → Go to end of form
Prescription Medications
1. 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.
Medication Name Print the first 20 letters onlyPlease print clearly  Strength (mg, IU, etc.) Write the decimal as one of the digits  Number Prescribed Circle: Day, Week, Month  PRN Medicine?  On the average during the last 2 weeks, how many of these pills did you take a day/week/month? 
1.  ___D W M  Y N  ___D W M  
2.  ___D W M  Y N  ___D W M  
3.  ___D W M  Y N  ___D W M  
4.  ___D W M  Y N  ___D W M  
5.  ___D W M  Y N  ___D W M  
6.  ___D W M  Y N  ___D W M  
7.  ___D W M  Y N  ___D W M  
8.  ___D W M  Y N  ___D W M  
9.  ___D W M  Y N  ___D W M  
10.  ___D W M  Y N  ___D W M  
11.  ___D W M  Y N  ___D W M  
12.  ___D W M  Y N  ___D W M  
13.  ___D W M  Y N  ___D W M  
14.  ___D W M  Y N  ___D W M  
15.  ___D W M  Y N  ___D W M 
Number unable to transcribe: [ ][ ]
OvertheCounter Medications
3. 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.
Medication Name Print the first 20 letters onlyPlease print clearly  Strength (mg, IU, etc.) Write the decimal as one of the digits  Number Prescribed Circle: Day, Week, Month  PRN Medicine?  On the average during the last 2 weeks, how many of these pills did you take a day/week/month? 
1.  ___D W M  Y N  ___D W M  
2.  ___D W M  Y N  ___D W M  
3.  ___D W M  Y N  ___D W M  
4.  ___D W M  Y N  ___D W M  
5.  ___D W M  Y N  ___D W M  
6.  ___D W M  Y N  ___D W M  
7.  ___D W M  Y N  ___D W M  
8.  ___D W M  Y N  ___D W M  
9.  ___D W M  Y N  ___D W M  
10.  ___D W M  Y N  ___D W M  
11.  ___D W M  Y N  ___D W M  
12.  ___D W M  Y N  ___D W M  
13.  ___D W M  Y N  ___D W M  
14.  ___D W M  Y N  ___D W M  
15.  ___D W M  Y N  ___D W M 
Number unable to transcribe: [ ][ ]
Comments: ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________

Interpretation
The U.S. Food and Drug Administration (FDA) maintains a searchable database of brandname drugs, generic drugs, and therapeutic biological products that can assist with classification and action of medications.
Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.
Equipment Needs
These questions can be administered in a computerized or noncomputerized format (i.e., paperandpencil instrument). Computer software is necessary to develop computerassisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computerassisted questionnaire.
Requirements
Requirement Category  Required 

Average time of greater than 15 minutes in an unaffected individual  No 
Major equipment  No 
Specialized requirements for biospecimen collection  No 
Specialized training  No 
Mode of Administration
Selfadministered
Life Stage:
Child, Adolescent, Adult, Senior
Specific Instructions:
Researchers should review the MultiEthnic Study of Atherosclerosis Medication (MESA) Methods section in the Diabetes Supplemental Information for specific directions on coding medications (see Diabetes Supplemental Information, [link[www.phenxtoolkit.org/toolkit_content/supplemental_info/diabetes/additional_info/MESA_Manual_of_Operations.docMESA Manual of Operations]]). The U.S. Food and Drug Administration (FDA) maintains a searchable database of brandname drugs, generic drugs, and therapeutic biological products, which is useful in classifying the medications.
Expert Review Panel note: The Expert Review Panel wants to alert investigators to the fact that the form requests information about medications taken over the previous 2 weeks, which may result in the form omitting a medication taken on a monthly basis. However, this medication will be captured in the prescribed medication section.
Release Date:
October 1, 2015
Definition
A questionnaire that captures the type and dosage of all prescription and overthecounter medications as well as dietary supplements.
Purpose
This measure captures whether an individual is currently taking insulin or other oral drugs to treat diabetes. Additionally, some medications may be taken to address other conditions that could be associated with the presence of type 1 or 2 diabetes.
Selection Rationale
The Diabetes Working Group preferred a comprehensive, intervieweradministered review of medication containers to simple questions about insulin and oral diabetes medications because respondents may be taking many medications for multiple conditions.
Language
English, Mandarin Chinese, Spanish
Standards
Standard  Name  ID  Source 

Common Data Elements (CDE)  Person Medication Inventory Assessment Description Text  3070662  CDE Browser 
Logical Observation Identifiers Names and Codes (LOINC)  Medication inventory proto  627935  LOINC 
Process and Review
The [link[phenx.org/node/62Expert Review Panel #1]] reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.
Guidance from the ERP includes:
• Revised descriptions of measure
Backcompatible: no changes to Data Dictionary
Previous version in Toolkit archive ([link[www.phenxtoolkit.org/index.php?pageLink=browse.archive.protocols&id=140000link]])
Source
U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung and Blood Institute. (2000). MultiEthnic Study of Arthrosclerosis (MESA). Medications.
General References
American Diabetes Association (ADA). (2014). Diagnosis and classification of diabetes mellitus. Diabetes Care, 37(Suppl. 1), S81S90.
Protocol ID:
140301
Variables:
Export VariablesVariable Name  Variable ID  Variable Description  Version  dbGaP Mapping 

PX140301_PRN_Medicine_Prescription_Medication7  PX140301080400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication7  PX140301080500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication7  PX140301080501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication8  PX140301090100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication8  PX140301090200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication8  PX140301090201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication8  PX140301090300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication8  PX140301090301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication8  PX140301090400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication8  PX140301090500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication8  PX140301090501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication9  PX140301100100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication9  PX140301100200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication9  PX140301100201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication9  PX140301100300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication9  PX140301100301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication9  PX140301100400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication9  PX140301100500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication9  PX140301100501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication10  PX140301110100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication10  PX140301110200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication7  PX140301080301  Circle: Day, Week, Month  4  N/A 
PX140301_Units_Prescription_Medication10  PX140301110201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication10  PX140301110300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication10  PX140301110301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication10  PX140301110400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication10  PX140301110500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication10  PX140301110501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication11  PX140301120100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication11  PX140301120200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication11  PX140301120201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication11  PX140301120300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication11  PX140301120301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication11  PX140301120400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication11  PX140301120500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication11  PX140301120501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication12  PX140301130100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication12  PX140301130200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication12  PX140301130201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication12  PX140301130300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication12  PX140301130301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication12  PX140301130400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication12  PX140301130500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication12  PX140301130501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication13  PX140301140100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication13  PX140301140200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication13  PX140301140201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication13  PX140301140300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication13  PX140301140301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication13  PX140301140400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication13  PX140301140500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication13  PX140301140501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication14  PX140301150100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication14  PX140301150200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication14  PX140301150201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication14  PX140301150300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication14  PX140301150301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication14  PX140301150400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication14  PX140301150500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication14  PX140301150501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication15  PX140301160100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication15  PX140301160200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication15  PX140301160201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication15  PX140301160300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication15  PX140301160301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication15  PX140301160400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication15  PX140301160500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication15  PX140301160501  Circle: Day, Week, Month  4  N/A 
PX140301_Number_Prescriptions_Unable_To_Transcribe  PX140301170000  Number unable to transcribe:  4  N/A 
PX140301_Name_Of_OTC_Medication1  PX140301180100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication1  PX140301180200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication1  PX140301180201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication1  PX140301180300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication1  PX140301180301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication1  PX140301180400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication1  PX140301180500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication1  PX140301180501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication2  PX140301190100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication2  PX140301190200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication2  PX140301190201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication2  PX140301190300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication2  PX140301190301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication2  PX140301190400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication2  PX140301190500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication2  PX140301190501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication3  PX140301200100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication3  PX140301200200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication3  PX140301200201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication3  PX140301200300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication3  PX140301200301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication3  PX140301200400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication3  PX140301200500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication3  PX140301200501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication4  PX140301210100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication4  PX140301210200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication4  PX140301210201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication4  PX140301210300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication4  PX140301210301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication4  PX140301210400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication4  PX140301210500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication4  PX140301210501  Circle: Day, Week, Month  4  N/A 
PX140301_Units_OTC_Medication5  PX140301220201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication5  PX140301220300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication5  PX140301220301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication5  PX140301220400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication5  PX140301220500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication5  PX140301220501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication6  PX140301230100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication6  PX140301230200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication6  PX140301230201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication6  PX140301230300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication6  PX140301230301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication6  PX140301230400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication6  PX140301230500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication6  PX140301230501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication7  PX140301240100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication7  PX140301240200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication7  PX140301240201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication7  PX140301240300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication7  PX140301240301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication7  PX140301240400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication7  PX140301240500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication7  PX140301240501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication8  PX140301250100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication8  PX140301250200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication8  PX140301250201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication8  PX140301250300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication8  PX140301250301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication8  PX140301250400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication8  PX140301250500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication8  PX140301250501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication9  PX140301260100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Name_Of_OTC_Medication5  PX140301220100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication5  PX140301220200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Strength_OTC_Medication9  PX140301260200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication9  PX140301260201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication9  PX140301260300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication9  PX140301260301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication9  PX140301260400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication9  PX140301260500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication9  PX140301260501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication10  PX140301270100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication10  PX140301270200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication10  PX140301270201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication10  PX140301270300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication10  PX140301270301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication10  PX140301270400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication10  PX140301270500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication10  PX140301270501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication11  PX140301280100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication11  PX140301280200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication11  PX140301280201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication11  PX140301280300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication11  PX140301280301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication11  PX140301280400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication11  PX140301280500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication11  PX140301280501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication12  PX140301290100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication12  PX140301290200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication12  PX140301290201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication12  PX140301290300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication12  PX140301290301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication12  PX140301290400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication12  PX140301290500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication12  PX140301290501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication13  PX140301300100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication13  PX140301300200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication13  PX140301300201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication13  PX140301300300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication13  PX140301300301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication13  PX140301300400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication13  PX140301300500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication13  PX140301300501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication14  PX140301310100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication14  PX140301310200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication14  PX140301310201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication14  PX140301310300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication14  PX140301310301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication14  PX140301310400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication14  PX140301310500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication14  PX140301310501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_OTC_Medication15  PX140301320100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_OTC_Medication15  PX140301320200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_OTC_Medication15  PX140301320201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_OTC_Medication15  PX140301320300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_OTC_Medication15  PX140301320301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_OTC_Medication15  PX140301320400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_OTC_Medication15  PX140301320500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_OTC_Medication15  PX140301320501  Circle: Day, Week, Month  4  N/A 
PX140301_Number_OTC_Unable_To_Transcribe  PX140301330000  Number unable to transcribe:  4  N/A 
PX140301_Comments  PX140301340000  Comments about medications  4  N/A 
PX140301_Brought_Medications  PX140301010000  Have you brought this bag with you? Are these all the medications that you have taken in the past two weeks?  4  Variable Mapping 
PX140301_Name_Of_Prescription_Medication1  PX140301020100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication1  PX140301020200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication1  PX140301020201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication1  PX140301020300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication1  PX140301020301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication1  PX140301020400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication1  PX140301020500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication1  PX140301020501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication2  PX140301030100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication2  PX140301030200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication2  PX140301030201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication2  PX140301030300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication2  PX140301030301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication2  PX140301030400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication2  PX140301030500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication2  PX140301030501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication3  PX140301040100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication3  PX140301040200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication3  PX140301040201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication3  PX140301040300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication3  PX140301040301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication3  PX140301040400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication3  PX140301040500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication3  PX140301040501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication4  PX140301050100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication4  PX140301050200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication4  PX140301050201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication4  PX140301050300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication4  PX140301050301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication4  PX140301050400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication4  PX140301050500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication4  PX140301050501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication5  PX140301060100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication5  PX140301060200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication5  PX140301060201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication5  PX140301060300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication5  PX140301060301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication5  PX140301060400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication5  PX140301060500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication5  PX140301060501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication6  PX140301070100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication6  PX140301070200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication6  PX140301070201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication6  PX140301070300  Number Prescribed  4  N/A 
PX140301_Number_Prescribed_DayWeekMonth_Prescription_Medication6  PX140301070301  Circle: Day, Week, Month  4  N/A 
PX140301_PRN_Medicine_Prescription_Medication6  PX140301070400  PRN Medicine?  4  N/A 
PX140301_Average_Number_Pills_Prescription_Medication6  PX140301070500  On the average during the last two weeks, how many of these pills did you take a day/week/month  4  N/A 
PX140301_Average_Taken_DayWeek_Month_Prescription_Medication6  PX140301070501  Circle: Day, Week, Month  4  N/A 
PX140301_Name_Of_Prescription_Medication7  PX140301080100  Print the first 20 letters onlyPlease print clearly.  4  N/A 
PX140301_Strength_Prescription_Medication7  PX140301080200  Strength (mg, IU, etc.). Write the decimal one of the digits.  4  N/A 
PX140301_Units_Prescription_Medication7  PX140301080201  Record the units of the strength of prescription medication  4  N/A 
PX140301_Number_Prescribed_Prescription_Medication7  PX140301080300  Number Prescribed  4  N/A 