What is the category of the medication the subject used to attempt to reduce nicotine dependency?
Medication Category
Record the type of medicaiton the subject used to reduce nicotine dependency.
Indicate if the subject experienced any medical conditions or events. If Yes, include the appropriate details where indicated on the CRF.
CMCAT
NICOTINE REPLACEMENT THERAPY; DRUG USED IN REDUCING NICOTINE DEPENDENCE OTHER THAN NRTS;
2
What is the subcategory for the medication?
Medication Subcategory
Record the medication subcategory, if not pre-printed on the CRF.
CMSCAT
LAST ATTEMPTED USE WITH THIS MEDICATION
3
What was the name of the medication the subject used to reduce nicotine dependency?
Medication
Record only one medication per line. Provide the full trade or proprietary name of the medication; otherwise, record the generic name.
Applicant-Defined CRF Completion Instructions
CMTRT
4
What was the duration of the medication used to reduce nicotine dependency for the last attempt?
Collected Duration
Provide the duration of the medication used.
Record all relevant medical conditions or events, as defined in the protocol. Record only one medical condition or event per line. Ensure that the medical conditions or events listed on the Medical History page do not meet any of the exclusion criteria.
CMDUR
5
What was the duration unit of the medication used to reduce nicotine dependency for the last attempt?
Collected Duration Unit
Select the appropriate duration unit of the medication used.
Record the start date of the medical event or condition using this format (DD-MON-YYYY).