Form:	(EXPIRED) Canary: PASS Baseline Medications v2.0

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 423)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 1417)
* 1417	Has participant ever taken any of the following statin medications? (Have you ever taken any of the following statin medications?) (Go To: 2200)
	Permissible Values (value): Atorvastatin (Lipitor) (1)
	Fluvastatin (Lescol) (2)
	Lovastatin (Mevacor) (3)
	Pravastatin (Pravachol) (4)
	Simvastatin (Zocor) (5)
	Rosuvastatin calcium (Crestor) (6)
	Lovastatin with niacin (Advicor) (8)
	Niacin/imvastatin (Simcor) (9)
	Atorvastatin with amlodipine (Norvasc) (Caduet) (10)
	Ezetimibe/simvastatin (Vytorin) (11)
	Pitavastatin (Livalo) (12)
	None (44) (Go To: 2467)
* 2467	Has participant taken any of the following diabetes medications? (Go To: 2200)
	Permissible Values (value): Alpha-glucosidase inhibitors: Acarbose (Precose), Miglitol (Glyset) (1)
	Biguanides: Metformin (Glucophage, Glucophage XR, Fortamet, Riomet, Glumetza) (2)
	Combination therapy: Avandamet (Rosiglitazone and Metformin), Glucovance (Glyburide and Metformin), Metaglip (Glipizide and Metformin) (3)
	Insulin (5)
	Meglitinides: Nateglinide (Starlix) Repaglinide (Prandin) (6)
	Sulfonylureas: Acetohexamide (Dymelor), Chlorpropamide (Diabinese), Glimepiride (Amaryl), Glipizide (Glucotrol, Glucotol XL), Glyburide (Micronase, DiaBeta, Glynase), Tolazamide (Tolinase), Tolbutamide (Orinase) (7)
	Thiazolidinediones or Glitazones: Pioglitazone (Actos), Rosiglitazone (Avandia) (8)
	DPP-4 Inhibitors [Sitagliptin (Januvia), Saxagliptin (Onglyza), Linagliptin ( Tradjenta)] (9)
	Bile Acid Sequestrants Colesevelam (Welchol) (12)
	Co-Transporter 2 (SGLT2) Inhibitor (Jardiance) (13)
	Incretin mimetics (exenatide (Byetta, Bydureon), liraglutide (Victoza), dulaglutide (Trulicity), lixisenatide (Adlyxin), semaglutide (Ozempic)) (14)
	None (44) (Go To: 2468)
* 2468	Has the participant taken any of the following medications with hormonal effects? (Go To: 2200)
	Permissible Values (value): 5α-reductase inhibitors: Dutasteride (Avodart), Finasteride (Proscar) (1)
	Nandrolone (Deca-Durabolin, Durabolin, Nandrolin) (4)
	Testosterone replacement: (Testim, Androgel) (5)
	None (44) (Go To: 2469)
* 2469	Has the participant taken any of the following non-steroidal anti-inflammatory drugs (NSAIDS)? (Go To: 2200)
	Permissible Values (value): Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin) (1)
	Diclofenac (Cataflam, Voltaren, Voltaren XR, Arthrotec) (2)
	Diflunisal (Dolobid) (3)
	Etodolac (Lodine, Lodine XL) (4)
	Fenoprofen calcium (Nalfon) (5)
	Flurbiprofen (Ansaid) (6)
	Ibuprofen (Advil, Motrin, Motrin IB, Nuprin) (7)
	Indomethacin (Indocin, Indocin SR) (8)
	Ketoprofen (Actron, Orudis, Orudis KT, Oruvail) (9)
	Meclofenamate sodium (Meclomen) (10)
	Mefenamic acid (Ponstel) (11)
	Meloxicam (Mobic) (12)
	Nabumetone (Relafen) (13)
	Naproxen (Aleve, Anaprox, Naprosyn, Naprelan) (14)
	Oxaprozin (Daypro) (15)
	Piroxicam (Feldene) (16)
	Salicylate (Arthropan, Arthritab, Bayer Select, CMT, Doan's Pills, Magan, Mobidin, Mobogesic, Tricosal, Trilisate, various generics) (17)
	Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab) (18)
	Sulindac (Clinoril) (19)
	Tolmetin sodium (Tolectin) (20)
	None (44) (Go To: 2470)
* 2470	Has the participant taken any of the following COX-2 selective non-steroidal anti-inflammatory drugs (NSAIDS)? (Go To: 2200)
	Permissible Values (value): Celecoxib (Celebrex) (1)
	Rofecoxib (Vioxx) (2)
	Valdecoxib (Bextra) (3)
	None (44) (Go To: 1097)
1873	Medication Name: (Go To: 2200)
* 2200	How long was this medication taken? (Go To: 2202)
	Permissible Values (value): 0-2 years (1)
	2-4 years (2)
	4-6 years (3)
	6-8 years (4)
	8-10 years (5)
	Unknown/refused (99)
* 2202	Is this medication currently taken? (Go To: 2201)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown/refused (9)
2201	How often is/was this medication taken? (Go To: 1097)
	Permissible Values (value): less than 1 day per week (0)
	1-2 days per week (1)
	3-4 days per week (2)
	5-6 days per week (3)
	7 days per week (4)
	Unknown/refused (9)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)