Medication History

This form captures information about the patient’s medication history.

• Add a new row in the table for each medication history instance.

• Enter the medication name, route of administration, dosage, units of dosage, prescription start date, end date, and reasons for discontinuation.

• Indicate whether this prescription was part of a taper regimen in the comment field .

• For tapers, enter each taper segment as a new row, changing the dosage for every segment.

Please note that the data you collect in this section is study-dependent, and there is no standard guideline for what medication history to collect. Please refer to your principal investigator and study protocol for guidance on which medication history data to collect.

In general, the following medications are of interest:

Immunosuppressive Therapy

• Glucocorticoids

• Cyclophosphamide

• Mycophenolate

• Azathioprine

• Calcineurin Inhibitors

• Methotrexate

• Biologics

• Immunomodulatory drugs such as HCQ

• Other immune-modifying drugs

Conservative Therapy

• Renin-angiotensin-aldosterone system blockers

• Antihypertensives

• Diuretics

• Potassium Binders

• Statins

• SGLT2 Inhibitors

If the medication's start date is unavailable, use July 1 with the approximate year of diagnosis.

• In the comment section, enter the approximate number of days the patient was on that medication.

• If an exact year is not available, an approximation is acceptable.

• If any approximations are used, please make a note in the comments section of the corresponding row.

Once the date is entered, please click on the calculator to calculate the days from the INDEX diagnosis date (start and end).