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Re: [Gnumed-devel] clin_medication

From: J Busser
Subject: Re: [Gnumed-devel] clin_medication
Date: Wed, 13 Oct 2004 03:16:16 -0700

At 10:12 PM -0400 10/12/04, Ian Haywood wrote:
I vote for frequency as a number in hours, this covers hourly eye drops
to weekly bisphosphonates.

Frequency -- if it means bid, tid, qid etc (or is there some other preferred term for this?) -- has to be distinguished from "period" which in the schema is
        integer, NOT NULL, the length of the dosing cycle, in hours

the commonest value for "period" would be 24, because it is only when the dosage is NOT the same every day that one would change this. Examples would include:

- alternate day corticosteroids
- cycling hormonal therapy and chemotherapy
- warfarin dosed at 4mg Mondays, Wednesdays, Fridays vs 3mg on the other days

I would suggest a default of 24h unless it is preferred that this be assigned by a widget?

I cannot think of an *outpatient* situation where the "cycle" would be less than 24 hours, only hospital-based, for example intravenous infusions at varying rates (iron, N-acetylcysteine). Am I overlooking other candidate use cases?

For the "period", 168 is awkward to input, when one intends "weekly".
We might use the concept d for days, w for weeks hence 7d would be translated to 168 hours
-- similar to that of the date & time input widget --

What field should carry the bid tid etc? While this could be relegated to a free text field, a lookup table could permit mapping to the numeric value for how often per day which, when combined with the dosage can help calculate how much (how many tablets) to supply.

PS in the schema, in place of "dose", can I propose "dosage"? In English the word "dose" can be a verb (to "dose" someone) or can refer to a single or one-time "dose" whereas "dosage" IMO unambiguously refers to the amount of medication to be taken in order to effect a "dose" and as pointed out in the schema the dosAGE can vary within a treatment cycle (picky, I know, but clear?).

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