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Re: [Gnumed-devel] proper English term needed for medication

From: Jim Busser
Subject: Re: [Gnumed-devel] proper English term needed for medication
Date: Thu, 29 Oct 2009 01:07:04 -0700

On 2009-10-29, at 12:55 AM, Karsten Hilbert wrote:

So "regular medication" seems to fit the bill.

Even for drugs used irregularly (episodically, and prn)?
Would the following exchange on another list help?


Jim Busser wrote: To me, current medications would consist of:

- short-term
- ongoing

Reply: This is very important - prescribing errors from EMRs (because of the ease of prescribing) have been identified as an issue. There has been recent discussion on the XXXXXX UserGroup list about this and how best to handle it. A doc from the UK, now practicing in Canada reminded us: "Represcribing medication in an EMR is dangerously easy - the UK experience is that adverse events occur when acute and repeat medications are mixed up by prescribers."

Acute and Repeats are the 2 terms I am most comfortable with (could be persuaded of others, probably). The problem with 'ongoing' is that it does not distinguish clearly an ongoing acute med from and ongoing repeat (chronic) med. (I don't think 'chronic' works either.)

Acute and Repeat worked well for me when I was in the Uk and I did not hear of one person who found it confusing.

Well, the problem with "Acute" is that the condition may persist beyond the original supply dispensed, so you could end up with an "Acute" which had become a "Repeat" (of an Acute). Consequently, does it remain "Acute" (despite that it has been repeated) --- in other words, is it "another Acute prescription" --- or does it become a "Repeat" prescription, despite that the plan was to limit the use?

There could be important yet subtle distinctions if the frame of reference is the *condition* vs the *medication* vs the *prescription*:

acute condition --> medication status (intent) = short-term --> prescription (intent or type) = Acute

If (at the next visit) a further supply would be needed, the medication would still be intended as a short-term medication, while the prescription as envisioned in the reply would presumably be kept "Acute" as in -- maybe -- "another Acute prescription?

Working from a medication list, and prescribing from it, would obviate the need to classify the *prescription*. Working from a medication list might also afford a coherent base from which to work, since you could maintain (in such a list) the substances that are being taken, despite that they are being prescribed by doctors outside your EMR (say, by outside specialists) *plus* those taken by the patient without prescription (OTC and alternative medicines). That is the approach, at least, being tried in this other EMR.

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