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[Gnumed-devel] Rethinking drug reference

From: Jim Busser
Subject: [Gnumed-devel] Rethinking drug reference
Date: Fri, 19 Feb 2010 16:52:32 -0800

Might we agree that – except when we have a special reason to jump immediately 
to a specific commercial ("brand") product – the more desirable clinical 
process may be to lookup by therapeutic class (e.g. angiotensin converting 
enzyme inhibitors, beta-adrenergic blockers, anti-histamines non-sedating) 

a) our knowledge of whether a drug is clinically useful comes typically from 
the class
b) having selected a class, we can gain a listing of all products containing an 
ingredient in this class
c) this could allow the user to filter on:
        "all products in this class" vs
        "single agent products only" vs
        "combo agent products only"
d) from such a list, interactions between class members and a reference list of 
the patient's existing medications could be queried and shown
Might we agree to also desire these filters:
- limit to commercially available in country
- limit to commercially available anywhere
- do not limit (to enable lookups)

and to enable
- per ingredient linking to an external source of reference information
- per product linking to an external source of reference information
- user-settable designation of the source and the lookup syntax

and to put down on a future roadmap:
- calculate / show eligibility to access the product(s)
- calculate / show cost info per product
- calculate / show individualized risk / benefit for using the product

If the above would be a good approach, shall we want to make possible:

1. Pick from (search for / under) therapeutic class
2. Pick from (search for / under) ingredient
3. Pick from (search under) commercially available products, based on 
properties determined by the manufacturer (i.e. combinations, routes, forms, 
strengths, package sizes, cost, administrative approval which -- IMO -- is 
mainly a function of the manufacturers' pricing policies)
4. Build a list (even if not all will flow into a new prescription) to check 
for interactions
5. Save from list (even where not every element was to be newly prescribed)

- filters as listed above
- filters (extra) to limit to (or exclude) certain routes or forms

- the display must always be clear as to which product(s) are combo-products
- the display would preferably make it easy to see what's in the combo 
products, to facilitate a suitable selection   

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