Re: [Gnumed-devel] Re: GNUmed and FreeDiams (medication management)

[Karsten Hilbert]

> From January 23, 2010 devel list (release 0.6)
> 
>       - can interface with German "MMI/Gelbe Liste" external drug database
>       - show info on drug/substance by PZN / name
>       - show interactions
>       - import drugs/substances

That is now also true for FreeDiams.

> Looking at the work-in-progress (gnumed v15) database schema are multiple
> tables. Perhaps, in the table list that follows, the tables "above" are
> roughly speaking (but not exactly) fed from "below":
> 
> … (ever?) used by patients:
> 
>       
> http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#clin.table.active-substance

Does not exist anymore.

> … (subset of)
> 
>       
> http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.consumable-substance

Stores substances patients may use on themselves. Tar, carvedilol,
metoprolol, nicotin, alcohol, Ibuprofen, cannabis, penicillin etc.

> … (superset of)
> 
>       
> http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.branded-drug

Defines branded drug products at the level GNUmed currently cares.
Consumable_substances are linked with this table as appropriate.

> So… should branded_drug (for Canada) import some of the same data as is
> used in FreeDiams' "DRUGS" table:
> 
>       … this table could have added to it "new" drugs, but would not "lose"
> them after they would no longer be produced

yes

> And…
> 
>       1) does branded_drug "seed" and update the table Consumable_substance ?

No.

>       2) how should Consumable_substance handle "no-longer-available" drugs?

Consumable_substance has no business meddling in legal affairs.

> … on the one hand, a clinician does not want to offer, to a patient,
> something that can no longer be obtained. On the other hand, even despite that
> a substance can no longer be officially or legally be obtained, entires
> may have to be made to a chart after the drug is no longer obtainable and it
> is possible that patients might continue to use drugs from some
> pre-existing or alternate supply even when the drug is not still being 
> produced. So I
> suppose it makes sense to keep always, in Consumable_substance, the values
> but rely on something like FreeDiams to show you that it is no longer
> available to be prescribed?

Sounds reasonable to me. Since GNUmed does not currently concern
itself with prescriptions that would be the job of something that does.

> Maybe it is worth to add (into branded_drug and into Consumable_substance)
> a column "status" which

- not at the moment
- "status" would be way to generic a column name

Karsten
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