Re: [Gnumed-devel] clin_medication

[J Busser]

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 --
http://www.gnumed.org/documentation/develop/discussion/date.html

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?).