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

[Jim Busser]

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?

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> 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.