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

[Karsten Hilbert]

On Thu, Oct 29, 2009 at 01:07:04AM -0700, Jim Busser wrote:
> Subject: Re: [Gnumed-devel] proper English term needed for medication
> X-Mailer: Apple Mail (2.1076)
> 
> 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)?

That is the catch: While "Dauer" in German does not imply
anything about the actual regimen of intake it does imply
permanency of approval to ingest.

"regular"

        seems to imply "regular*ly* taken"

"ongoing"

        seems to imply "currently being taken"

"repeat"

        suffers from administration mix,
        "acute" meds can also need repeat prescriptions

"chronic"

        seems to carry too much diagnostic connotation

"long-term"

        I'll probably best use this in the backend for the column name
        as it nicely implies "expected to be taken for a long but rather
        indefinite duration"

        We can still try to find the best term (if possible)
        to use in the client.

"permanent"

        seems to imply too much finality

"perpetual"

        seems in less common use than other terms

> 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

Hm, "repeat" starts to mix administrative with clinical
matters. I have provided my Grandma with a prescription for
600 tablets of levodopa for which she'll probably never need
a repeat (prescription) - but it's surely expected to be a
lifelong medication ;-)

"acute" suffers from the problem stated below.

> >(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.)

+1 !

> 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).

+1 !

So, how about long-term ?

> 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.

Yep, that's what we do :-)

Karsten
-- 
GPG key ID E4071346 @ wwwkeys.pgp.net
E167 67FD A291 2BEA 73BD  4537 78B9 A9F9 E407 1346