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Re: [Gnumed-devel] pregnancy and ace-inhibitor
From: |
Jim Busser |
Subject: |
Re: [Gnumed-devel] pregnancy and ace-inhibitor |
Date: |
Sun, 28 Feb 2010 08:06:46 -0800 |
On 2010-02-28, at 12:41 AM, Sebastian Hilbert wrote:
> Does GNUmed have a mean to display an ongoing pregnancy yet ?
> I propose a feature to track that information.
I suggest we remind if we already some way to identify (store and keep
query-able) the presence or absence of chronic (or even short term) states.
Pregnancy would seem on a continuum of
pre-menarchal
fertile (no protection status)
fertile (on contraception)
fertile (unprotected)
fertile (attempting pregnancy)
pregnant
post-meopausal
infertile (e.g. primary; post-surgical)
I took out lactating, on account that lactating women can become fertile, so
those states are not mutually exclusive. Lactation is a state pertinent to drug
(contra) indications though I do not know if it is yet supported in French INN
tables.
I don't know whether the above would be better handled by a special variable /
table, or whether inside some larger archetypal system within GM.
From the point of view of drug interactions, the schema would be simplified by
managing female fertility state, and separately lactating state, in the problem
list despite that they are not diseases.
If we would contemplate it more closely, the draft list above combines
biological with behavioral with medication states... the patient who was taking
an oral contraceptive may lapse in their prescription, and so despite that they
were coded in an EMR as fertile (on contraception) they may actually not be.
Maybe this entire ATC class of medications when first initiated or discontinued
could result in a prompt in GM to reconsider the manually-managed fertility
state.
We did also previously on the list acknowledge other states (risks) as may
include being sexually active (even if infertile, certain sexual activity is
relevant to infectious diseases) and occupations were also potential risk
factors. Smoking and alcohol, as well. So fertility state could join these in
some structure other than the problem list. ??