Re: [Gnumed-devel] improved medication list

[Sebastian Hilbert]

Am Sonntag 04 Juli 2010, 21:39:41 schrieb Karsten Hilbert:
> On Sat, Jul 03, 2010 at 08:28:42AM +0200, Hilbert, Sebastian wrote:
> > > I have improved the current medication table in the LaTeX
> > > format. This is now much more suitable for patients
> > > wondering how they should take their medication.
> > 
> > Conny is saying that there is too much information. While the information
> > is technically correct it could lead to a patient taking sixty pills
> > (pulse value)
> 
> Excellent point !
> 
> > She prefers to only have it say heart medication or blood pressure
> > medication or pain medication.
> 
> While this is very patient-minding it isn't in our hands
> because GNUmed doesn't know the purpose of the medication at
> that level of granularity.
> 
> > Maybe we could have another simpler template. I understand
> > that the information there is manual input anyway so she could write
> > whatever is there.
> 
> Exactly, a mindful doctor will put such things in the proper
> field such that they end up on the right spot on the
> printout.
> 
> > The component information for combination drugs needs to go away for
> > her preferred template as well.
> 
> Hm, hm, what happens when the pharmacy replaces the brand
> the doctor had prescribed and perhaps discussed with the
> patient ?
> 
> This happens every day. The patient must be able to identify
> components in drugs (I know the patient never will but it
> must be possible).
> 
> > A fairly young patient (50 or so) recently confronted her saying. Hey, a
> > few weeks back my urologist noticed elevated PSA-levels. He screwed up
> > because he failed to detect my (now diagnosed) lung cancer.
> 
> Uhm, like, what does this tell me ?

Despite the fact that patients may be young (as in should be able to follow 
direction without problems) less information may be more as pytients will 
randomly connect facts leading to problems with medication

So the good old



-------------------------------------------------------

Metoprolol 95mg 1-0-0

still looks the best version
-------------------------------------------------------


For the inclined patient


Metoprolol 95mg     1-0-0    heart medication
HCT 12,5mg              1-0-0   Wassertablette (diuretics)

might be more interesting but not neccessarly better.
-------------------------------------------------------

For the patient you think it will be important and makes sense_


Metoprolol 95mg     1-0-0    heart medication
HCT 12,5mg              1-0-0   Wassertablette (diuretics)


===============
notes
===============

Metoprolol 95mg     report hearte < 60 bpm
HCT 12,5mg              report increased urinating at night
Clopidogrel 75          never, ever discontinue with out referring to you heart 
specialist
general                 measure weight daily, report weight gain above 1kg in 
two 
days 

-------------------------------------------------------

While important manual text input will keep collegues from providing that 
information. A phrasewheel which will learn phrases over time could help here. 
Which leads me to the point that the prescribing doctor should be listed and 
therefore collected if issueing a refill for another specialist (e.g. 
neurologist)

--------------------------------------------------------

Metoprolol 95mg     1-0-0    heart medication
HCT 12,5mg              1-0-0   Wassertablette (diuretics)

===============
notes
===============

Metoprolol           report hearte < 60 bpm  (orig. prescribed by Dr.McCoy) 
HCT                        report increased urinating at night (orig. 
prescribed by 
Dr.McCoy)
Clopidogrel         never, ever discontinue without referring to your heart 
                           specialist (orig. prescribed by heart center )
general advice   measure weight daily, report weight gain above 1kg 
                           in two days 


The additional information can (but never will) be consumed by the patient but 
is available to any other physician the patient might see.

discharge from hospital is totally different where ideally drugs would be 
listed along with the information substituted by and discontinued because. I 
have so far never seen a system that supports that.

Sebastian