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[Gnumed-devel] Problem discontinuing component (agent) in a combo drug


From: Jim Busser
Subject: [Gnumed-devel] Problem discontinuing component (agent) in a combo drug
Date: Tue, 09 Nov 2010 12:39:59 -0800

Having a bit of trouble following GNUmed's medication list usage...

1) "Reason" intends to capture reason discontinued... however being positioned 
under "Started" it risks to look like the reason why the drug was started. 
Suggest to indent under Discontinued and either accept the reduction in input 
space or expand the input box to two lines.

How does one select and input a combo drug?

2) If I input "Substance" say metoprolol, there is no auto-filtering of the 
phrasewheel matches under Brand but then even when I select Metopharm which is 
a combo drug, I see no appearance of the patient receiving also 
hydrochorothiazide. 

3) If I leave blank "Substance" and into Brand type meto and select the match 
(MetoPharm) then I see auto-populated the "Preparation" as tablets but nothing 
in the substance.

... does this need an external database to work? That IMO is a problem.

4) Why is the colour of required value "Episode" orange and not red?

5) I like the medication list button "Allergy" which offers to discontinue a 
drug, however

(a) it does not really offer... there is no "undo"... can we provide a way to 
reverse this or to require to accept a dialog which includes the name of the 
selected substance in case there was a mis-selection?

(b) when the Brand drug is a combo, and while it may be intended that the 
patient still takes the other component(s), this is not possible (and is 
misleading and risks error) if the patient is allowed to continue on the same 
Brand. Therefore
- can GNUmed check if the selection to be discontinued (for allergy) is a 
multi-part drug?
- should maybe GNUmed offer to discontinue none or all and also, how is the 
allergy to be decided? I can understand that that doctor may have a suspicion 
of one component more than the other but maybe allergies need to be entered to 
both, and the doctor then decides (after a warning) to maybe try the patient on 
the hopefully tolerated component and then they can later discontinue the 
allergy against the tolerated component?


-- Jim

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