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[Gnumed-devel] Re: GNUmed and FreeDiams (medication management)


From: Jim Busser
Subject: [Gnumed-devel] Re: GNUmed and FreeDiams (medication management)
Date: Wed, 29 Dec 2010 15:37:42 -0800

I have cross-posted this to gnumed-devel where Karsten may prefer to reply in 
case this discussion becomes too narrow for freediams list…


On 2010-12-29, at 11:05 AM, Graham Chiu wrote:

> Doesn't Gnumed allow the import of medications from a CCR/CCD ?

From January 23, 2010 devel list (release 0.6)

        - can interface with German "MMI/Gelbe Liste" external drug database
        - show info on drug/substance by PZN / name
        - show interactions
        - import drugs/substances

Looking at the work-in-progress (gnumed v15) database schema are multiple 
tables. Perhaps, in the table list that follows, the tables "above" are roughly 
speaking (but not exactly) fed from "below":

… (ever?) used by patients:

        
http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#clin.table.active-substance

… (subset of)

        
http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.consumable-substance

… (superset of)

        
http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.branded-drug

… (cross-referenced to)

        
http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.atc

… (multiple of above referenced to)

        
http://salaam.homeunix.com/~ncq/gnumed/schema/gnumed_v15/gnumed-schema.html#ref.table.data-source


So… should branded_drug (for Canada) import some of the same data as is used in 
FreeDiams' "DRUGS" table:

        `UID` varchar(20) NOT NULL      -->     external_code
        `NAME` varchar(1000) NOT NULL   -->     description (better: "name" or 
"brand_name" ?)
        `FORM` varchar(500)     -->     preparation (better: "form" ?)
        `ROUTE` varchar(100)
        `ATC` varchar(7)        --> atc_code
        `GLOBAL_STRENGTH` varchar(40)

        --> SET external_code_type = "DIN" or "CA DIN"

        … this table could have added to it "new" drugs, but would not "lose" 
them after they would no longer be produced

And…

        1) does branded_drug "seed" and update the table Consumable_substance ?
        2) how should Consumable_substance handle "no-longer-available" drugs?

… on the one hand, a clinician does not want to offer, to a patient, something 
that can no longer be obtained. On the other hand, even despite that a 
substance can no longer be officially or legally be obtained, entires may have 
to be made to a chart after the drug is no longer obtainable and it is possible 
that patients might continue to use drugs from some pre-existing or alternate 
supply even when the drug is not still being produced. So I suppose it makes 
sense to keep always, in Consumable_substance, the values but rely on something 
like FreeDiams to show you that it is no longer available to be prescribed?

Maybe it is worth to add (into branded_drug and into Consumable_substance) a 
column "status" which
        - in branded_drug can be updated from external sources
        - in Consumable_substance can be updated from branded_drug
                (or manually for substances which are not branded drugs)
 
-- Jim







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