Re: [Gnumed-devel] Unable to clearly enough select a combo drug from Add button > Brand by component

[Karsten Hilbert]

To somewhat alleviate this situation I have (for the 1.2
branch) made the drug component phrasewheel include the
external ID type and value if known.

That way it is *possible* to differentiate which drug is
going to be selected at the very least (if the external ID
had been entered as is done automatically when interfacing
with FreeDiams).

One could also - if needed - (ab)use the external ID of
brands to hold a differentiating comment:

external_id_brand_type = 'fake'
external_id_brand = 'this is Altace HCT 5/12.5 (and not 10/12.5)'

Karsten

On Wed, Jun 20, 2012 at 03:00:54PM +0000, Jim Busser wrote:

> My problem is that, in Canada, the combination which contains
> 
>       hydrochorothiazide 12.5 mg
>       ramipril 10mg
> 
> is called Altace HCT but this same name is used for
> 
>       hydrochorothiazide 12.5 mg
>       ramipril 5mg
> 
> as is evident from this join of brand and consumable substance data, ordered 
> by drug external code. What I was desiring to select for my patient was the 
> third "pair" (ext code 02283158):
> 
>  description | pk1  | pk2  | so | ext_code |    external_code_type    |     
> description     | atc_code | amount | unit 
> -------------+------+------+----+----------+--------------------------+---------------------+----------+--------+------
>  Altace Hct  | 9574 | 3709 |  8 | 02283131 | FreeDiams::CA_HCDPD::DIN | 
> hydrochlorothiazide | C03AA03  |   12.5 | mg
>  Altace Hct  | 9574 | 6058 |  8 | 02283131 | FreeDiams::CA_HCDPD::DIN | 
> ramipril            | C09AA05  |    2.5 | mg
>  Altace Hct  | 9575 | 6059 |  8 | 02283158 | FreeDiams::CA_HCDPD::DIN | 
> ramipril            | C09AA05  |    5.0 | mg
>  Altace Hct  | 9575 | 3709 |  8 | 02283158 | FreeDiams::CA_HCDPD::DIN | 
> hydrochlorothiazide | C03AA03  |   12.5 | mg
>  Altace Hct  | 9576 | 3709 |  8 | 02283166 | FreeDiams::CA_HCDPD::DIN | 
> hydrochlorothiazide | C03AA03  |   12.5 | mg
>  Altace Hct  | 9576 | 6060 |  8 | 02283166 | FreeDiams::CA_HCDPD::DIN | 
> ramipril            | C09AA05  |   10.0 | mg
>  Altace Hct  | 9577 | 6059 |  8 | 02283174 | FreeDiams::CA_HCDPD::DIN | 
> ramipril            | C09AA05  |    5.0 | mg
>  Altace Hct  | 9577 | 3711 |  8 | 02283174 | FreeDiams::CA_HCDPD::DIN | 
> hydrochlorothiazide | C03AA03  |   25.0 | mg
>  Altace Hct  | 9578 | 6060 |  8 | 02283182 | FreeDiams::CA_HCDPD::DIN | 
> ramipril            | C09AA05  |   10.0 | mg
>  Altace Hct  | 9578 | 3711 |  8 | 02283182 | FreeDiams::CA_HCDPD::DIN | 
> hydrochlorothiazide | C03AA03  |   25.0 | mg
> (10 rows)
> 
> however when I input into GNUmed 1.2's "Brand by component" filter the string
> 
>       Altace HCT
> 
> I am offered
> 
>       hydrochlorothiazide 12.5mg tablet (Altace Hct)
>       hydrochlorothiazide 25.0mg tablet (Altace Hct)
>       ramipril 10.0mg tablet (Altace Hct)
>       ramipril 5.0mg tablet (Altace Hct)
>       ramipril 2.5mg tablet (Altace Hct)
> 
> and my problem is that selecting the desired lower strength of 
> hydrochlorothiazide does not resolve to the desired combo, because there are 
> two such combos (one with 5mg and one with 10mg) and the desired 
> hydrochlorothiazide *happens* to be the one that is linked to the 5mg 
> strength of ramipril.
> 
> Only through trial and error did I resolve that a selection of ramipril 10mg 
> gained me the combination that I wanted (because it is possible that it could 
> have been linked to the higher, 25mg dose of hydrochlorothiazide).
> 
> This also reminds me that a combo drug 'description' (brand name) will not 
> always make clear in GNUmed that the drug is a combo drug... when I wrote my 
> data pack, I had preferred to keep the Brand names unaltered.
> 
> It would be better if a user, when selecting a component, could more clearly 
> know whether their selection was part of a multi-component drug. Can the 
> phrasewheel know this information and in such cases can the brand name be 
> surrounded by double parens instead of single e.g.
> 
>       hydrochlorothiazide 12.5mg tablet ((Altace Hct))
>       hydrochlorothiazide 25.0mg tablet ((Altace Hct))
>       ramipril 10.0mg tablet ((Altace Hct))
>       ramipril 5.0mg tablet ((Altace Hct))
>       ramipril 2.5mg tablet ((Altace Hct))
> 
> which allows to communicate to the user without having to further complicate 
> the Brand names. Yes, I know I can rewrite my data pack to modify the Brand 
> names so that they are no longer, in fact, proper brand names but there is a 
> downside to that. Also, my proposal adds safety because it helps visually 
> hint to prevent accidental user selection of a combo drug, when they intended 
> only a single-component drug.

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