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proper English term needed for medication
by Karsten Hilbert
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I am looking for a compound noun which describes drugs/a
drug expected to be taken perpetually, such as hypertensive agents. In German we say "Dauermedikament". A literal translation could be "permanent medication". Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-28, at 3:13 PM, Karsten Hilbert wrote:
> I am looking for a compound noun which describes drugs/a > drug expected to be taken perpetually, such as hypertensive > agents. > > In German we say "Dauermedikament". A literal translation > could be "permanent medication". In English we might mainly think of the adverb to take a medication *indefinitely* but if you want an adjective + noun I would better suggest ongoing medication ... the ongoing speaking to the lack of an intended stop date _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Wed, Oct 28, 2009 at 03:42:18PM -0700, Jim Busser wrote:
> >drug expected to be taken perpetually, such as hypertensive > >agents. > > > >In German we say "Dauermedikament". A literal translation > >could be "permanent medication". > > In English we might mainly think of the adverb > > to take a medication *indefinitely* > > but if you want an adjective + noun I would better suggest > > ongoing medication > > ... the ongoing speaking to the lack of an intended stop date The "ongoing" not being in danger of being confused with "current" ? Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-28, at 3:48 PM, Karsten Hilbert wrote:
> The "ongoing" not being in danger of being confused > with "current" ? Seemingly not... (I asked on a local medical list): Begin forwarded message: > I agree with your suggestion James - i.e. "ongoing". I also agree > that "current" carries the implication of 'subject to change'. Off > the top of my head I can't think of a better term. > > Chris. > > Jim Busser wrote: > >> A german doctor working on a free EMR asked me: >> >>> I am looking for a compound noun which describes drugs/a >>> drug expected to be taken perpetually, such as hypertensive >>> agents. >>> >>> In German we say "Dauermedikament". A literal translation >>> could be "permanent medication". >> >> At my suggestion – which is "ongoing medication" – he asked >> >>> Is there much danger of confusion with "Current medication"? >> >> My answer would be no, but I figured best to run past people who >> would come at this question more blindly. To me, current >> medications would include those that may be intended to be stopped >> (such as a course of antibiotics or anti-inflammatories). To me, >> current medications would consist of: >> >> - short-term >> - ongoing >> >> plus, of course, "not intended to be ongoing, despite that somehow >> the patient has continued it, or ended up back on it" >> >> Does the concept better need some term better than "ongoing"? _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-29, at 12:55 AM, Karsten Hilbert wrote:
> So "regular medication" seems to fit the bill. Even for drugs used irregularly (episodically, and prn)? Would the following exchange on another list help? ********************************************************************** > Jim Busser wrote: To me, current medications would consist of: >> >> - short-term >> - ongoing > > Reply: This is very important - prescribing errors from EMRs > (because of the ease of prescribing) have been identified as an > issue. There has been recent discussion on the XXXXXX UserGroup list > about this and how best to handle it. A doc from the UK, now > practicing in Canada reminded us: "Represcribing medication in an > EMR is dangerously easy - the UK experience is that adverse events > occur when acute and repeat medications are mixed up by prescribers." > > Acute and Repeats are the 2 terms I am most comfortable with (could > be persuaded of others, probably). The problem with 'ongoing' is > that it does not distinguish clearly an ongoing acute med from and > ongoing repeat (chronic) med. (I don't think 'chronic' works either.) > > Acute and Repeat worked well for me when I was in the Uk and I did > not hear of one person who found it confusing. Well, the problem with "Acute" is that the condition may persist beyond the original supply dispensed, so you could end up with an "Acute" which had become a "Repeat" (of an Acute). Consequently, does it remain "Acute" (despite that it has been repeated) --- in other words, is it "another Acute prescription" --- or does it become a "Repeat" prescription, despite that the plan was to limit the use? There could be important yet subtle distinctions if the frame of reference is the *condition* vs the *medication* vs the *prescription*: acute condition --> medication status (intent) = short-term --> prescription (intent or type) = Acute If (at the next visit) a further supply would be needed, the medication would still be intended as a short-term medication, while the prescription as envisioned in the reply would presumably be kept "Acute" as in -- maybe -- "another Acute prescription? Working from a medication list, and prescribing from it, would obviate the need to classify the *prescription*. Working from a medication list might also afford a coherent base from which to work, since you could maintain (in such a list) the substances that are being taken, despite that they are being prescribed by doctors outside your EMR (say, by outside specialists) *plus* those taken by the patient without prescription (OTC and alternative medicines). That is the approach, at least, being tried in this other EMR. _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Thu, Oct 29, 2009 at 01:07:04AM -0700, Jim Busser wrote:
> Subject: Re: [Gnumed-devel] proper English term needed for medication > X-Mailer: Apple Mail (2.1076) > > On 2009-10-29, at 12:55 AM, Karsten Hilbert wrote: > > >So "regular medication" seems to fit the bill. > > Even for drugs used irregularly (episodically, and prn)? That is the catch: While "Dauer" in German does not imply anything about the actual regimen of intake it does imply permanency of approval to ingest. "regular" seems to imply "regular*ly* taken" "ongoing" seems to imply "currently being taken" "repeat" suffers from administration mix, "acute" meds can also need repeat prescriptions "chronic" seems to carry too much diagnostic connotation "long-term" I'll probably best use this in the backend for the column name as it nicely implies "expected to be taken for a long but rather indefinite duration" We can still try to find the best term (if possible) to use in the client. "permanent" seems to imply too much finality "perpetual" seems in less common use than other terms > Would the following exchange on another list help? :-) > >Jim Busser wrote: To me, current medications would consist of: > >> > >>- short-term > >>- ongoing > > > >Reply: This is very important - prescribing errors from EMRs > >(because of the ease of prescribing) have been identified as an > >issue. There has been recent discussion on the XXXXXX UserGroup > >list about this and how best to handle it. A doc from the UK, now > >practicing in Canada reminded us: "Represcribing medication in an > >EMR is dangerously easy - the UK experience is that adverse events > >occur when acute and repeat medications are mixed up by > >prescribers." > > > >Acute and Repeats are the 2 terms I am most comfortable with Hm, "repeat" starts to mix administrative with clinical matters. I have provided my Grandma with a prescription for 600 tablets of levodopa for which she'll probably never need a repeat (prescription) - but it's surely expected to be a lifelong medication ;-) "acute" suffers from the problem stated below. > >(could be persuaded of others, probably). The problem with > >'ongoing' is that it does not distinguish clearly an ongoing acute > >med from and ongoing repeat (chronic) med. (I don't think > >'chronic' works either.) +1 ! > Well, the problem with "Acute" is that the condition may persist > beyond the original supply dispensed, so you could end up with an > "Acute" which had become a "Repeat" (of an Acute). +1 ! So, how about long-term ? > If (at the next visit) a further supply would be needed, the > medication would still be intended as a short-term medication, while > the prescription as envisioned in the reply would presumably be kept > "Acute" as in -- maybe -- "another Acute prescription? > > Working from a medication list, and prescribing from it, would > obviate the need to classify the *prescription*. Working from a > medication list might also afford a coherent base from which to > work, since you could maintain (in such a list) the substances that > are being taken, despite that they are being prescribed by doctors > outside your EMR (say, by outside specialists) *plus* those taken by > the patient without prescription (OTC and alternative medicines). > That is the approach, at least, being tried in this other EMR. Yep, that's what we do :-) Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Liz-25
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> On Thu, Oct 29, 2009 at 01:07:04AM -0700, Jim Busser wrote:
>> Subject: Re: [Gnumed-devel] proper English term needed for medication >> X-Mailer: Apple Mail (2.1076) >> >> On 2009-10-29, at 12:55 AM, Karsten Hilbert wrote: >> >> >So "regular medication" seems to fit the bill. >> >> Even for drugs used irregularly (episodically, and prn)? > > That is the catch: While "Dauer" in German does not imply > anything about the actual regimen of intake it does imply > permanency of approval to ingest. > > > "long-term" > > I'll probably best use this in the backend for the column name > as it nicely implies "expected to be taken for a long but rather > indefinite duration" > > We can still try to find the best term (if possible) > to use in the client. > we use short term and long term in AU probably in general usage _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-29, at 1:37 AM, Karsten Hilbert wrote:
>>> >>> So "regular medication" seems to fit the bill. >> >> Even for drugs used irregularly (episodically, and prn)? > > That is the catch: While "Dauer" in German does not imply > anything about the actual regimen of intake it does imply > permanency of approval to ingest. > > "regular" > > seems to imply "regular*ly* taken" > > "ongoing" > > seems to imply "currently being taken" > > "repeat" > > suffers from administration mix, > "acute" meds can also need repeat prescriptions > > "chronic" > > seems to carry too much diagnostic connotation > > "long-term" > > I'll probably best use this in the backend for the column name > as it nicely implies "expected to be taken for a long but rather > indefinite duration" > > We can still try to find the best term (if possible) > to use in the client. > > "permanent" > > seems to imply too much finality > > "perpetual" > > seems in less common use than other terms Another benefit of long-term is that it nicely balances against short- term. Any given medication is one or the other, or null. Null may be desirable for non-prescribed medications or substances since you may like to not be having to classify unapproved substances on intended duration. Also better to not second-guess an external specialist (provider's) medication treatment plan although if it had been properly communicated -- or at at the point where the GP inherits or takes responsibility -- the classification could be done. _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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"long-term" so be it.
Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-29, at 8:16 AM, Karsten Hilbert wrote: "long-term" so be it. agreed only for further info contributed elsewhere In <another EMR> I believe the terms are acute and continuous. There was also a function to bring up all continuous so you could untick those not required. However one Dr. never differentiated between acute and continuous, so the program stayed in default at continuous. The problem was design. To order a new med, acute or continuous was the first selection and refreshed the screen, not always quickly. If instead the last act were the choice of an acute order button OR a continuous button COLOUR CODED, it would be more functional. However drugs like antibiotics, which were the big offenders could have acute as a default algorithm. Indicated by say the acute button flashing. _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-28, at 3:13 PM, Karsten Hilbert wrote: > I am looking for a compound noun which describes drugs/a > drug expected to be taken perpetually, such as hypertensive > agents. > > In German we say "Dauermedikament". A literal translation > could be "permanent medication". in the table clin.substance_intake ? What column will this be? _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Thu, Oct 29, 2009 at 12:25:05PM -0700, Jim Busser wrote:
> >I am looking for a compound noun which describes drugs/a > >drug expected to be taken perpetually, such as hypertensive > >agents. > > > >In German we say "Dauermedikament". A literal translation > >could be "permanent medication". > > in the table clin.substance_intake ? > > What column will this be? clin.substance_intake.is_long_term Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-29, at 12:39 PM, Karsten Hilbert wrote:
>> What column will this be? > > clin.substance_intake.is_long_term Is it better boolean as above or would it be better to be categorical clin.substance_intake.category values {short-term, long-term, NULL} default = NULL Also in this table, I wondered for a moment I wondered whether .duration could take either an interval-based value (when known exactly) or when not known exactly could take the value of short- term or long-term I suspect the data type "interval" would allow only a time-based value therefore it would have to be some other field. That would beg the question as to any conceptual +- programmatic interaction with duration? IOW: if duration is null, the category of medication could be short-term or long-term if the medication category is long-term, does that mean the duration should be nulled? do we acknowledge potential ambiguity between duration as "intended" duration as "elapsed time since started .clin_when" duration as 'how long did they take it, if they stopped on or before today" if a duration is specified and is understood to mean "as intended or post-hoc actual", should a specified duration be construed to mean short-term, or maybe still the medication could be intended as long- term with the duration used to pre-specify a plan of reassessment? If the latter, then there would be neither conceptual nor programmatic linkage between duration and category, and the meaning of duration should be clarified to be Intended duration of use (whether total, or until reassessment), or actual duration if stopped, if known _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Thu, Oct 29, 2009 at 12:47:43PM -0700, Jim Busser wrote:
> >>What column will this be? > > > > clin.substance_intake.is_long_term > > Is it better boolean as above or would it be better to be categorical > > clin.substance_intake.category > > values {short-term, long-term, NULL} default = NULL :-) Remember that SQL has three-valued logic, so the above is True, False, NULL anyway (because I made is_long_term nullable). > Also in this table, I wondered for a moment I wondered whether > .duration could take either an interval-based value (when known > exactly) or when not known exactly could take the value of short- > term or long-term > > I suspect the data type "interval" would allow only a time-based > value therefore it would have to be some other field. That would be a goog option. I considered doing so. Null would mean unknown. Infinity would mean long-term. Minus infinity would mean short-term. Anything else would be a true duration. Unfortunately, interval doesn't yet support infinity. I talked to the PostgreSQL about that. They are working on it. > if duration is null, the category of medication could be short-term > or long-term yes > if the medication category is long-term, does that mean the duration > should be nulled? yes, and it is (by the cConsumedSubstance class): duration = ( case when %(is_long_term)s is True then null else gm.nullify_empty_string(%(duration)s) end )::interval, > do we acknowledge potential ambiguity between > duration as "intended" > duration as "elapsed time since started .clin_when" > duration as 'how long did they take it, if they stopped on or > before today" That is currently at the discretion of the clinician (due to lack of more fields). Intended is "intended if .started + .duration > today, else hopefully how long actually taken". IOW: if (.started + .duration) < today then we would strive to make it how-long-actually-taken if (.started + .duration) > today then current treatment intent > if a duration is specified and is understood to mean "as intended or > post-hoc actual", should a specified duration be construed to mean > short-term, or maybe still the medication could be intended as long- > term with the duration used to pre-specify a plan of reassessment? It could, yes. > If the latter, then there would be neither conceptual nor > programmatic linkage between duration and category, and the meaning > of duration should be clarified to be > > Intended duration of use (whether total, or until reassessment), or > actual duration if stopped, if known yes, see above Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Liz-25
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> Also in this table, I wondered for a moment I wondered > whether .duration could take either an interval-based value (when > known exactly) or when not known exactly could take the value of short- > term or long-term > > IOW: > > if duration is null, the category of medication could be short-term or > long-term > > if the medication category is long-term, does that mean the duration > should be nulled? > > do we acknowledge potential ambiguity between > duration as "intended" > duration as "elapsed time since started .clin_when" > duration as 'how long did they take it, if they stopped on or before > today" > even long-term has a duration this is the time that the prescription could last if taken as directed so long-term stays on the screen, and doesn´t leave the list at the end of the duration short-term is dropped off the screen > if a duration is specified and is understood to mean "as intended or > post-hoc actual", should a specified duration be construed to mean > short-term, or maybe still the medication could be intended as long- > term with the duration used to pre-specify a plan of reassessment? > our systems just drop the short-term stuff the concept of the end of the time prompting a review is handled in our system by a separate review / recall listing _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Fri, Oct 30, 2009 at 07:33:00AM +1100, edodd@... wrote:
> even long-term has a duration Only if mixed with administrative concerns: > this is the time that the prescription could last if taken as directed What we are working on for the time being is a medication list that is (as yet) unencumbered by such practicalities :-) In that sense, long-term is to mean "expected to be needed for a long and rather indefininite time". > so long-term stays on the screen, and doesn´t leave the list at the end of > the duration > short-term is dropped off the screen Automatically ? I would rather wish in my list it somehow get marked as "finished" prompting (conceptually, not yet technically) my review. This is what Jim suggested IMO (by grouping drugs). > > if a duration is specified and is understood to mean "as intended or > > post-hoc actual", should a specified duration be construed to mean > > short-term, or maybe still the medication could be intended as long- > > term with the duration used to pre-specify a plan of reassessment? > > our systems just drop the short-term stuff I see. While it seems convenient to me I also feel it has some risk associated with it such as when a long-term drug was accidentally marked as short-term with a duration of 2 weeks. Patient comes back in 3 months, feeling just as well with or without the drug (the crux of non-symptomatic hypertension), and the drug being forgotten. Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Jim Busser
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On 2009-10-30, at 4:46 AM, Karsten Hilbert wrote: > While it seems convenient to me I also feel it has > some risk associated with it such as when a long-term drug > was accidentally marked as short-term with a duration of 2 > weeks. Patient comes back in 3 months, feeling just as well > with or without the drug (the crux of non-symptomatic > hypertension), and the drug being forgotten. So by default items should neither be short-term not long-term, but null. _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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Re: proper English term needed for medication
by Karsten Hilbert
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On Fri, Oct 30, 2009 at 09:17:01AM -0700, Jim Busser wrote:
> Subject: Re: [Gnumed-devel] proper English term needed for medication > X-Mailer: Apple Mail (2.1076) > > > On 2009-10-30, at 4:46 AM, Karsten Hilbert wrote: > > >While it seems convenient to me I also feel it has > >some risk associated with it such as when a long-term drug > >was accidentally marked as short-term with a duration of 2 > >weeks. Patient comes back in 3 months, feeling just as well > >with or without the drug (the crux of non-symptomatic > >hypertension), and the drug being forgotten. > > So by default items should neither be short-term not long-term, but > null. Yes, that's the way it is. Karsten -- GPG key ID E4071346 @ wwwkeys.pgp.net E167 67FD A291 2BEA 73BD 4537 78B9 A9F9 E407 1346 _______________________________________________ Gnumed-devel mailing list Gnumed-devel@... http://lists.gnu.org/mailman/listinfo/gnumed-devel |
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