Maximum lifetime dose of a particular drug or class of drugs

Tags: #<Tag:0x00007f0f1c189d18> #<Tag:0x00007f0f1c189bd8> #<Tag:0x00007f0f1c189a98>

Hi Order Entry design folks.

For Chemotherapy Ordering, we have a requirement to be able to alert users when a particular drug (or class of drugs) may have a lifetime maximum dosage, and to otherwise be able to utilize this for better decision support and patient safety.

I’m interested in opinions on where this might best be represented in the data model. Some possible ideas:

  • On DrugIngredient.maximumLifetimeDose/maximumLifetimeDoseUnits (not sure if DrugIngredient is used at all currently)

  • Drug.Concept represents ingredient; Optionally this Concept is in a ConceptSet representing the Class of Drug; This Concept or ConceptSet has ConceptAttributes storing maximumLifetimeDose and maximumLifetimeDoseUnits

Thoughts on these or other recommended approaches for where this might fit into the data model? (@dearmasm, @rdahlman3, @darius, @burke FYI)

Thanks, Mike

1 Like

@akanter FYI

I would point out that typically this is something that would be associated with the drug concept/ingredient and not the drug formulation. Lifetime dose as opposed to maximum daily dose. Since the latter IS related to the particular strength/formulation. I hesitate to add something like this to the drug table as it only applies to a minority of drugs. I do think we need something like a concept-attribute table which would handle a diverse set of different values attached to concepts.

Thanks @akanter. Agreed. We do have ConceptAttribute associated with Concept now. It was added in a relatively recent version. Perhaps this is the best place to store it. We can then either associate this Concept directly with a Drug or with a DrugIngredient if that table becomes used.