What is the recommended approach for handling brand names for drugs as well as the linkage to the generic (baseline drug formulation), e.g., Paracetamol, Panadol, Panadol Extra, Hedex, Kamadol (local generic variant)
The CIEL approach is to have generic names as concepts with brand names as synonyms. These are mapped to RxNORM codes. The Drug table should have branded/strength/form combinations based on the formulary of the clinic and these are linked to there generic forms in the concept table.
Thanks @akanter is there any CIEL example that you can provide which illustrates this?
Turns out that the current CIEL implementation is a bit more complicated. The Drug entries are mapped to the precise ingredient in the concept table (for example, Oseltamivir 30 MG Oral Capsule is mapped to OSELTAMIVIR PHOSPHATE, but the brand names (Tamiflu) are mapped to the ingredient concept (Oseltamivir). The only way to go from brand name through to dose form in the drug table is to navigate RxNORM which would link the ingredient to precise ingredient. Thanks for raising this, Stephen, we’d need to add synonyms to the precise ingredients at least for those with drug table entries from the WHO essential drug list.
@akanter is it possible to have simple ones like Paracetamol followed by HIV & TB drugs to kick us off to use as examples
What is your intention to use the drug table? Are you using the WHO EDL we already provide? Most drugs and brand names are already included in CIEL, just without form specific information for the drug table. That would require some management that we have not done for everyone. PIH has included some in their dictionary. Let me know what you want to do.
@akanter We are adding dispensing to UgandaEMR so I would like to know how such is handled in CIEL so that we can follow the same approach which is why I am asking for an example to see how it is done and how we have to integrate it in our metadata
You know me I am a stickler for doing things the recommended way to ease upgrades and integrations later
Can you provide a formulary list of drugs to be included in UgandaEMR? Have you seen the drug table provided in the CIEL dropbox? I am willing to help tighten up the workflow between synonym, concept and drug table entry if you can provide the specifics.
I will look at the drug table and advise tomorrow as I get the formularly, however the list of ART regimens that we are using is in a power point at this link. https://www.dropbox.com/s/tk7q6rdql3snbxn/ART-Regimens.pptx?dl=0
PIH uses this drugs.csv file to install all drugs for our Haiti hospital. There are similar files for other countries/sites.
The interesting columns for you @ssmusoke:
- “Nom du Produit (Name of product)” which is the drug.name. Names are always generic. The uuid column the drug.uuid.
- “Concept mapping” which maps to the drug.concept_id. Some mappings are PIH, but all these concepts should be in CIEL. Hasn’t been a priority for us to update. Always a generic.
One of the annoyances is that the drug.name doesn’t have a mechanism to handle locale, but fortunately you don’t have this problem in Uganda. Our Mexico drug list is in Spanish.
Thanks @ball for sharing, this helps to drive our understanding and potential approaches.
We do not have a language problem “yet”