Drug Quantity for Solid and Liquid Preparations

[clairblacketer]

Drug Quantity

• Requester: Christian Reich, Klaus Bonadt
• Discussion: No forum posts

---

Proposal

Relevant table: DRUG_EXPOSURE

• We propose to abolish the effective_drug_dose field from the DRUG_EXPOSURE table entirely. The content can be handled by the quantity table.

DRUG_EXPOSURE

Field	Required	Type	Description
drug_exposure_id	Yes	integer	A system-generated unique identifier for each Drug utilization event.
person_id	Yes	integer	A foreign key identifier to the person who is subjected to the Drug. The demographic details of that person are stored in the person table.
drug_concept_id	Yes	integer	A foreign key that refers to a Standard Concept identifier in the Standardized Vocabularies for the Drug concept.
drug_exposure_start_date	Yes	date	The start date for the current instance of Drug utilization. Valid entries include a start date of a prescription, the date a prescription was filled, or the date on which a Drug administration procedure was recorded.
drug_exposure_start_datetime	No	datetime	The start date and time for the current instance of Drug utilization. Valid entries include a start date of a prescription, the date a prescription was filled, or the date on which a Drug administration procedure was recorded.
drug_exposure_end_date	No	date	The end date for the current instance of Drug utilization. It is not available from all sources.
drug_exposure_end_datetime	No	datetime	The end date and time for the current instance of Drug utilization. It is not available from all sources.
drug_type_concept_id	Yes	integer	A foreign key to the predefined Concept identifier in the Standardized Vocabularies reflecting the type of Drug Exposure recorded. It indicates how the Drug Exposure was represented in the source data.
stop_reason	No	varchar(20)	The reason the Drug was stopped. Reasons include regimen completed, changed, removed, etc.
refills	No	integer	The number of refills after the initial prescription. The initial prescription is not counted, values start with 0.
quantity	No	float	The quantity of drug as recorded in the original prescription or dispensing record.
days_supply	No	integer	The number of days of supply of the medication as recorded in the original prescription or dispensing record.
sig	No	clob	The directions ("signetur") on the Drug prescription as recorded in the original prescription (and printed on the container) or dispensing record.
route_concept_id	No	integer	A foreign key to a predefined concept in the Standardized Vocabularies reflecting the route of administration.
effective_drug_dose	No	float	Numerical value of Drug dose for this Drug Exposure record.
dose_unit_concept_ id	No	integer	A foreign key to a predefined concept in the Standardized Vocabularies reflecting the unit the effective_drug_dose value is expressed.
lot_number	No	varchar(50)	An identifier assigned to a particular quantity or lot of Drug product from the manufacturer.
provider_id	No	integer	A foreign key to the provider in the provider table who initiated (prescribed or administered) the Drug Exposure.
visit_occurrence_id	No	integer	A foreign key to the visit in the visit table during which the Drug Exposure was initiated.
drug_source_value	No	varchar(50)	The source code for the Drug as it appears in the source data. This code is mapped to a Standard Drug concept in the Standardized Vocabularies and the original code is, stored here for reference.
drug_source_concept_id	No	integer	A foreign key to a Drug Concept that refers to the code used in the source.
route_source_value	No	varchar(50)	The information about the route of administration as detailed in the source.
dose_unit_source_value	No	varchar(50)	The information about the dose unit as detailed in the source.

• We need to have a way to define drug_strength if we have no product information, but only ingredients or drug forms, or if like in chemotherapies or pediatric preparations the drug strength is not defined by the product.

Currently, this information is stored as:

• drug_concept_id - contains the ingredient
• quantity or effective drug_dose - value
• nowhere or dose_unit_concept_id - unit

This works well for ingredients and uni-ingredient drug forms. We should however define a single way of doing it.

Also, we have a problem with multi-ingredient drug forms, because we only have one field.

Conventions

• All dosing information is handled through single ingredients stored in the drug_concept_id, and the dosing in quantity (for the amount) and drug_strength.amount_unit_concept_id. See approved proposals for extension of DRUG_STRENGTH and for dosing.

Use Cases

• Calculation of daily or total dose of a DRUG_EXPOSURE record.

[clairblacketer]

Proposal #72 is related to this one, however, it details removing both EFFECTIVE_DRUG_DOSE and DOSE_UNIT_CONCEPT_ID from DRUG_EXPOSURE though this proposal only removes EFFECTIVE_DRUG_DOSE. Which one is correct?

[clairblacketer]

@cgreich I am going to remove both EFFECTIVE_DRUG_DOSE and DOSE_UNIT_CONCEPT_ID as the latter describes the former.

[cgreich]

Yes, please.

[clairblacketer]

Closing this issue as it was added CDM v5.2