How to express that a medication has continuous use?

1

Hello,

I need to represent in a MedicationRequest that a medication has continuous use, like an antihypertensive. I’m in doubt of how to represent it because the Dosage resource doesn’t seem to have an explicit attribute to it.
Which would be the best way to represent this information?

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2

In FHIR R4, the MedicationRequest.courseOfTherapyType is intended to convey “The description of the overall pattern of the administration of the medication to the patient”. Exemplar values in the value set includes “continuous”.

If you are using a previous versions, then you would need an extension.

Within dosage, a dosage line without an end date conveys continuous use, but the courseOfTherapyType attribute is more explicit.

3

Thanks! I overlooked that.

I tought that this information would be in the Dosage resource because for example, in the scenario of an asma medication, that have to be taken just in crisis scenario, the attribute Dosage.asNeeded (of type boolean) would be set there with value “true”.

So if I understand correctly I should also set MedicationRequest.courseOfTherapyType with “continuous” right?

4

Hello again, I forgot to ask how to represent this information in the MedicationStatement. I was planning to use MedicationStatement.effectivePeriod to that, leaving “end” blank, but I don’t have the information of “start” either (countinuous use in my frontend is just a checkbox).

5

AsNeeded isn’t intended to be used for a continuous dose. If you set asNeeded to “true”, it means the patient is only taking the medication when they needed it for some type of symptom (like pain) or condition.

6

That is the correct way to convey this in MedicationStatement.

7

Further comment on the use of dosage. You could use an open-ended boundsPeriod in dosage.timing, but you would have to do this for each dosage line (if there are multiple dosage lines).

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