MedicationRequest Resource: Difference between Initial fill quantity/duration and other duration/quantity?

Hi there,

Hoping to understand the difference between the following fields and related use-cases:

MedicationRequest.dispenseRequest.initialFill.quantity
MedicationRequest.dispenseRequest.initialFill.duration

MedicationRequest.dispenseRequest.quantity
MedicationRequest.dispenseRequest.expectedSupplyDuration

^Presumably the fields above account for a difference between the initial fill/first fill and repeats?
If both are not needed (ie quantity for initial and repeats is the same), presumably you can use the second set of elements? OR will both repeats populate the second set of elements even if the values are not different?

Typically you’d only specify the quantity or the duration, not both. The two elements give you a choice of saying “Dispense 60 tablets” or “Dispense 30 days supply” - as ordering can happen either way.

Thanks Lloyd. That makes sense.

But there are still 2 fields for quantity ie initial fill.quantity and quantity

And 2 fields for duration

Initialfill.duration and supplyduration

And I’m not sure if all are required if you have more than one fill? As in the first quantity will populate the initialfill.quantity and the subsequent fill/s would populate the quantity field (what I don’t understand is they tend to be the same value)

Or can you just use the quantity field for the initial and subsequent fills?

Sometimes certain drugs aren’t well tolerated or effective, so the prescriber might indicate an initial shorter fill quantity/period to evaluate how well the medication is working and then larger amounts for subsequent regular fills.

E.g. “first fill 30 tablets, then 90 tablets, 3 refills”

Thanks again, Lloyd.

If there us no difference between the initial fill and refill quantity, would would just use MedicationRequest.dispenseRequest.quantity? for recording that data

OR do you always use for the first fill:

MedicationRequest.dispenseRequest.initialFill.quantity

You’d only use initialFill if the first fill is expected to be different. Feel free to submit a change request if you think additional clarification is needed on this element.