ACTION.medication - evaluate effect

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We are doing some modelling for a solution to follow patients with Cystic fibrosis. They have intensive periodes of antibiotic medication treatment. A part of this is to evaluate the effect of the cure.

Based on microbiological test results the doctor will ordinate some medication. This is given at a outpatient contact. After a few weeks the effect of the medication is evaluated.

The question is: Which careflow step in the archetype should be used for such an action?

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An INSTRUCTION to evaluate the effect of medication change?
Or an EVALUATION to records the interpretation of the effect?
Or do you mean the state (ISM) of the ACTION.medication?

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Might be, but there is an existing carwflow step for medication reassessed with description

  • The individual medication has been reassessed, for example whether the medication should still be taken. This is not intended to capture review of the medication list.

This is pretty close to my use-case. The only difference is that my use-case is only to evaluate the effect, but not do any changes in the order.

The role collecting the effect is a nurse which is not formally the one to do changes in the medication.

My open question is if such a use-case is covered by the intention of ACTION.medication?

The concept description for ACTION.medication is quite open and might open for such a use.

  • Any activity related to the planning, scheduling, prescription management, dispensing, administration, cessation and other use of a medication, vaccine, nutritional product or other therapeutic item.
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In a similar situation for the Better Meds app (Pharmacist review), we used a separate review Action.

The Review step in the Meds action archetype, I would have said was for ‘simple clinical’ review we felt pharmacist review was a slightly separate process.

https://ckm.apperta.org/ckm/templates/1051.57.49

I’m not sure I like the main archetype, even though it has my name on it!!

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Perhaps there’s scope for something like a generic Intervention Response, or Response to Treatment archetype. It could be really simple - Better, Worse, No Difference, Unknown/Unable to Measure.
There might be a requirement for a time frame, over which the intervention would be expected to have an effect. This could be immediate, like the use of IV Amiodarone for SVT, or weeks in the case of chemotherapy.
Apologies if this exists already, I couldn’t see anything of that nature on CKM.

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My immediate thinking is that this requires a separate archetype, and to my knowledge it doesn’t currently exist.

To me, observing and evaluating effect is a separate activity from the more “formalised” order/administration of the INSTRUCTION and ACTION.

As Grant points out, this also needs a point or interval in time, and I think an OBSERVATION would probably be best suited for this information.

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Thanks for all the feedback. I have to revisit the problem and evaluate your suggestions. Will be back in this thread in a few days. :ok_hand:

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