How to populate drug_exposure from drug administration data when there are multiple actions (like drug given, on hold, rate changed, stopped etc)

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How to populate drug_exposure from drug administration data when there are multiple actions (like drug given, on hold, rate changed, stopped etc)

CDM or THEMIS convention?

Themis

Table or Field level?

Table

Is this a general convention?

No

Summary of issues

• In EHR data for drug administration data, there are often multiple actions (like drug given, on hold, rate changed, stopped etc) recorded for the same drug administered to the patient.
• As the CDM does not capture these kind of "statuses" one may have questions whether these actions should be filtered in some way or at all.

Summary of answer

• The OMOP CDM is only interested in events that happen to the patient (i.e include actions that suggest the drug was administered to the patient)
• If a patient missed or refused a dose of medication, then you don’t create a record in the CDM.
• When the rate changes, you end the first record and start the 2nd record with then new quantity of medication a person receives.
• Administrations should use the appropriate from the drug_type_concept_id [Accepted Concepts(https://athena.ohdsi.org/search-terms/terms?domain=Type+Concept&standardConcept=Standard&page=1&pageSize=15&query=)

Related links

• Forum Post
• Forum Post

[clairblacketer]

Issue # and location

• Themis issue #108

Issue summary

In EHR data for drug administration data, there are often multiple actions (like drug given, on hold, rate changed, stopped etc) recorded for the same drug administered to the patient. The CDM does not record a status on drug records, so how should these actions be modeled?

Convention type

Table

CDM table

drug_exposure

CDM field

NA

Links to issue discussion

Links to location of discussion on forums, CDM GitHub, Themis GitHub, etc.

Format as follows:

• OHDSI Forums discussion
• OHDSI Forums discussion

Provenance of data

EHR

The ratified convention

• The OMOP CDM is only interested in events that happen to the patient (i.e include actions that suggest the drug was administered to the patient). If a patient missed or refused a dose of medication, then a record should not be created in the CDM.
• When the rate changes, you end the first record and start the 2nd record with then new quantity of medication a person receives.
• Administrations should use the appropriate drug_type_concept_id [Accepted Concepts(https://athena.ohdsi.org/search-terms/terms?domain=Type+Concept&standardConcept=Standard&page=1&pageSize=15&query=)

Date of ratification/published

NA

Downstream implications

No

Link to DQD check

No

Related conventions/further information

#Tags drug_exposure, medication_administration

[MelaniePhilofsky]

Edited a typo.