This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
STU
3).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
Continuous
Integration
Build
of
available
versions,
see
FHIR
(will
be
incorrect/inconsistent
at
times).
See
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
R3
Responsible
Owner:
Pharmacy
Work
Group
|
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| Dosage | |||||||||
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| Dosage | ||||||||
| Definition |
Indicates how the medication is/was taken or should be taken by the patient. |
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| Short Display | How the medication is/was taken or should be taken | ||||||||
| Cardinality | 0..* | ||||||||
|
| BackboneType | ||||||||
| Summary | true | ||||||||
| Constraints |
|
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| Dosage.sequence | |||||||||
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| Dosage.sequence | ||||||||
| Definition |
Indicates the order in which the dosage instructions should be applied or interpreted. |
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| Short Display | The order of the dosage instructions | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | integer | ||||||||
| Requirements |
If the sequence number of multiple Dosages is the same, then it is implied that the instructions are to be treated as concurrent. If the sequence number is different, then the Dosages are intended to be sequential. |
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| Summary | true | ||||||||
| Dosage.text | |||||||||
|
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Dosage.text | ||||||||
| Definition |
Free text dosage instructions e.g. SIG. |
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| Short Display | Free text dosage instructions e.g. SIG | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | string | ||||||||
| Requirements |
Free text dosage instructions can be used for cases where the instructions are too complex to code. The content of this attribute does not include the name or description of the medication. When coded instructions are present, the free text instructions may still be present for display to humans taking or administering the medication. It is expected that the text instructions will always be populated. If the dosage.timing attribute is also populated, then the dosage.text should reflect the same information as the timing. Additional information about administration or preparation of the medication should be included as text. |
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| Summary | true | ||||||||
| Dosage.additionalInstruction | |||||||||
|
| Dosage.additionalInstruction | ||||||||
| Definition |
Supplemental instructions to the patient on how to take the medication (e.g. "with meals" or"take half to one hour before food") or warnings for the patient about the medication (e.g. "may cause drowsiness" or "avoid exposure of skin to direct sunlight or sunlamps"). | ||||||||
| Short Display |
Supplemental
instruction
or
warnings
to
the
patient
-
e.g.
|
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|
|
0..* | ||||||||
| Terminology Binding | SNOMED CT Additional Dosage Instructions ( Example ) | ||||||||
| Type | CodeableConcept | ||||||||
| Requirements |
Additional
instruction
|
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| Summary | true | ||||||||
| Comments | Information about administration or preparation of the medication (e.g. "infuse as rapidly as possibly via intraperitoneal port" or take "immediately following drug x") should be populated in dosage.text. | ||||||||
| Dosage.patientInstruction | |||||||||
|
| Dosage.patientInstruction | ||||||||
| Definition |
Instructions in terms that are understood by the patient or consumer. |
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| Short Display | Patient or consumer oriented instructions | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | string | ||||||||
| Summary | true | ||||||||
| Dosage.timing | |||||||||
|
| Dosage.timing | ||||||||
| Definition |
When medication should be administered. |
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| Short Display | When medication should be administered | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | Timing | ||||||||
| Requirements |
The
timing
schedule
for
giving
the
medication
to
the
patient.
|
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| Summary | true | ||||||||
| Comments |
This
attribute
|
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|
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| Dosage.asNeeded | ||||||||
| Definition |
Indicates
whether
the
Medication
is
only
taken
when
needed
within
a
specific
dosing
schedule
(Boolean
| ||||||||
| Short Display | Take "as needed" | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | boolean | ||||||||
| Summary | true | ||||||||
| Comments | Can express "as needed" without a reason by setting the Boolean = True. In this case the CodeableConcept is not populated. | ||||||||
| Constraints |
| ||||||||
| Dosage.asNeededFor | |||||||||
| Element Id | Dosage.asNeededFor | ||||||||
| Definition | Indicates whether the Medication is only taken based on a precondition for taking the Medication (CodeableConcept). |
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| Short Display | Take "as needed" (for x) | ||||||||
| Cardinality |
|
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| Terminology Binding | SNOMED CT Medication As Needed Reason Codes ( Example ) | ||||||||
| Type |
|
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|
|
true | ||||||||
| Comments |
Can
express
|
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| Constraints |
| ||||||||
| Dosage.site | |||||||||
|
| Dosage.site | ||||||||
| Definition |
Body site to administer to. |
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| Short Display | Body site to administer to | ||||||||
| Cardinality | 0..1 | ||||||||
| Terminology Binding | SNOMED CT Anatomical Structure for Administration Site Codes ( Example ) | ||||||||
| Type | CodeableConcept | ||||||||
| Requirements |
A coded specification of the anatomic site where the medication first enters the body. |
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| Summary | true | ||||||||
| Comments |
If
the
use
case
requires
attributes
from
the
BodySite
resource
(e.g.
to
identify
and
track
separately)
then
use
the
standard
extension
|
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| Dosage.route | |||||||||
|
|
Dosage.route | ||||||||
| Definition |
How drug should enter body. |
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| Short Display | How drug should enter body | ||||||||
| Cardinality | 0..1 | ||||||||
| Terminology Binding | SNOMED CT Route Codes ( Example ) | ||||||||
| Type | CodeableConcept | ||||||||
| Requirements |
A code specifying the route or physiological path of administration of a therapeutic agent into or onto a patient's body. |
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| Summary | true | ||||||||
| Dosage.method | |||||||||
|
|
Dosage.method | ||||||||
| Definition |
Technique for administering medication. |
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| Short Display | Technique for administering medication | ||||||||
| Cardinality | 0..1 | ||||||||
| Terminology Binding | SNOMED CT Administration Method Codes ( Example ) | ||||||||
| Type | CodeableConcept | ||||||||
| Requirements |
A coded value indicating the method by which the medication is introduced into or onto the body. Most commonly used for injections. For examples, Slow Push; Deep IV. |
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| Summary | true | ||||||||
| Comments |
Terminologies used often pre-coordinate this term with the route and or form of administration. |
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|
|
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| Element Id | Dosage.doseAndRate | ||||||||
| Definition |
Depending on the resource,this is the amount of medication administered, to be administered or typical amount to be administered. | ||||||||
| Short Display | Amount of medication administered, to be administered or typical amount to be administered | ||||||||
| Cardinality | 0..* | ||||||||
| Summary | true | ||||||||
| Dosage.doseAndRate.type | |||||||||
| Element Id | Dosage.doseAndRate.type | ||||||||
| Definition | The kind of dose or rate specified, for example, ordered or calculated. | ||||||||
| Short Display | The kind of dose or rate specified | ||||||||
| Cardinality | 0..1 | ||||||||
| Terminology Binding |
DoseAndRateType
(
Example
)
| ||||||||
| Type | CodeableConcept | ||||||||
| Requirements | If the type is not populated, assume to be "ordered". | ||||||||
| Summary | true | ||||||||
| Dosage.doseAndRate.dose[x] | |||||||||
| Element Id | Dosage.doseAndRate.dose[x] | ||||||||
| Definition |
Amount of medication per dose. |
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| Short Display | Amount of medication per dose | ||||||||
|
|
0..1 | ||||||||
| Type | Range | SimpleQuantity | ||||||||
| [x] Note |
See
Choice
of
|
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| Requirements |
The amount of therapeutic or other substance given at one administration event. |
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| Summary | true | ||||||||
| Comments |
Note that this specifies the quantity of the specified medication, not the quantity for each active ingredient(s). Each ingredient amount can be communicated in the Medication resource. For example, if one wants to communicate that a tablet was 375 mg, where the dose was one tablet, you can use the Medication resource to document that the tablet was comprised of 375 mg of drug XYZ. Alternatively if the dose was 375 mg, then you may only need to use the Medication resource to indicate this was a tablet. If the example were an IV such as dopamine and you wanted to communicate that 400mg of dopamine was mixed in 500 ml of some IV solution, then this would all be communicated in the Medication resource. If the administration is not intended to be instantaneous (rate is present or timing has a duration), this can be specified to convey the total amount to be administered over the period of time as indicated by the schedule e.g. 500 ml in dose, with timing used to convey that this should be done over 4 hours. |
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| Dosage.doseAndRate.rate[x] | |||||||||
| Element Id | Dosage.doseAndRate.rate[x] | ||||||||
| Definition | Amount of medication per unit of time. | ||||||||
| Short Display | Amount of medication per unit of time | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | Ratio | Range | SimpleQuantity | ||||||||
| [x] Note | See Choice of Datatypes for further information about how to use [x] | ||||||||
| Requirements | Identifies the speed with which the medication was or will be introduced into the patient. Typically the rate for an infusion e.g. 100 ml per 1 hour or 100 ml/hr. May also be expressed as a rate per unit of time e.g. 500 ml per 2 hours. Other examples: 200 mcg/min or 200 mcg/1 minute; 1 liter/8 hours. Sometimes, a rate can imply duration when expressed as total volume / duration (e.g. 500mL/2 hours implies a duration of 2 hours). However, when rate doesn't imply duration (e.g. 250mL/hour), then the timing.repeat.duration is needed to convey the infuse over time period. | ||||||||
| Summary | true | ||||||||
| Comments | It is possible to supply both a rate and a doseQuantity to provide full details about how the medication is to be administered and supplied. If the rate is intended to change over time, depending on local rules/regulations, each change should be captured as a new version of the MedicationRequest with an updated rate, or captured with a new MedicationRequest with the new rate. It is possible to specify a rate over time (for example, 100 ml/hour) using either the rateRatio and rateQuantity. The rateQuantity approach requires systems to have the capability to parse UCUM grammar where ml/hour is included rather than a specific ratio where the time is specified as the denominator. Where a rate such as 500ml over 2 hours is specified, the use of rateRatio may be more semantically correct than specifying using a rateQuantity of 250 mg/hour. | ||||||||
| Dosage.maxDosePerPeriod | |||||||||
|
| Dosage.maxDosePerPeriod | ||||||||
| Definition |
Upper limit on medication per unit of time. |
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| Short Display | Upper limit on medication per unit of time | ||||||||
|
|
|
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| Type | Ratio | ||||||||
| Requirements |
The maximum total quantity of a therapeutic substance that may be administered to a subject over the period of time. For example, 1000mg in 24 hours. |
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| Summary | true | ||||||||
| Comments |
This
is
intended
for
use
as
an
adjunct
to
the
dosage
when
there
is
an
upper
cap.
For
example
|
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| Dosage.maxDosePerAdministration | |||||||||
|
|
Dosage.maxDosePerAdministration | ||||||||
| Definition |
Upper limit on medication per administration. |
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| Short Display | Upper limit on medication per administration | ||||||||
| Cardinality | 0..1 | ||||||||
| Type | SimpleQuantity | ||||||||
| Requirements |
The maximum total quantity of a therapeutic substance that may be administered to a subject per administration. |
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| Summary | true | ||||||||
| Comments |
This is intended for use as an adjunct to the dosage when there is an upper cap. For example, a body surface area related dose with a maximum amount, such as 1.5 mg/m2 (maximum 2 mg) IV over 5 – 10 minutes would have doseQuantity of 1.5 mg/m2 and maxDosePerAdministration of 2 mg. |
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Dosage.maxDosePerLifetime
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0..1 | ||||||||
| Type |
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| Summary | true | ||||||||