NAPKON Pediatrics Module
1.0.0 - trial-use

NAPKON Pediatrics Module - Local Development build (v1.0.0). See the Directory of published versions

Resource Profile: Immunosuppresive Permanent Medication

Defining URL:https://www.napkon.de/fhir/StructureDefinition/immunosuppresive-permanent-medication
Version:1.0.0
Name:ImmunosuppresivePermanentMedication
Title:Immunosuppresive Permanent Medication
Status:Active as of 2021-09-13
Definition:

Immunosuppresive Permanent Medication

Publisher:Charité - Universitätsmedizin Berlin
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

https://www.napkon.de/fhir/StructureDefinition/immunosuppresive-permanent-medication

Guidance

Parameter Case Report Form FHIR Resource Attribute
Was the patient receiving immunosuppressive therapy prior to admission? If yes, which? MedicationStatement.medicationCodeableConcept

This profile is used in conjunction with the Preadmission Medications List profile: Each instance of this profile shall be added to the Preadmission Medications List to indicate that the medications were administered prior to admission.

Response Option SNOMED CT Code NAPKON Pediatrics Code
Systemische Steroide Product containing steroid (product) -
Systemische Calcineurin-Inhibitoren Product containing calcineurin inhibitor (product) -
mTOR-Inhibitoren - #P10 "Mammalian target of rapamycin (mTOR)-Kinase inhibitor"
Sphingosin-Analoga - #P1 "Sphingosine analogue"
Antimetabolite Product containing antimetabolite (product) -
Alkylantien Product containing alkylating agent (product) -
TNF-Inhibitoren Product containing tumor necrosis factor alpha inhibitor (product) -
IL-1-Inhibitoren Product containing interleukin 1 receptor antagonist (product) -
IL-2-Inhibitoren - #P2 "Interleukin 2 receptor antagonist"
IL-6-Inhibitoren - no product code found Substance with interleukin 6 receptor antagonist mechanism of action (substance) -
IL-17-Inhibitoren - #P3 "Interleukin 17 receptor antagonist"
IL-23-Inhibitoren Product containing interleukin 23 receptor antagonist (product) -
CTLA-4-Antagonisten - no product code found Substance with cytotoxic T-lymphocyte-associated protein 4 inhibitor mechanism of action (substance) -
CD20-Antikörper - #P4 "Anti-CD20 antibody"
CD52-Antikörper - #P5 "Anti-CD52 antibody"
CD3-Antikörper - #P6 "Anti-CD3 antibody"
CD3/CD19-Antikörper - #P7 "Anti-CD3/CD19 antibody"
Anti-T-Lymphozytenglobulin Product containing equine antithymocyte immunoglobulin (medicinal product) -
Integrin-Inhibitoren - #P8 "Integrin inhibitor"
BAFF-Inhibitoren - #P9 "B cell activating factor inhibitor"
JAK-Inhibitoren Product containing Janus kinase inhibitor (product) -
Tyrosinkinase-Inhibitoren Product containing protein-tyrosine kinase inhibitor (product) -
IgE-Antikörper - no product code found Immunoglobulin E (substance) -
Interferone Product containing interferon (product) -
Andere Medicinal product acting as immunosuppressant (product) -

This profile of a FHIR MedicationStatement is derived from the MedicationStatement profile of the Medical Informatics Initiative (MII).

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*ProfileMedicationStatementMedikationRecord of medication being taken by a patient
... id SΣ0..1stringLogical id of this artifact
... meta SΣ0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source SΣ0..1uriIdentifies where the resource comes from
.... profile SΣ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


.... tag Σ0..*CodingTags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
... Slices for modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
Slice: Unordered, Open by value:url
... identifier Σ0..*IdentifierExternal identifier
... basedOn ΣI0..*Reference(MedicationRequest | CarePlan | ServiceRequest)Fulfils plan, proposal or order
... partOf SΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... status ?!SΣ1..1codeactive | completed | entered-in-error | intended | stopped | on-hold | unknown | not-taken
Binding: Medication Status Codes (required): A coded concept indicating the current status of a MedicationStatement.

... statusReason 0..*CodeableConceptReason for current status
Binding: SNOMEDCTDrugTherapyStatusCodes (example): A coded concept indicating the reason for the status of the statement.


... category Σ0..1CodeableConceptType of medication usage
Binding: Medication usage category codes (preferred): A coded concept identifying where the medication included in the MedicationStatement is expected to be consumed or administered.

... Slices for medication[x] SΣ1..1CodeableConceptWhat medication was taken
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.

.... medication[x]:medicationCodeableConcept SΣ0..1CodeableConceptWhat medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.

..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
...... coding:sct Σ0..1CodingCode defined by a terminology system
Binding: Immunosuppressive Permanent Medications (required)
...... coding:atc Σ0..1CodingCode defined by a terminology system
Binding: Immunosuppressive Permanent Medications ATC (required)
..... text Σ0..1stringPlain text representation of the concept
... subject SΣI0..1Reference(Patient | Group)A reference from one resource to another
... context SΣI0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] SΣ1..1The date/time or interval when the medication is/was/will be taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... dateAsserted Σ0..1dateTimeWhen the statement was asserted?
... informationSource I0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization)Person or organization that provided the information about the taking of this medication
... derivedFrom I0..*Reference(Resource)Additional supporting information
... reasonCode 0..*CodeableConceptReason for why the medication is being/was taken
Binding: Condition/Problem/DiagnosisCodes (example): A coded concept identifying why the medication is being taken.


... reasonReference SI0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... note 0..*AnnotationFurther information about the statement
... dosage S0..*DosageDetails of how medication is/was taken or should be taken
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ0..1integerThe order of the dosage instructions
.... text SΣ0..1stringFree text dosage instructions e.g. SIG
.... additionalInstruction Σ0..*CodeableConceptSupplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".


.... patientInstruction Σ0..1stringPatient or consumer oriented instructions
.... timing SΣ0..1TimingWhen medication should be administered
.... asNeeded[x] Σ0..1Take "as needed" (for x)
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.

..... asNeededBooleanboolean
..... asNeededCodeableConceptCodeableConcept
.... site SΣ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
...... coding:SNOMED Σ0..*Coding​Code defined by a terminology system
Binding: Target Site - IPS (example): target site IPS



Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version0..1stringVersion of the system - if relevant
....... code0..1codeSymbol in syntax defined by the system
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
....... id 0..1stringUnique id for inter-element referencing
....... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system SΣ1..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... route SΣ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding SΣ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
...... coding:EDQM SΣ0..*Coding​Code defined by a terminology system
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standard Terms



Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://standardterms.edqm.eu
....... version0..1stringVersion of the system - if relevant
....... code0..1codeSymbol in syntax defined by the system
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
....... id 0..1stringUnique id for inter-element referencing
....... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system SΣ1..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... coding:SNOMED SΣ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... version0..1stringVersion of the system - if relevant
....... code0..1codeSymbol in syntax defined by the system
....... display0..1stringRepresentation defined by the system
....... userSelected0..1booleanIf this coding was chosen directly by the user
....... id 0..1stringUnique id for inter-element referencing
....... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system SΣ1..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code SΣ1..1codeSymbol in syntax defined by the system
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... method Σ0..1CodeableConceptTechnique for administering medication
Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.

.... doseAndRate SΣ0..*ElementAmount of medication administered
..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... type Σ0..1CodeableConceptThe kind of dose or rate specified
Binding: DoseAndRateType (example): The kind of dose or rate specified.

..... dose[x] SΣI0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] SΣI0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)
.... maxDosePerPeriod ΣI0..1RatioUpper limit on medication per unit of time
.... maxDosePerAdministration ΣI0..1SimpleQuantityUpper limit on medication per administration
.... maxDosePerLifetime ΣI0..1SimpleQuantityUpper limit on medication per lifetime of the patient

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*ProfileMedicationStatementMedikationRecord of medication being taken by a patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ0..*canonical(StructureDefinition)Profiles this resource claims to conform to
... partOf ΣI0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Observation)Part of referenced event
... Slices for medication[x] Σ1..1CodeableConceptWhat medication was taken
Slice: Unordered, Closed by type:$this
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.

.... medication[x]:medicationCodeableConcept Σ0..1CodeableConceptWhat medication was taken
Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying the substance or product being taken.

... subject ΣI0..1Reference(Patient | Group)A reference from one resource to another
... context ΣI0..1Reference(Encounter | EpisodeOfCare)Encounter / Episode associated with MedicationStatement
... effective[x] Σ1..1The date/time or interval when the medication is/was/will be taken
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... reasonReference I0..*Reference(Condition | Observation | DiagnosticReport)Condition or observation that supports why the medication is being/was taken
... dosage 0..*DosageDetails of how medication is/was taken or should be taken
.... text Σ0..1stringFree text dosage instructions e.g. SIG
.... timing Σ0..1TimingWhen medication should be administered
.... site Σ0..1CodeableConceptBody site to administer to
Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.

..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
...... coding:SNOMED Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
....... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... system Σ1..1uriIdentity of the terminology system
....... code Σ1..1codeSymbol in syntax defined by the system
.... route Σ0..1CodeableConceptHow drug should enter body
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

..... Slices for coding Σ0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
...... coding:EDQM Σ0..*Coding​Code defined by a terminology system
Binding: Medicine Route of Administration - IPS (preferred): EDQM Standard Terms



Required Pattern: At least the following
....... system1..1uriIdentity of the terminology system
Fixed Value: http://standardterms.edqm.eu
....... system Σ1..1uriIdentity of the terminology system
....... code Σ1..1codeSymbol in syntax defined by the system
...... coding:SNOMED Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
....... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
....... system Σ1..1uriIdentity of the terminology system
....... code Σ1..1codeSymbol in syntax defined by the system
.... doseAndRate Σ0..*ElementAmount of medication administered
..... dose[x] ΣI0..1Amount of medication per dose
...... doseRangeRange
...... doseQuantityQuantity(SimpleQuantity)
..... rate[x] ΣI0..1Amount of medication per unit of time
...... rateRatioRatio
...... rateRangeRange
...... rateQuantityQuantity(SimpleQuantity)

doco Documentation for this format

​This structure is derived from ProfileMedicationStatementMedikation

NameFlagsCard.TypeDescription & Constraintsdoco
.. MedicationStatement 0..*ProfileMedicationStatementMedikationRecord of medication being taken by a patient
... medicationCodeableConcept 0..1CodeableConceptWhat medication was taken
.... Slices for coding 0..*CodingCode defined by a terminology system
Slice: Unordered, Open by pattern:$this
..... coding:sct 0..1CodingCode defined by a terminology system
Binding: Immunosuppressive Permanent Medications (required)
..... coding:atc 0..1CodingCode defined by a terminology system
Binding: Immunosuppressive Permanent Medications ATC (required)

doco Documentation for this format

​This structure is derived from ProfileMedicationStatementMedikation

Summary

Slices

This structure defines the following Slices:

  • The element MedicationStatement.medicationCodeableConcept.coding is sliced based on the value of pattern:$this

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet / Code
MedicationStatement.meta.securityextensibleAll Security Labels
MedicationStatement.meta.tagexampleCommonTags
MedicationStatement.languagepreferredCommonLanguages
Max Binding: AllLanguages
MedicationStatement.statusrequiredMedication Status Codes
MedicationStatement.statusReasonexampleSNOMEDCTDrugTherapyStatusCodes
MedicationStatement.categorypreferredMedication usage category codes
MedicationStatement.medication[x]exampleSNOMEDCTMedicationCodes
MedicationStatement.medication[x]:medicationCodeableConceptexampleSNOMEDCTMedicationCodes
MedicationStatement.medication[x]:medicationCodeableConcept.coding:sctrequiredImmunosuppressivePermanentMedications
MedicationStatement.medication[x]:medicationCodeableConcept.coding:atcrequiredImmunosuppressivePermanentMedicationsATC
MedicationStatement.reasonCodeexampleCondition/Problem/DiagnosisCodes
MedicationStatement.dosage.additionalInstructionexampleSNOMEDCTAdditionalDosageInstructions
MedicationStatement.dosage.asNeeded[x]exampleSNOMEDCTMedicationAsNeededReasonCodes
MedicationStatement.dosage.siteexampleSNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationStatement.dosage.site.coding:SNOMEDexamplePattern: SNOMED CT code null
MedicationStatement.dosage.routeexampleSNOMEDCTRouteCodes
MedicationStatement.dosage.route.coding:EDQMpreferred​Pattern: null
MedicationStatement.dosage.methodexampleSNOMEDCTAdministrationMethodCodes
MedicationStatement.dosage.doseAndRate.typeexampleDoseAndRateType