TEMPLATE *CL 7.4 Adverse Reaction List (*CL 7.4 Adverse Reaction List)

TEMPLATE ID*CL 7.4 Adverse Reaction List
Concept*CL 7.4 Adverse Reaction List
DescriptionNot Specified
PurposeNot Specified
References
Other Details (Language Independent)
  • MetaDataSet:Sample Set : Template metadata sample set
Language useden
Citeable Identifier1013.26.806
Root archetype idopenEHR-EHR-COMPOSITION.adverse_reaction_list.v1
Adverse reaction listAdverse reaction list: A persistent and managed list of adverse reactions experienced by the subject that may influence clinical decision-making and care provision.
Adverse reaction riskAdverse reaction risk: Risk of harmful or undesirable physiological response which is unique to an individual and associated with exposure to a substance.
Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.
Optional[{source=openEHR,FHIR}]
Data
SubstanceSubstance: Identification of a substance, or substance class, that is considered to put the individual at risk of an adverse reaction event.
Both an individual substance and a substance class are valid entries in 'Substance'. If the value in 'Substance' is an individual substance, it may be duplicated in 'Specific substance'. It is strongly recommended that both 'Substance' and 'Specific substance' be coded with a terminology capable of triggering decision support, where possible. For example: Snomed CT, DM+D, RxNorm, NDFRT, ATC, New Zealand Universal List of Medicines and Australian Medicines Terminology. Free text entry should only be used if there is no appropriate terminology available.
Optional[{source=openEHR,FHIR,DAM}]
StatusStatus: Assertion about the certainty of the propensity, or potential future risk, of the identified 'Substance' to cause a reaction.
Decision support would typically raise alerts for 'Suspected', 'Likely', 'Confirmed', and ignore a 'Refuted' reaction. Clinical systems may choose not to display Adverse reaction entries with a 'Refuted' status in the Adverse Reaction List. However, 'Refuted' may be useful for reconciliation of the adverse reaction list or when communicating between systems . Some implementations may choose to make this field mandatory. 'Resolved' may be used variably across systems, depending on clinical use and context - there appears to be differing opinion whether this should still be used to raise potential alerts or to display in an Adverse Reaction List. The free text data type will allow for local variation by enabling other value sets to be applied to this data element in a template - in this situation it is recommended that values should be coded using a terminology.
Optional[{source=FHIR, DAM}]
  • Suspected 
  • Likely 
  • Confirmed 
  • Resolved 
  • Refuted 
Onset of last reactionOnset of last reaction: The date and/or time of the onset of the last known occurrence of a reaction event.
This date may be be a duplicate of the most recent 'Onset of reaction' date. Where a textual representation of the date of last occurrence is required e.g 'In Childhood, '10 years ago' the Comment element should be used.
Optional[{source=IMH}]
CommentComment: Additional narrative about the propensity for the adverse reaction, not captured in other fields.
For example: including reason for flagging a 'Criticality' of 'High risk'; and instructions related to future exposure or administration of the Substance, such as administration within an Intensive Care Unit or under corticosteroid cover.
Optional[{source=openEHR}]
Reaction eventReaction event: Details about each adverse reaction event linked to exposure to the identified 'Substance'.
Optional[{source=openEHR,FHIR,DAM}]
ManifestationManifestation: Clinical symptoms and/or signs that are observed or associated with the adverse reaction.
Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash. 'No reaction'may be appropriate where a previous reaction has been noted but the reaction did not re-occur after further exposure. It is preferable that 'Manifestation' should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED-CT or ICD10.
Optional[{source=FHIR, openEHR,DAM}]
Protocol
Last updatedLast updated: Date when the propensity or the reaction event was updated.
Note: maps to recordedDate in FHIR.
Optional[{source=openEHR, FHIR, DAM}]
Supporting clinical record informationSupporting clinical record information: Link to further information about the presentation and findings that exist elsewhere in the health record, including allergy test reports.
For example, presenting symptoms, examination findings, diagnosis etc. [Note: FHIR,DAM: Maps to Sensitivity Test.]
Optional[{source=FHIR, openEHR, DAM}]
Reaction reported?Reaction reported?: Has the adverse reaction ever been reported to a regulatory body?
Optional[{source=openEHR}]
Report summaryReport summary: Structured details about reports that have been forwarded to regulatory bodies.
Date of reportDate of report: Date that the report was sent to the regulatory authority.
Report commentReport comment: Narrative about the adverse reaction report or reporting process.
For example, the reason for non-reporting.
Optional[{source=openEHR}]
Adverse reaction reportAdverse reaction report: Link to an adverse reaction Report sent to a regulatory body.
Optional[{source=openEHR}]
Exclusion of an Adverse ReactionExclusion of an Adverse Reaction: Positive statement/s about adverse reactions that need to be recorded as clinically excluded from the health record at a specific point in time.
Data
Exclusion StatementExclusion Statement: A statement about exclusion of known adverse reactions in the health record.
For example: "No known adverse reactions"; "No known adverse reaction to" (penicillin).
  • No known history of adverse reaction or allergy
Protocol
Date Last UpdatedDate Last Updated: The date at which the exclusion was last clinically asserted, affirmed or confirmed.
Absence of InformationAbsence of Information: Statement that specified health information is not available for inclusion in the health record or extract at the time of recording.
Data
Absence statementAbsence statement: Positive statement that no information is available.
For example: "No information available about adverse reactions"; No information available about problems or diagnoses"; "No information available about previous procedures performed"; or "No information available about medications used".
  • No information available about previous adverse reaction or allergy
Protocol
Last updatedLast updated: The date at which the absence was last updated.