Detectedissue-example.xml

Drug-drug interaction between prescription and medication statement (id = "ddi")

<DetectedIssue xmlns="http://hl7.org/fhir">
  <id value="ddi"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p><b>Severity: High</b> - Risk of internal bleeding</p>
      <p>Those who take acetaminophen along with the widely used blood-thinning drug warfarin may
         face the risk of serious internal bleeding. People on warfarin who take acetaminophen
         for at least seven days in a row should be closely watched for bleeding.</p>
      <ul>
        <li><a href="MedicationStatement/tylenol">500 mg Acetaminophen tablet 1/day, PRN since 2010</a></li>
        <li><a href="MedicationOrder/warfarin">Warfarin 1 MG TAB prescribed Jan. 5, 2014</a></li>
      </ul>
      <p>Mitigation: Jan 5, 2014 by Dr. Adam Careful: </p>
      <p>Asked patient to discontinue regular use of Tylenol and to consult with clinician if they
         need to resume to allow appropriate INR monitoring</p>
    </div>
  </text>
  <category>
    <coding>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="DRG"/>
      <display value="Drug Interaction Alert"/>
    </coding>
  </category>
  <severity value="high"/>
  <implicated>
    <reference value="MedicationStatement/tylenol"/>
    <display value="500 mg Acetaminophen tablet 1/day, PRN since 2010"/>
  </implicated>
  <implicated>
    <reference value="MedicationOrder/warfarin"/>
    <display value="Warfarin 1 MG TAB prescribed Jan. 5, 2014"/>
  </implicated>
  <detail value="Risk of internal bleeding.  Those who take acetaminophen along with the widely used blood-thinning
   drug warfarin may face the risk of serious internal bleeding. People on warfarin who take
   acetaminophen for at least seven days in a row should be closely watched for bleeding."/>
  <date value="2014-01-05"/>
  <author>
    <reference value="Device/dsp"/>
  </author>
  <mitigation>
    <action>
      <coding>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="13"/>
        <display value="Stopped Concurrent Therapy"/>
      </coding>
      <text value="Asked patient to discontinue regular use of Tylenol and to consult with clinician if they
       need to resume to allow appropriate INR monitoring"/>
    </action>
    <date value="2014-01-05"/>
    <author>
      <reference value="Practitioner/example"/>
      <display value="Dr. Adam Careful"/>
    </author>
  </mitigation>
</DetectedIssue>