Release 5 Preview #2

This page is part of the FHIR Specification (v4.4.0: R5 Preview #2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

11.10.0 Dosage

Pharmacy

Work Group

Maturity Level: 3

Standards Status: Trial Use

The Dosage structure defines general dosage instruction information typically represented in medication requests, medication dispenses and medication statements.

Note: the Dosage structure allows modifier extensions.

Structure

Name	Flags	Card.	Type	Description & Constraints
Dosage	Σ TU		Element	How the medication is/was taken or should be taken Elements defined in Ancestors: id, extension, modifierExtension
sequence	Σ	0..1	integer	The order of the dosage instructions
text	Σ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" SNOMED CT Additional Dosage Instructions (Example)
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	Σ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) SNOMED CT Medication As Needed Reason Codes (Example)
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to SNOMED CT Anatomical Structure for Administration Site Codes (Example)
route	Σ	0..1	CodeableConcept	How drug should enter body SNOMED CT Route Codes (Example)
method	Σ	0..1	CodeableConcept	Technique for administering medication SNOMED CT Administration Method Codes (Example)
doseAndRate	Σ	0..*	Element	Amount of medication administered
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified DoseAndRateType (Example)
dose[x]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			SimpleQuantity
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			SimpleQuantity
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
Documentation for this format

UML Diagram (Legend)

XML Template

<Dosage xmlns="http://hl7.org/fhir">
 <!-- from Element: extension -->
 <sequence value="[integer]"/><!-- 0..1 The order of the dosage instructions -->
 <text value="[string]"/><!-- 0..1 Free text dosage instructions e.g. SIG -->
 <additionalInstruction><!-- 0..* CodeableConcept Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" --></additionalInstruction>
 <patientInstruction value="[string]"/><!-- 0..1 Patient or consumer oriented instructions -->
 <timing><!-- 0..1 Timing When medication should be administered --></timing>
 <asNeeded[x]><!-- 0..1 boolean|CodeableConcept Take "as needed" (for x) --></asNeeded[x]>
 <site><!-- 0..1 CodeableConcept Body site to administer to --></site>
 <route><!-- 0..1 CodeableConcept How drug should enter body --></route>
 <method><!-- 0..1 CodeableConcept Technique for administering medication --></method>
 <doseAndRate>  <!-- 0..* Amount of medication administered -->
  <type><!-- 0..1 CodeableConcept The kind of dose or rate specified --></type>
  <dose[x]><!-- 0..1 Range|Quantity(SimpleQuantity) Amount of medication per dose --></dose[x]>
  <rate[x]><!-- 0..1 Ratio|Range|Quantity(SimpleQuantity) Amount of medication per unit of time --></rate[x]>
 </doseAndRate>
 <maxDosePerPeriod><!-- 0..1 Ratio Upper limit on medication per unit of time --></maxDosePerPeriod>
 <maxDosePerAdministration><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per administration --></maxDosePerAdministration>
 <maxDosePerLifetime><!-- 0..1 Quantity(SimpleQuantity) Upper limit on medication per lifetime of the patient --></maxDosePerLifetime>
</Dosage>

JSON Template

{
  // from Element: extension
  "sequence" : <integer>, // The order of the dosage instructions
  "text" : "<string>", // Free text dosage instructions e.g. SIG
  "additionalInstruction" : [{ CodeableConcept }], // Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  "patientInstruction" : "<string>", // Patient or consumer oriented instructions
  "timing" : { Timing }, // When medication should be administered
  // asNeeded[x]: Take "as needed" (for x). One of these 2:
  "asNeededBoolean" : <boolean>,
  "asNeededCodeableConcept" : { CodeableConcept },
  "site" : { CodeableConcept }, // Body site to administer to
  "route" : { CodeableConcept }, // How drug should enter body
  "method" : { CodeableConcept }, // Technique for administering medication
  "doseAndRate" : [{ // Amount of medication administered
    "type" : { CodeableConcept }, // The kind of dose or rate specified
    // dose[x]: Amount of medication per dose. One of these 2:
    "doseRange" : { Range },
    "doseQuantity" : { Quantity(SimpleQuantity) },
    // rate[x]: Amount of medication per unit of time. One of these 3:
    "rateRatio" : { Ratio }
    "rateRange" : { Range }
    "rateQuantity" : { Quantity(SimpleQuantity) }
  }],
  "maxDosePerPeriod" : { Ratio }, // Upper limit on medication per unit of time
  "maxDosePerAdministration" : { Quantity(SimpleQuantity) }, // Upper limit on medication per administration
  "maxDosePerLifetime" : { Quantity(SimpleQuantity) } // Upper limit on medication per lifetime of the patient
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .

[
 # from Element: Element.extension
  fhir:Dosage.sequence [ integer ]; # 0..1 The order of the dosage instructions
  fhir:Dosage.text [ string ]; # 0..1 Free text dosage instructions e.g. SIG
  fhir:Dosage.additionalInstruction [ CodeableConcept ], ... ; # 0..* Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness"
  fhir:Dosage.patientInstruction [ string ]; # 0..1 Patient or consumer oriented instructions
  fhir:Dosage.timing [ Timing ]; # 0..1 When medication should be administered
  # Dosage.asNeeded[x] : 0..1 Take "as needed" (for x). One of these 2
    fhir:Dosage.asNeededBoolean [ boolean ]
    fhir:Dosage.asNeededCodeableConcept [ CodeableConcept ]
  fhir:Dosage.site [ CodeableConcept ]; # 0..1 Body site to administer to
  fhir:Dosage.route [ CodeableConcept ]; # 0..1 How drug should enter body
  fhir:Dosage.method [ CodeableConcept ]; # 0..1 Technique for administering medication
  fhir:Dosage.doseAndRate [ # 0..* Amount of medication administered
    fhir:Dosage.doseAndRate.type [ CodeableConcept ]; # 0..1 The kind of dose or rate specified
    # Dosage.doseAndRate.dose[x] : 0..1 Amount of medication per dose. One of these 2
      fhir:Dosage.doseAndRate.doseRange [ Range ]
      fhir:Dosage.doseAndRate.doseSimpleQuantity [ Quantity(SimpleQuantity) ]
    # Dosage.doseAndRate.rate[x] : 0..1 Amount of medication per unit of time. One of these 3
      fhir:Dosage.doseAndRate.rateRatio [ Ratio ]
      fhir:Dosage.doseAndRate.rateRange [ Range ]
      fhir:Dosage.doseAndRate.rateSimpleQuantity [ Quantity(SimpleQuantity) ]
  ], ...;
  fhir:Dosage.maxDosePerPeriod [ Ratio ]; # 0..1 Upper limit on medication per unit of time
  fhir:Dosage.maxDosePerAdministration [ Quantity(SimpleQuantity) ]; # 0..1 Upper limit on medication per administration
  fhir:Dosage.maxDosePerLifetime [ Quantity(SimpleQuantity) ]; # 0..1 Upper limit on medication per lifetime of the patient
]

Changes since Release 3

Dosage

Dosage.doseAndRate.dose[x]

Add Type Quantity()
Remove Type Quantity()

Dosage.doseAndRate.rate[x]

Add Type Quantity()
Remove Type Quantity()

See the Full Difference for further information