Info about medications

[aboccali]

Hi everyone,

I have a question about how medications work in Synthea. While studying various state machines, I noticed that it’s possible to prescribe a medication to a patient, but I don’t quite understand whether that prescription actually affects any clinical markers of the condition.

For example, in the Alzheimer’s module I don’t see any parameters (such as MMSE) that are directly modified as a result of the prescription. On the other hand, when looking at the hypertension module, I noticed that SBP and DBP values are high before the first prescription and then normalize afterwards.

So I’d like to ask: how or what mechanism manages the effect of a medication on biomarkers? Is the logic different depending on the disease module? And is the medication effect modeled within the disease’s own state machine, in the medication submodules, or elsewhere?

Thanks in advance!

[jawalonoski]

All the medications in the modules act as placebos, unless some logic is created, somewhere, that makes the medication impact something.

A module could explicitly branch flow on active medications, to record different levels of lab results or progression of disease. Or a module could be assuming compliance and adherence when it determines progression (or vice versa).

Some vital signs or lab values are written explicitly in the modules, and some values are generated from the biometrics file.

Some vital signs, for example blood pressure, are determined with code depending on active medications. See BloodPressureValueGenerator.java.

In the case of Alzheimer's and MMSE, since you mentioned it, the way the modules are written, none of the medications reverse the disease or improve scores in any way. They effectively are on the patient record, but do not meaningfully impact the projected outcomes. Again, the way the module is written.

[aboccali]

Okay, perfect!

Thank you!!!

Alberto