A hypersensitivity describes a substance or group of substances that is monitored so that a hypersensitivity reaction can be prevented.
Purpose
A drug hypersensitivity is recorded so that prescribers, providers and administrators can take it into account when prescribing, dispensing and administering medication. It is recorded in such a way that a medication monitoring system can give a warning at the right time. Other sensitivities such as food, contact, inhalation, insect venom and occupational allergens are recorded so that healthcare providers can take them into account in a general sense.
It is important to share sensitivities with other caregivers of the patient so that they too can provide care in a safe manner. For that purpose, it is possible to record and exchange additional information so that the receiving party can appreciate the hypersensitivity. For example, by describing the method of determination, and also a description of (a) reaction(s) to the substance.
A (drug) hypersensitivity is not the same as a problem or episode. That's because a hypersensitivity is captured specifically from the context of surveillance. A (drug) hypersensitivity is therefore not recorded in the context of diagnostics or in the context of treatment of a (drug) hypersensitivity.
Evidence Base
In order to be able to register and handle hypersensitivities in the work process of prescribers and pharmacists (in pharmacovigilance), the available codings in the G-standard and SHB are used for medicines in the Netherlands. The working method is laid down in the agreement set Registration and transfer of drug hypersensitivities.
For hypersensitivity to food, articles (such as bandages and plasters), plants and animals, five reference lists based on SNOMED CT containing food allergens, inhalation allergens, insect venom allergens, occupational allergens and contact allergens are used. Free text is also possible.
Information Model
Type
Id
Concept
Card.
Definition
DefinitionCode
Reference
NL-CM:8.4.1
Hypersensitivity
Root concept of the Hypersensitivity information model. This root concept contains all data elements of the Hypersensitivity information model.
NL-CM:8.4.2
Reaction
0..*
Root concept of the Reaction information model. This root concept contains all data elements of the Reaction information model.
Date and time when the hypersensitivity first manifested itself in a reaction. This can be an exact date and time, but also a global indication of the date (for example, only year or year and month).
NL-CM:8.4.12
Criticality
1
The healthcare professional's assessment of whether the hypersensitivity is a contraindication to intended or unintended exposure to the substance, group of substances or environmental factor to which the patient is hypersensitive.
Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page
Example Instances
Only available in Dutch
Overgevoeligheid
Stof
Amoxicilline/clavulaanzuur
Penicillines
Overgevoeligheidscategorie
Geneesmiddelen
Geneesmiddelen
EersteAuteur::Zorgverlener
Naam
Mevr. Zaal
Mevr. Zaal
Specialisme
SEH-arts
SEH-arts
Risicobeoordeling
Laag
Ernstig
Manier van vast stellen
Vastgesteld op basis van het klinisch beeld
Op basis van anamnese
Omschrijving van de bron
Gesprek met patiënt
-
Toelichting
-
-
Begindatumtijd
25-10-2021
25-10-2021
Startbewakingdatumtijd
25-10-2021
25-10-2021
Datum van afsluiten
-
-
Overgevoeligheidstatus
Actief
Actief
Reactie
ReactieErnst
Ernstig
Matig
ReactieTijdstip
12-10-2020
02-06-2021
ReactieSymptomen
Trombocytopenie
Jeuk
Veroorzakendestof
Amoxicilline/clavulaanzuur
Penicillines
Issues
No known allergies
The question is whether to offer a code for "No known allergies (SNOMED CT 160244002)" and subdirectories in this information model that fall under this code, or to determine that, where applicable, the document should outline when the information model is to be applied. Value set for the ‘Causative substance’ concept
Currently, no defined code list is yet available for allergenic substances other than medication. Entering SNOMED CT must therefore suffice to code allergenic substances for the time-being. The G standard is used to code medical products.
Technical specifications in HL7v3 CDA and HL7 FHIR
To exchange information based on health and care information models, additional, more technical specifications are required.<BR>
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:
HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment
HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR