Reaction-v1.0(2023EN)

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General information

Name: nl.zorg.Reaction NL.png
Version: 1.0
HCIM Status:Final
Release: 2023
Release status: Prepublished
Release date: 15-10-2023

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Metadata

DCM::CoderList Werkgroep Overgevoeligheid
DCM::ContactInformation.Address *
DCM::ContactInformation.Name *
DCM::ContactInformation.Telecom *
DCM::ContentAuthorList Werkgroep Overgevoelighed
DCM::CreationDate 4-11-2021
DCM::DeprecatedDate
DCM::DescriptionLanguage nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name PM
DCM::EndorsingAuthority.Telecom
DCM::Id 2.16.840.1.113883.2.4.3.11.60.40.3.5.3
DCM::KeywordList Reactie
DCM::LifecycleStatus Final
DCM::ModelerList Werkgroep overgevoeligheid
DCM::Name nl.zorg.Reactie
DCM::PublicationDate 15-10-2023
DCM::PublicationStatus Prepublished
DCM::ReviewerList
DCM::RevisionDate 16-11-2021
DCM::Supersedes
DCM::Version 1.0
HCIM::PublicationLanguage EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (01-12-2021) .

Concept

An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction.
The substances can be categorized as follows:

  • Medicine
  • Medicine category
  • Ingredient/addition
  • Nutrition
  • Environmental factor
  • Animal
  • Plants
  • Chemicals
  • Inhaled allergenic

Purpose

Documenting and communicating allergies and intolerances is an important part of medical registration. It concerns the core of patient safety in general and medication safety in particular. In the execution of research, treatment and care, these patient characteristics constantly have to be taken into account.
In principle, allergies and intolerances are also disorders and also could be entered as a problem. Nevertheless, these are usually entered separately.
Allergies/Intolerances have a lot in common with warnings (Alert). An important difference is that with allergies and intolerances, a lot of detailed information is recorded on things such as the reactions to the causative substance. Furthermore, not every warning is a problem or medical condition. Every allergy/intolerance is, however, while not every allergy or intolerance implies a warning.

Evidence Base

For all allergies in the Netherlands, the codes available in the G standard are used to register and complete medicinal allergies in the work process of prescribers and pharmacists (in medication monitoring). This is outlined in the document “Allergies and unwanted substances IR V-2-3-1”.

This code is insufficient when it comes to reactions to exposure to food products, items (such as bandages and band-aids), plants and animals. For these items, the standard allows the use of free text or the use of SNOMED CT code. However, no validated value set is currently available for this purpose for SNOMED CT.

Information Model


#2398#2396#2391#2390HealthProfessional-v4.0(2023EN)#CausativeSubstanceHPKCodelist#CausativeSubstanceAllergicAgentCodelist#RouteOfExposureCodelist#CausativeSubstanceThesaurus122Codelist#CausativeSubstanceSNKCodelist#CausativeSubstanceSSKCodelist#2392#2406#2393#2395#ReactionPhenomenonCodelist#SeverityCodelist#2404#2388#2403Reaction-v1.0Model(2023EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:5.3.1 Arrowdown.pngReaction Root concept of the Reaction information model. This root concept contains all data elements of the Reaction information model.
CD.png NL-CM:5.3.7 Arrowright.pngReactionPhenomenon 0..* The substantive specification of the reaction (symptoms) that occurs when the patient is exposed to the substance.​
List2.png ReactionPhenomenonCodelist
Folder.png NL-CM:5.3.6 Arrowdown.pngCausativeAagent 0..1 Container of the CausativeAagent concept.This container contains all data elements of the CausativeAagent concept.
BL.png NL-CM:5.3.5 Arrowright.pngRadiation 0..* Indicates whether it is (presumably) a reaction to radiation.
CD.png NL-CM:5.3.8 Arrowright.pngCausativeSubstance 0..* The substance that (presumably) caused the reaction.​
List2.png CausativeSubstanceAllergicAgentCodelist
List2.png CausativeSubstanceHPKCodelist
List2.png CausativeSubstanceSNKCodelist
List2.png CausativeSubstanceSSKCodelist
List2.png CausativeSubstanceThesaurus122Codelist
ST.png NL-CM:5.3.9 Arrowright.pngReactionDescription 0..1 Textual description of the reaction as a whole including the reaction phenomena (symptoms).
CD.png NL-CM:5.3.10 Arrowright.pngSeverity 0..1 The severity of the reaction as a result of exposure to the substance.
List2.png SeverityCodelist
CD.png NL-CM:5.3.11 Arrowright.pngRouteOfExposure 0..1 Way in which the patient came into contact with the causative agent or the way in which the agent was administered.
List2.png RouteOfExposureCodelist
Folder.png NL-CM:5.3.4 Arrowdown.pngSpecificationExposure 0..* Container of the SpecificationExposure concept.This container contains all data elements of the SpecificationExposure concept.
TS.png NL-CM:5.3.12 Arrowright.pngReactionPeriod 0..1 Start Date: Date and time the response started. This may also only be a date or a partial date, if not known more precisely. TimeDuration: Duration of the reaction. End date: Date and time when the response stopped occurring. This may also only be a date or a partial date, if this is not known more precisely.​


TS.png NL-CM:5.3.3 Arrowright.pngDateTimeCommit 1 The date the reaction was recorded​.
Verwijzing.png NL-CM:5.3.2 Arrowright.pngAuthor::HealthProfessional 1 Person who records the reaction, this can be a healthcare professional, patient or contact person.​
Block.png HealthProfessional

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page List2.png

Example Instances

Only available in Dutch

Reactie
ReactieErnst Ernstig Matig
ReactieTijdstip 12-10-2020 02-06-2021
ReactieSymptomen Trombocytopenie Jeuk
Veroorzakendestof Fragmin Amoxicilline
DatumTijdVastlegging 13-10-2020 13:15 03-06-2021 12:00
Auteur::Zorgverlener Mevr. Zaal Dhr. Jacobs
EersteAuteur::Zorgverlener
Naam Mevr. Zaal Mevr. Zaal
Specialisme SEH-arts SEH-arts
ReactieBeschrijving - Over het hele lichaam.

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.

References

1. Z-INDEX. (2011) Allergieën en ongewenste middelen [Online] v. R V-2-3-1 Beschikbaar op: http://www.z-index.nl/g-standaard/beschrijvingen/functioneel/wijzigingen/mb/bewaking-op-allergie/IR%20Allergieen%20V%202-1-1.pdf [Geraadpleegd: 15 oktober 2014]

2. HL7 FHIR Resource AllergyIntolerance. [Online] Continuous Build. Beschikbaar op: http://hl7-fhir.github.io/allergyintolerance.html [Geraadpleegd: 12 maart 2014]

Valuesets

CausativeSubstanceAllergicAgentCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.1 Binding: Required
Conceptname Codesystem name Codesystem OID
SNOMED CT: ^98061000146100|Dutch total non-drug allergen simple reference set| SNOMED CT 2.16.840.1.113883.6.96

CausativeSubstanceHPKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.2 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-Standaard Handels Product Kode (HPK) 2.16.840.1.113883.2.4.4.7

CausativeSubstanceSNKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.3 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Stofnaamcode (SNK) 2.16.840.1.113883.2.4.4.1.750

CausativeSubstanceSSKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.4 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK) 2.16.840.1.113883.2.4.4.1.725

CausativeSubstanceThesaurus122Codelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.5 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Ongewenste medicatiegroepen 2.16.840.1.113883.2.4.4.1.902.122

ReactionPhenomenonCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.7 Binding: Extensible
Conceptname Conceptcode Codesystem name Codesystem OID Description
Anaphylaxis 39579001 SNOMED CT 2.16.840.1.113883.6.96 Anafylaxie
Angioedema 41291007 SNOMED CT 2.16.840.1.113883.6.96 Angio-oedeem
Upper respiratory tract hypersensitivity reaction 490008 SNOMED CT 2.16.840.1.113883.6.96 Overgevoeligheidsreactie van de bovenste luchtwegen
Dyspnea 267036007 SNOMED CT 2.16.840.1.113883.6.96 Kortademigheid
Bronchospasm 4386001 SNOMED CT 2.16.840.1.113883.6.96 Bronchospasme
Urticaria 126485001 SNOMED CT 2.16.840.1.113883.6.96 Urticaria
Contact dermatitis 40275004 SNOMED CT 2.16.840.1.113883.6.96 Contactdermatitis
Itching of skin 418363000 SNOMED CT 2.16.840.1.113883.6.96 Jeuk
Eruption 271807003 SNOMED CT 2.16.840.1.113883.6.96 Exantheem
Allergic conjunctivitis 473460002 SNOMED CT 2.16.840.1.113883.6.96 Allergische conjunctivitis
Lyell syndrome 768962006 SNOMED CT 2.16.840.1.113883.6.96 Syndroom van Lyle
Nausea and vomiting 16932000 SNOMED CT 2.16.840.1.113883.6.96 Misselijk en braken
Diarrhea 62315008 SNOMED CT 2.16.840.1.113883.6.96 Diarree
Drug-induced erythema multiforme 297942002 SNOMED CT 2.16.840.1.113883.6.96 Door medicatie veroorzaakte erythema multiforme
Fever 386661006 SNOMED CT 2.16.840.1.113883.6.96 Koorts
Overig OTH NullFlavor 2.16.840.1.113883.5.1008 Overig

RouteOfExposureCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.6 Binding: Required
Conceptname Codesystem name Codesystem OID
SNOMED CT: <284009009|Route of administration value| SNOMED CT 2.16.840.1.113883.6.96

SeverityCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.8 Binding: Required
Conceptname Conceptcode Codesystem name Codesystem OID Description
Mild 255604002 SNOMED CT 2.16.840.1.113883.6.96 Licht
Moderate severity 6736007 SNOMED CT 2.16.840.1.113883.6.96 Matig
Severe 24484000 SNOMED CT 2.16.840.1.113883.6.96 Ernstig

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Technical specifications in HL7v3 CDA and HL7 FHIR

To exchange information based on health and care information models, additional, more technical specifications are required.
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:

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About this information

The information in this wikipage is based on Prerelease 2023-1
SNOMED CT and LOINC codes are based on:

  • SNOMED Clinical Terms versie: 20230930 [R] (september 2023-editie)
  • LOINC version 2.76

Conditions for use are located on the mainpage List2.png
This page is generated on 31/10/2023 18:36:17 with ZibExtraction v. 9.3.8704.31782

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