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An Ontological Analysis of Drug Prescriptions: Addressing Ambiguity and Frustrations in Healthcare

This research delves into the Prescription of DRugs Ontology (PDRO) to tackle issues of ambiguity and frustrations in drug prescriptions. It explores the taxonomy of instructions and performs a mereological analysis to enhance clarity in prescriptions. The study identifies e-prescribing platform challenges and adverse drug events, stressing the importance of supporting decision aid for both patients and doctors. Developed based on OBO Foundry principles with BFO 2.0 as the top ontology, PDRO is aimed at improving prescription practices and reducing adverse outcomes. Future work focuses on representing patient compliance with instructions, handling synonymy between instructions, and incorporating deontic entities into the ontology structure.

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An Ontological Analysis of Drug Prescriptions: Addressing Ambiguity and Frustrations in Healthcare

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  1. An ontological analysis of drug prescriptions Ontologie, Données, Informatique Médicale IRIT, Toulouse 2019, May 27th Jean-François Ethier Paul Fabry RyeyanTaseen Adrien Barton

  2. Plan • Problems and desiderata • The Prescription of DRugs Ontology (PDRO) • A taxonomy of instructions in drug prescriptions • A mereological analysis of instructions

  3. Problem: Prescriptions as a source of ambiguity • “In case the patient has chest pain that significantly impacts his quality of life”? • “In case the patient has chest pain” ?(and it is a sign that something serious is happening)

  4. Problem: Prescriptions as a source of ambiguity “Metoprolol 50mg PO bid”

  5. Problem: Prescriptions as a source of ambiguity

  6. Problem: E-prescribing platforms as a source of frustrations • What is intended by the prescriber: ‘Atorvastatin 80 mg tab’ • What can be prescribed in some e-prescribing platforms:‘Apo-atorvastatin 80 mg tab’

  7. Problem: Prescriptions as a source of adverse drug events Adverse drug events in the US: • cause about 5% of all hospital admissions. • are estimated to be the 4th to 6th leading cause of death.

  8. Desiderata: Supporting decision aid… … for patients … for doctors

  9. Prescription of Drugs Ontology (PDRO) • Built according to OBO Foundry principles • BFO 2.0 as a top ontology • Classes from IAO, OBI, DRON, OMRSE and VO were imported • Available online at https://www.github.com/openLHS/PDRO

  10. BFO and IAO

  11. Data itemvs. Directive information entity

  12. Example of drug prescription Document creation time specification Patient identification Drug administration specification (DAS) Drug cessation… Drug administration modification… …prescription item Drug distribution specification (DDS) Drug administration initiation or continuation…

  13. A taxonomy of instructions has_part some has_part some has_part some

  14. A taxonomy of instructions has_part some

  15. Example of relevant instances

  16. Example of relevant instances

  17. Example of relevant instances

  18. The parts of a drug administration specification BFO:has_part

  19. Conditions is_a ‘if less than 4g has been taken today’ ‘if less than 30 doses have been taken’ ‘q8h’ ‘x 7 days’ ‘if it is Monday’ ‘if symptoms of bronchitis’

  20. Future work • We need to represent not only the instructions by doctors and pharmacists, but also the process of individuals following (or not) such instructions -> need to axiomatize a relation directs. • How to represent synonymy between instructions? • How to represent specification and contradiction of one instruction by another one? • How to represent deontic entities (permissions, obligations, interdictions, recommendations)?

  21. Thank you for your attention! Adrien Barton Jean-François Ethier Paul Fabry RyeyanTaseen https://www.github.com/openLHS/PDRO

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