mp:VDraft 3.0.0 Ontwerp medicatieproces 9 ENG/praktijkvoorbeelden/gebruiken

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1 Merging building blocks under a single pharmaceutical treatment

A GP has prescribed escitalopram to a patient for an anxiety disorder.

MA: escitalopram 40 mg tablet, 1 tablet once daily

The patient has not given consent for his medication data to be made available. As a result, when he records his medication use in his PGO, he does not have access to the MA. Consequently, the MGB is recorded in a new MBH.
After some time, the patient informs the GP that he now agrees to making his medication data available. He has also opened his PGO for querying. The GP can now see that building blocks for propranolol exist in two different MBHs.
The patient’s MGB was recorded later than the MA and has the same type of MBH-id. According to the agreements in the Implementation guide migration and hybrid situation V2.0, this would mean that the GP’s MBH should be closed. The EVS also proposes this to the GP. However, the GP decides to maintain her own MA and to close the patient’s MBH instead.

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2 Patient requests repeat prescription via prescriber

On 30 March, a GP prescribes bisoprolol to a patient as maintenance treatment for stable angina pectoris.

MA: bisoprolol 5 mg tablet, 1 tablet once daily, from 30 March

VV: bisoprolol 5 mg tablet, for 3 months

When the patient’s supply runs out, he contacts the GP by phone to request a repeat of this medication. The GP approves the request and creates a new VV, sending it along with the associated MA to the patient’s pharmacy.

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3 Patient requests repeat prescription via supplier

On 30 March, a GP prescribes bisoprolol to a patient as maintenance treatment for stable angina pectoris.

MA: bisoprolol 5 mg tablet, 1 tablet once daily, from 30 March

VV: bisoprolol 5 mg tablet, for 3 months

When the patient’s supply runs out, he requests a repeat of this medication from the supplier. The supplier sends a VVV to the prescriber. The prescriber approves the proposal and sends an AVVV and a new VV with the associated MA back to the supplier.

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4 Reducing dosage on the patient’s initiative

A patient has been prescribed propranolol. The patient is experiencing severe sleep disturbances and has reduced the medication. The patient records an MGB with the changed dosage and the date from which this reduced dose is being taken in startDateTime. The patient indicates that the reason for the change is an adverse effect in ReasonModificationOrDiscontinuationOfUse and specifies in Comment that the adverse effect is insomnia. The patient also notes that the use is not as agreed, resulting in 'no' in the data element AsAgreedIndicator.


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5 Stopping medication on the patient’s initiative

Since starting propranolol, a patient has been experiencing insomnia. On 13 August, he decides to stop the medication without informing the prescriber. The patient records 'discontinued' in MedicationUseStopType and notes in startDateTime the date on which he stopped.
In ReasonModificationOrDiscontinuationOfUse, he records 'adverse reaction to drug' and specifies in Comment that the adverse effect is insomnia. He sets the AsAgreedIndicator to 'no'. This indicates that he stopped the medication on his own initiative.

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6 Patient requests repeat medication from the prescriber via Proposal dispense request

A patient uses medication for skin complaints. His supply has run out, and because he is abroad for a few days, he cannot immediately obtain new medication. He records an MGB with MedicationUseStopType 'suspended' and notes in ReasonModificationOrDiscontinuationOfUse 'no stock left'.
At the same time, he sends a VVV to the prescriber. If the prescriber approves the proposal, a VV is sent to the supplier. The AVVV is then received by the patient.

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7 Medication is used as agreed

The patient has been prescribed ferrous fumarate for anaemia.

MA: ferrous fumarate 100 mg tablet, 1 tablet twice per week, to be taken half an hour before meals

The medication starts on 4 June and has no end date. On 10 June, the GP records the patient’s medication use for the period from 4 to 10 June.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	ferrous fumarate 100 mg tablet
UseIndicator	yes
AsAgreedIndicator	yes
MedicationUseStopType	leave empty
startDateTime	4 June 2026
endDateTime	10 June 2026
DosingInstructions	as agreed

8 Medication is used as agreed and patients intends to keep doing so

The patient has been prescribed ferrous fumarate for anaemia.

MA: ferrous fumarate 100 mg tablet, 1 tablet twice per week, to be taken half an hour before meals

The medication starts on 4 June and has no end date. On 10 June, the GP records the patient’s medication use and their intention to keep using this medication as agreed.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	ferrous fumarate 100 mg tablet
UseIndicator	yes
AsAgreedIndicator	yes
MedicationUseStopType	leave empty
startDateTime	4 June 2026
endDateTime	leave empty
DosingInstructions	as agreed

9 Medication is used but not as agreed

The patient has been prescribed metformin for diabetes.

MA: metformin 500 mg tablet, 1 tablet three times daily, to be taken with meals

The medication starts on 4 June and has no end date.
During the first week after starting, the patient regularly forgets to take the dose at lunchtime because he is often out during the day. He takes the morning and evening doses as prescribed. He records this in an MGB.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	metformin 500 mg tablet
UseIndicator	yes
AsAgreedIndicator	no
MedicationUseStopType	leave empty
startDateTime	7 June 2026
endDateTime	11 June 2026
DosingInstructions	1 tablet two times daily

10 Medication not used, this is not as agreed

The patient has been prescribed colecalciferol (vitamin D3) for a vitamin D deficiency.

MA: colecalciferol 800 IU tablet, 1 tablet once daily, to be taken with a meal

The medication starts on 4 June 2026 and has no end date. During a long weekend away, the patient realizes that he forgot to take the medication. Upon returning home, he records that he did not take the medication during this period.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	colecalciferol 800 IU tablet
UseIndicator	no
AsAgreedIndicator	no
MedicationUseStopType	suspended
startDateTime	20 July 2026
endDateTime	23 July 2026
DosingInstructions	leave empty

11 Medication is not used, this is as agreed

The patient has been prescribed ferrous fumarate for anaemia.

MA: ferrous fumarate 100 mg tablet, 1 tablet twice per week, to be taken half an hour before meals

The medication starts on 4 June 2026.
On 12 August 2026, a follow-up check shows that the patient no longer has anaemia, and the doctor decides to stop the medication. At a subsequent consultation, the doctor records during medication verification that the patient has indeed stopped taking this medication from 12 August 2026.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	ferrous fumarate tablet 100 mg
UseIndicator	no
AsAgreedIndicator	yes
MedicationUseStopType	discontinued (or leave empty)*
startDateTime	12 August 2026
endDateTime	leave empty
DosingInstructions	leave empty

* When stopping medication in accordance with the MA/TA, it does not matter whether the data element MedicationUseStopType is filled with the value ‘discontinued’ or left empty. Both situations are processed correctly on the receiving end and indicate the same type of stop.
If the medication is stopped not in accordance with the MA/TA, the data element MedicationUseStopType is expected to be filled with the value ‘discontinued’.

12 Medication is not used after the PeriodOfUse and this is as agreed

The patient has an infection and is prescribed amoxicillin on 1 September. The medication must be taken for seven days. The PeriodOfUse ends on 8 September 2026, after which the patient records that he no longer uses the medicine.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	amoxicillin 500 mg dispersible tablet
UseIndicator	no
AsAgreedIndicator	yes
MedicationUseStopType	discontinued (or leave empty)*
startDateTime	8 September 2026
endDateTime	leave empty
DosingInstructions	leave empty

13 Medication is not used during the PeriodOfUse and this is as agreed

The patient has seasonal hay fever and has been prescribed cetirizine. The medication is intended to be taken as needed when symptoms occur. The patient has not had symptoms for three months and records that he did not use the medication during that period.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	cetirizine 10 mg tablet
UseIndicator	no
AsAgreedIndicator	yes
MedicationUseStopType	discontinued or suspended (or leave empty) *
startDateTime	8 August 2026
endDateTime	8 November 2026
DosingInstructions	leave empty

14 Medication is used but unknown whether this is as agreed

The patient has influenza and uses paracetamol 500 mg for muscle pain, purchased from the local drugstore. He has been taking four to six tablets daily for four days and expects to continue this for approximately three more days.
On 12 August 2026 the patient records this as medication use.

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Completion of the MedicationUse building block:

Data element	Value
ProductUsed	paracetamol 500 mg tablet
UseIndicator	yes
AsAgreedIndicator	leave empty
MedicationUseStopType	leave empty
startDateTime	8 August 2026
DurationOfUse	7 days
DosingInstructions	4 to 6 tablets per day

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15 Document history

Version	Date	Description
9 3.0.0-rc.2	March 2026	for all changes see: *Release notes