Drug Exposure
The Drug Exposure domain captures records about the utilisation of a drug when ingested or otherwise introduced into the body. A drug is a biochemical substance formulated in such a way that when administered to a person it will exert a certain physiological effect. Drugs include prescription and over-the-counter medicines, vaccines, and large-molecule biologic therapies. Radiological devices ingested or applied locally do not count as drugs.
Drug Exposure is inferred from clinical events associated with orders, prescriptions written, pharmacy dispensing, procedural administrations, and other patient-reported information, for example:
- The “Prescription” section of an EHR captures prescriptions written by physicians or from electronic ordering systems.
- The “Medication list” section of an EHR for both non-prescription products and medications prescribed by other providers.
- Prescriptions fulfilled by pharmacies.
- Drugs administered as part of a procedure, such as chemotherapy or vaccines.
Field | Required | Type | FK Table | Description |
---|---|---|---|---|
drug_exposure_id | Yes | bigint | A system-generated unique identifier for each Drug utilisation event. | |
person_id | Yes | bigint | PERSON | A foreign key identifier to the Person who is subjected to the Drug. The demographic details of that Person are stored in the PERSON table. |
drug_concept_id | Yes | bigint | CONCEPT | A foreign key that refers to a Standard Concept identifier in the Standardized Vocabularies for the Drug concept. |
drug_exposure_start_date | Yes | date | The UTC start date for the current instance of Drug utilisation. | |
drug_exposure_start_datetime | No | datetime | The UTC start date and time for the current instance of Drug utilisation. | |
drug_exposure_end_date | No | date | The UTC end date for the current instance of Drug utilisation. This is populated in the event that a datetime is not available (e.g. for home administrations). | |
drug_exposure_end_datetime | No | datetime | The UTC end date and time for the current instance of Drug utilisation. It is NULL
if the administration is not complete. |
|
verbatim_end_date | No | date | Not used. | |
drug_type_concept_id | Yes | bigint | CONCEPT | A foreign key to the predefined Concept identifier of the “Type Concept” domain in the Standardized Vocabularies reflecting the type of Drug Exposure recorded. |
stop_reason | No | varchar(20) | Not used. | |
refills | No | integer | Not used. | |
quantity | Yes | numeric/float | ||
days_supply | No | integer | Not used. | |
sig | No | text | Not used. | |
route_concept_id | No | bigint | CONCEPT | A foreign key to a predefined concept in the Standardized Vocabularies reflecting the route of administration. |
lot_number | No | varchar(50) | Not used. | |
provider_id | No | bigint | PROVIDER | Not used. |
visit_occurrence_id | No | bigint | VISIT_OCCURRENCE | A foreign key to the Visit Occurrence during which the Drug Exposure was initiated. |
visit_detail_id | No | bigint | VISIT_DETAIL | A foreign key to the Visit Detail during which the Drug Exposure was initiated. |
drug_source_value | No | varchar(50) | Not used. | |
drug_source_concept_id | No | bigint | CONCEPT | Not used. |
route_source_value | No | varchar(50) | Not used. | |
dose_unit_source_value | No | varchar(50) | Not used. | |
last_updated_datetime | Yes | datetime | Initially this is the time the row was written to OMOP. If the row is subsequently updated, it then becomes the most recent update time. | |
deleted_datetime | No | datetime | NULL
initially. Set to the time when the row was marked for deletion. A value in this column sent to the central data source will result in this row being deleted (by person_id
) from the combined dataset. Deletions only need to be sent once. |
Conventions
- Valid Concepts for the
drug_concept_id
field belong to the “Drug” domain. Most Concepts in the Drug domain are based on RxNorm, but some may come from other sources (like dm+d). Concepts are members of the Clinical Drug or Pack, Branded Drug or Pack, Drug Component or Ingredient classes. - A Drug Type is assigned to each Drug Exposure to track from what source the information was drawn or inferred from. The valid
domain_id
for these Concepts is “Type Concept”. - The
route_concept_id
refers to a Standard Concept of the “Route” domain. Note: Route information can also be inferred from the Drug product itself by determining the Drug Form of the Concept, creating some partial overlap of the same type of information. However, theroute_concept_id
could resolve ambiguities of how a certain Drug Form is actually applied. For example, a “Solution” could be used orally or parenterally, and this field will make such determination. - If possible, the Visit in which the drug was prescribed or delivered is recorded in the
visit_occurrence_id
field through a reference to the VISIT_OCCURRENCE table.