Prescription: Titrated drug dose

care/facility/api/serializers/patient_consultation.py

@@ -24,6 +24,7 @@
     Facility,
     PatientRegistration,
     Prescription,
+    PrescriptionDosageType,
     PrescriptionType,
 )
 from care.facility.models.asset import AssetLocation
@@ -151,17 +152,20 @@
     medico_legal_case = serializers.BooleanField(default=False, required=False)
 
     def get_discharge_prescription(self, consultation):
-        return Prescription.objects.filter(
-            consultation=consultation,
-            prescription_type=PrescriptionType.DISCHARGE.value,
-            is_prn=False,
-        ).values()
+        return (
+            Prescription.objects.filter(
+                consultation=consultation,
+                prescription_type=PrescriptionType.DISCHARGE.value,
+            )
+            .exclude(dosage_type=PrescriptionDosageType.PRN.value)
+            .values()
+        )
 
     def get_discharge_prn_prescription(self, consultation):
         return Prescription.objects.filter(
             consultation=consultation,
             prescription_type=PrescriptionType.DISCHARGE.value,
-            is_prn=True,
+            dosage_type=PrescriptionDosageType.PRN.value,
         ).values()
 
     class Meta:
@@ -609,17 +613,20 @@
     )
 
     def get_discharge_prescription(self, consultation):
-        return Prescription.objects.filter(
-            consultation=consultation,
-            prescription_type=PrescriptionType.DISCHARGE.value,
-            is_prn=False,
-        ).values()
+        return (
+            Prescription.objects.filter(
+                consultation=consultation,
+                prescription_type=PrescriptionType.DISCHARGE.value,
+            )
+            .exclude(dosage_type=PrescriptionDosageType.PRN.value)
+            .values()
+        )
 
     def get_discharge_prn_prescription(self, consultation):
         return Prescription.objects.filter(
             consultation=consultation,
             prescription_type=PrescriptionType.DISCHARGE.value,
-            is_prn=True,
+            dosage_type=PrescriptionDosageType.PRN.value,
         ).values()
 
     class Meta:

care/facility/api/serializers/prescription.py

@@ -2,7 +2,12 @@
 from django.utils import timezone
 from rest_framework import serializers
 
-from care.facility.models import MedibaseMedicine, MedicineAdministration, Prescription
+from care.facility.models import (
+    MedibaseMedicine,
+    MedicineAdministration,
+    Prescription,
+    PrescriptionDosageType,
+)
 from care.users.api.serializers.user import UserBaseMinimumSerializer
 
 
@@ -19,23 +24,60 @@
         )
 
 
+class MedicineAdministrationSerializer(serializers.ModelSerializer):
+    id = serializers.UUIDField(source="external_id", read_only=True)
+
+    administered_by = UserBaseMinimumSerializer(read_only=True)
+    archived_by = UserBaseMinimumSerializer(read_only=True)
+
+    def validate_administered_date(self, value):
+        if value > timezone.now():
+            raise serializers.ValidationError(
+                "Administered Date cannot be in the future."
+            )
+        if self.context["prescription"].created_date > value:
+            raise serializers.ValidationError(
+                "Administered Date cannot be before Prescription Date."
+            )
+        return value
+
+    def validate(self, attrs):
+        if (
+            not attrs.get("dosage")
+            and self.context["prescription"].dosage_type
+            == PrescriptionDosageType.TITRATED
+        ):
+            raise serializers.ValidationError(
+                {"dosage": "Dosage is required for titrated prescriptions."}
+            )
+        elif (
+            self.context["prescription"].dosage_type != PrescriptionDosageType.TITRATED
+        ):
+            attrs.pop("dosage", None)
+
+        return super().validate(attrs)
+
+    class Meta:
+        model = MedicineAdministration
+        exclude = ("deleted",)
+        read_only_fields = (
+            "external_id",
+            "administered_by",
+            "archived_by",
+            "archived_on",
+            "created_date",
+            "modified_date",
+            "prescription",
+        )
+
+
 class PrescriptionSerializer(serializers.ModelSerializer):
     id = serializers.UUIDField(source="external_id", read_only=True)
     prescribed_by = UserBaseMinimumSerializer(read_only=True)
-    last_administered_on = serializers.SerializerMethodField()
+    last_administration = MedicineAdministrationSerializer(read_only=True)
     medicine_object = MedibaseMedicineSerializer(read_only=True, source="medicine")
     medicine = serializers.UUIDField(write_only=True)
 
-    def get_last_administered_on(self, obj):
-        last_administration = (
-            MedicineAdministration.objects.filter(prescription=obj)
-            .order_by("-administered_date")
-            .first()
-        )
-        if last_administration:
-            return last_administration.administered_date
-        return None
-
     class Meta:
         model = Prescription
         exclude = (
@@ -75,47 +117,36 @@
                     }
                 )
 
-        if attrs.get("is_prn"):
+        if not attrs.get("base_dosage"):
+            raise serializers.ValidationError(
+                {"base_dosage": "Base dosage is required."}
+            )
+
+        if attrs.get("dosage_type") == PrescriptionDosageType.PRN:
             if not attrs.get("indicator"):
                 raise serializers.ValidationError(
                     {"indicator": "Indicator should be set for PRN prescriptions."}
                 )
+            attrs.pop("frequency", None)
+            attrs.pop("days", None)
         else:
             if not attrs.get("frequency"):
                 raise serializers.ValidationError(
                     {"frequency": "Frequency should be set for prescriptions."}
                 )
+            attrs.pop("indicator", None)
+            attrs.pop("max_dosage", None)
+            attrs.pop("min_hours_between_doses", None)
+
+            if attrs.get("dosage_type") == PrescriptionDosageType.TITRATED:
+                if not attrs.get("target_dosage"):
+                    raise serializers.ValidationError(
+                        {
+                            "target_dosage": "Target dosage should be set for titrated prescriptions."
+                        }
+                    )
+            else:
+                attrs.pop("target_dosage", None)
+
         return super().validate(attrs)
         # TODO: Ensure that this medicine is not already prescribed to the same patient and is currently active.
-
-
-class MedicineAdministrationSerializer(serializers.ModelSerializer):
-    id = serializers.UUIDField(source="external_id", read_only=True)
-
-    administered_by = UserBaseMinimumSerializer(read_only=True)
-    prescription = PrescriptionSerializer(read_only=True)
-    archived_by = UserBaseMinimumSerializer(read_only=True)
-
-    def validate_administered_date(self, value):
-        if value > timezone.now():
-            raise serializers.ValidationError(
-                "Administered Date cannot be in the future."
-            )
-        if self.context["prescription"].created_date > value:
-            raise serializers.ValidationError(
-                "Administered Date cannot be before Prescription Date."
-            )
-        return value
-
-    class Meta:
-        model = MedicineAdministration
-        exclude = ("deleted",)
-        read_only_fields = (
-            "external_id",
-            "administered_by",
-            "archived_by",
-            "archived_on",
-            "created_date",
-            "modified_date",
-            "prescription",
-        )

care/facility/api/viewsets/prescription.py

@@ -16,11 +16,13 @@
 from care.facility.models import (
     MedicineAdministration,
     Prescription,
+    PrescriptionDosageType,
     PrescriptionType,
     generate_choices,
 )
 from care.facility.static_data.medibase import MedibaseMedicine
 from care.utils.filters.choicefilter import CareChoiceFilter
+from care.utils.filters.multiselect import MultiSelectFilter
 from care.utils.queryset.consultation import get_consultation_queryset
 from care.utils.static_data.helpers import query_builder, token_escaper
 
@@ -33,6 +35,9 @@ def inverse_choices(choices):
 
 
 inverse_prescription_type = inverse_choices(generate_choices(PrescriptionType))
+inverse_prescription_dosage_type = inverse_choices(
+    generate_choices(PrescriptionDosageType)
+)
 
 
 class MedicineAdminstrationFilter(filters.FilterSet):
@@ -82,7 +87,7 @@ def archive(self, request, *args, **kwargs):
 
 
 class ConsultationPrescriptionFilter(filters.FilterSet):
-    is_prn = filters.BooleanFilter()
+    dosage_type = MultiSelectFilter()
     prescription_type = CareChoiceFilter(choice_dict=inverse_prescription_type)
     discontinued = filters.BooleanFilter()
 

care/facility/migrations/0415_rename_dosage_prescription_base_dosage_and_more.py

@@ -0,0 +1,88 @@
+# Generated by Django 4.2.8 on 2024-02-10 10:05
+
+from django.db import migrations, models
+
+import care.utils.models.validators
+
+
+class Migration(migrations.Migration):
+    dependencies = [
+        ("facility", "0414_remove_bed_old_name"),
+    ]
+
+    def set_prn_prescriptions_dosage_type(apps, schema_editor):
+        Prescription = apps.get_model("facility", "Prescription")
+        Prescription.objects.filter(is_prn=True).update(dosage_type="PRN")
+
+    def reverse_set_prn_prescriptions_dosage_type(apps, schema_editor):
+        Prescription = apps.get_model("facility", "Prescription")
+        Prescription.objects.filter(dosage_type="PRN").update(is_prn=True)
+
+    operations = [
+        migrations.RenameField(
+            model_name="prescription",
+            old_name="dosage",
+            new_name="base_dosage",
+        ),
+        migrations.AddField(
+            model_name="prescription",
+            name="dosage_type",
+            field=models.CharField(
+                choices=[
+                    ("REGULAR", "REGULAR"),
+                    ("TITRATED", "TITRATED"),
+                    ("PRN", "PRN"),
+                ],
+                default="REGULAR",
+                max_length=100,
+            ),
+        ),
+        migrations.RunPython(
+            set_prn_prescriptions_dosage_type, reverse_set_prn_prescriptions_dosage_type
+        ),
+        migrations.RemoveField(
+            model_name="prescription",
+            name="is_prn",
+        ),
+        migrations.AddField(
+            model_name="medicineadministration",
+            name="dosage",
+            field=models.CharField(
+                blank=True,
+                max_length=100,
+                null=True,
+                validators=[
+                    care.utils.models.validators.DenominationValidator(
+                        allow_floats=True,
+                        max_amount=5000,
+                        min_amount=0.0001,
+                        precision=4,
+                        units={"mg", "ml", "drop(s)", "ampule(s)", "g", "tsp"},
+                    )
+                ],
+            ),
+        ),
+        migrations.AddField(
+            model_name="prescription",
+            name="instruction_on_titration",
+            field=models.TextField(blank=True, null=True),
+        ),
+        migrations.AddField(
+            model_name="prescription",
+            name="target_dosage",
+            field=models.CharField(
+                blank=True,
+                max_length=100,
+                null=True,
+                validators=[
+                    care.utils.models.validators.DenominationValidator(
+                        allow_floats=True,
+                        max_amount=5000,
+                        min_amount=0.0001,
+                        precision=4,
+                        units={"mg", "ml", "drop(s)", "ampule(s)", "g", "tsp"},
+                    )
+                ],
+            ),
+        ),
+    ]

care/facility/models/prescription.py

@@ -39,6 +39,12 @@ class PrescriptionType(enum.Enum):
     REGULAR = "REGULAR"
 
 
+class PrescriptionDosageType(models.TextChoices):
+    REGULAR = "REGULAR", "REGULAR"
+    TITRATED = "TITRATED", "TITRATED"
+    PRN = "PRN", "PRN"
+
+
 def generate_choices(enum_class):
     return [(tag.name, tag.value) for tag in enum_class]
 
@@ -98,11 +104,20 @@ class Prescription(BaseModel):
         blank=True,
         null=True,
     )
-    dosage = models.CharField(
+    base_dosage = models.CharField(
         max_length=100, blank=True, null=True, validators=[dosage_validator]
     )
+    dosage_type = models.CharField(
+        max_length=100,
+        choices=PrescriptionDosageType.choices,
+        default=PrescriptionDosageType.REGULAR.value,
+    )
 
-    is_prn = models.BooleanField(default=False)
+    # titrated fields
+    target_dosage = models.CharField(
+        max_length=100, blank=True, null=True, validators=[dosage_validator]
+    )
+    instruction_on_titration = models.TextField(blank=True, null=True)
 
     # non prn fields
     frequency = models.CharField(
@@ -148,6 +163,10 @@ def save(self, *args, **kwargs) -> None:
     def medicine_name(self):
         return str(self.medicine) if self.medicine else self.medicine_old
 
+    @property
+    def last_administration(self):
+        return self.administrations.order_by("-administered_date").first()
+
     def __str__(self):
         return self.medicine + " - " + self.consultation.patient.name
 
@@ -158,6 +177,9 @@ class MedicineAdministration(BaseModel):
         on_delete=models.PROTECT,
         related_name="administrations",
     )
+    dosage = models.CharField(
+        max_length=100, blank=True, null=True, validators=[dosage_validator]
+    )
     notes = models.TextField(default="", blank=True)
     administered_by = models.ForeignKey(
         "users.User",