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Narrative

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Source1

{
  "resourceType": "DetectedIssue",
  "id": "example-di01-duplicateTherapy",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/smp/StructureDefinition/smp-medication-action-plan-detected-issue"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "status": "preliminary",
  "code": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "DUPTHPY",
        "display": "Duplicate Therapy Alert"
      }
    ]
  },
  "severity": "high",
  "patient": {
    "reference": "Patient/examplePatient"
  },
  "identifiedDateTime": "2025-07-02T08:00:00Z",
  "author": {
    "reference": "Practitioner/examplePharmacist"
  },
  "implicated": [
    {
      "reference": "MedicationStatement/example-MedicationStatement-alprazolam-01",
      "display": "alprazolam 0.5 MG Oral Tablet"
    },
    {
      "reference": "MedicationStatement/example-MedicationStatement-metoclopramide-01",
      "display": "metoclopromide 10 MG Oral Tablet"
    }
  ],
  "detail": "Taking these medications contribute a risk of anticholinergic side effects that increase risk of cognitive impairment, dementia and falls.",
  "mitigation": [
    {
      "action": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
            "code": "13",
            "display": "Stopped Concurrent Therapy"
          }
        ],
        "text": "Discontinue noted medications to prevent cognitive worsening, due to duplicative impact with other anticholinergics."
      },
      "date": "2025-07-02T08:00:00Z",
      "author": {
        "reference": "Practitioner/examplePharmacist"
      }
    }
  ]
}