description: '**Concept**\r\nAn allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction. \r\nThe substances can be categorized as follows: \r\n\r\n* Medicine\r\n* Medicine category\r\n* Ingredient/addition\r\n* Nutrition\r\n* Environmental factor\r\n* Animal\r\n* Plants\r\n* Chemicals\r\n* Inhaled allergenic\r\n\r\n\r\n\r\n**Purpose**\r\nDocumenting and communicating allergies and intolerances is an important part of medical registration. It concerns the core of patient safety in general and medication safety in particular. In the execution of research, treatment and care, these patient characteristics constantly have to be taken into account. \r\nIn principle, allergies and intolerances are also disorders and also could be entered as a problem. Nevertheless, these are usually entered separately. \r\nAllergies/Intolerances have a lot in common with warnings (Alert). An important difference is that with allergies and intolerances, a lot of detailed information is recorded on things such as the reactions to the causative substance. Furthermore, not every warning is a problem or medical condition. Every allergy/intolerance is, however, while not every allergy or intolerance implies a warning.\r\n\r\n**Evidence Base**\r\nFor all allergies in the Netherlands, the codes available in the G standard are used to register and complete medicinal allergies in the work process of prescribers and pharmacists (in medication monitoring). This is outlined in the document “Allergies and unwanted substances IR V-2-3-1”. \r\n\r\nThis code is insufficient when it comes to reactions to exposure to food products, items (such as bandages and band-aids), plants and animals. For these items, the standard allows the use of free text or the use of SNOMED CT code. However, no validated value set is currently available for this purpose for SNOMED CT.\r\n\r\n**Example Instances**\r\n\r\n**Issues**\r\n**No known allergies**\r\nThe question is whether to offer a code for \"No known allergies (SNOMED CT 160244002)\" and subdirectories in this information model that fall under this code, or to determine that, where applicable, the document should outline when the information model is to be applied.\r\n**Value set for the ‘Causative substance’ concept **\r\nCurrently, no defined code list is yet available for allergenic substances other than medication. Entering SNOMED CT must therefore suffice to code allergenic substances for the time-being. The G standard is used to code medical products.' package_name: healthdata.be.r4.cbb derivation: specialization name: HdBeAllergyIntolerance abstract: true type: https://fhir.healthdata.be/StructureDefinition/LogicalModel/AllergyIntolerance elements: CausativeAgent: short: CausativeAgent _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Stof, groep stoffen of omgevingsfactor waar de patiënt allergisch of overgevoelig voor is.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: VeroorzakendeStof} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/CausativeAgent'} index: 0 AllergyCategory: short: AllergyCategory _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Identificeert de categorie van de overgevoeligheid aan zoals medicatie, voedsel of omgeving.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: AllergieCategorie} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/AllergyCategory'} index: 1 AllergyStatus: short: AllergyStatus _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Bewering over de status van de overgevoeligheid.} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: AllergieStatus} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/AllergyStatus'} index: 2 StartDateTime: short: StartDateTime _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - url: content valueMarkdown: "De datum en tijd dat de allergie of de ongewenste reactie is vastgesteld. \r\nDit kan een exacte datum en tijd zijn maar ook een globale aanduiding van de datum (bijvoorbeeld alleen jaar of jaar en maand)." type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: BeginDatumTijd} index: 3 Criticality: short: Criticality _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - url: content valueMarkdown: "Mate van kritiek zijn wordt gedefinieerd als \"de potentiële ernst van toekomstige reacties.\"\r\nDit vertegenwoordigt een klinisch oordeel over het worst case scenario voor een toekomstige reactie. Het kan worden gebaseerd op de ernst van de reacties in het verleden, de dosis en de wijze van blootstelling die in het verleden reacties veroorzaakten, en de levensbedreigende potentie van het type reactie. Mate van kritiek zijn is een kenmerk van de allergische aandoening, niet van de reactie." type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: MateVanKritiekZijn} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/CriticalExtent'} index: 4 LastReactionDateTime: short: LastReactionDateTime _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Opgave van de laatste maal dat een reactie in het licht van de overgevoeligheid is opgetreden.} type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: LaatsteReactieDatumTijd} index: 5 Comment: short: Comment _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Tekstuele toelichting op de overgevoeligheid die niet in één van de andere velden kan worden weergegeven.} type: string _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Toelichting} index: 6 Reaction: short: Reaction _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Container van het concept Reactie. Deze container bevat alle gegevenselementen van het concept Reactie.} type: BackboneElement _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Reactie} array: true index: 7 elements: Symptom: min: 1 short: Symptom index: 8 _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: De inhoudelijke specificatie van de reactie die optreedt indien de patiënt wordt blootgesteld aan de veroorzakende stof.} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Symptoom} array: true binding: {strength: extensible, valueSet: 'https://fhir.healthdata.be/ValueSet/Symptom'} SpecificSubstance: short: SpecificSubstance _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Meer specifieke aanduiding van de stof die de reactie opriep. Dit kan een specifieke stof uit een groep stoffen zijn waarvoor de patiënt allergisch of overgevoelig is.} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: SpecifiekeStof} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/CausativeAgent'} index: 9 ReactionDescription: short: ReactionDescription _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Tekstuele beschrijving van de reactie als geheel.} type: string _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: ReactieBeschrijving} index: 10 Severity: short: Severity _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: De ernst van de reactie ten gevolge van de blootgestelling aan de veroorzakende stof.} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Ernst} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/CriticalExtent'} index: 11 RouteOfExposure: short: RouteOfExposure _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Wijze waarop de patiënt in aanraking is gekomen met de veroorzakende stof of de wijze waarop de stof toegediend is.} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: WijzeVanBlootstelling} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/RouteOfExposure'} index: 12 ReactionTime: short: ReactionTime _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Datum en tijd waarop de reactie plaats gevonden heeft. Dit mag ook alleen een datum of een gedeeltelijke datum zijn, indien dit niet nauwkeuriger bekend is.'} type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: ReactieTijdstip} index: 13 required: [Symptom] package_version: 0.9.0-alpha class: logical kind: logical url: https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-AllergyIntolerance base: http://hl7.org/fhir/StructureDefinition/Element version: null required: [CausativeAgent]