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Overview

The Prescription model represents medication orders created during consultations. It stores an array of prescription items (medications) along with dosage, frequency, duration, and general instructions. Model Location: app/Models/Prescription.php Features:
  • Soft deletes enabled
  • JSON casting for prescription items array
  • Relationships with consultations, patients, and doctors
  • Support for multiple medications in a single prescription

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Database Schema

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id
bigint
required
Primary key, auto-incrementing
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consultation_id
bigint
required
Foreign key to consultations table. Cascades on delete.
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patient_id
bigint
required
Foreign key to patients table. Cascades on delete.
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doctor_id
bigint
required
Foreign key to users table. Cascades on delete.
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items
json
required
Array of prescription items. Each item contains:
  • medication - Medication name
  • dosage - Dosage amount and form
  • frequency - How often to take
  • duration - Length of treatment
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general_instructions
text
General instructions for the entire prescription
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created_at
timestamp
Record creation timestamp
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updated_at
timestamp
Record last update timestamp
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deleted_at
timestamp
Soft delete timestamp (null if not deleted)

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Fillable Attributes

The following attributes can be mass-assigned:
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consultation_id
integer
required
ID of the related consultation
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patient_id
integer
required
ID of the patient
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doctor_id
integer
required
ID of the prescribing doctor (User)
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items
array
required
Array of prescription items. Each item should have:
[
  {
    "medication": "Medication name",
    "dosage": "500mg",
    "frequency": "Cada 8 horas",
    "duration": "7 días"
  }
]
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general_instructions
text
General instructions (e.g., “Tomar con alimentos”)

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Relationships

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Consultation

Get the consultation associated with this prescription. 
$prescription = Prescription::find(1);
$consultation = $prescription->consultation;

echo $consultation->diagnosis;
echo $consultation->treatment_plan;
Relationship Type: belongsTo Related Model: App\Models\Consultation Foreign Key: consultation_id

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Patient

Get the patient for this prescription. 
$prescription = Prescription::find(1);
$patient = $prescription->patient;

echo $patient->full_name;
echo $patient->allergies; // Important for safety checks
Relationship Type: belongsTo Related Model: App\Models\Patient Foreign Key: patient_id

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Doctor

Get the doctor who prescribed this medication. 
$prescription = Prescription::find(1);
$doctor = $prescription->doctor;

echo "Prescribed by: " . $doctor->name;
Relationship Type: belongsTo Related Model: App\Models\User Foreign Key: doctor_id

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Type Casting

The model automatically casts the following attributes:
  • items: Cast to/from array (stored as JSON in database)

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Soft Deletes

The Prescription model uses soft deletes. Deleted records are not permanently removed from the database but marked with a deleted_at timestamp. 
// Soft delete a prescription
$prescription->delete();

// Include soft deleted records
$allPrescriptions = Prescription::withTrashed()->get();

// Get only soft deleted records
$deletedPrescriptions = Prescription::onlyTrashed()->get();

// Restore a soft deleted prescription
$prescription->restore();

// Permanently delete
$prescription->forceDelete();

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Usage Examples

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Creating a Prescription

use App\Models\Prescription;

$prescription = Prescription::create([
    'consultation_id' => 1,
    'patient_id' => 1,
    'doctor_id' => 5,
    'items' => [
        [
            'medication' => 'Amoxicilina',
            'dosage' => '500mg',
            'frequency' => 'Cada 8 horas',
            'duration' => '7 días',
        ],
        [
            'medication' => 'Ibuprofeno',
            'dosage' => '400mg',
            'frequency' => 'Cada 6 horas según necesidad',
            'duration' => '5 días',
        ],
    ],
    'general_instructions' => 'Tomar con alimentos. Completar el tratamiento antibiótico aunque se sienta mejor.',
]);

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Working with Prescription Items

$prescription = Prescription::find(1);

// Access items array
foreach ($prescription->items as $item) {
    echo "Medication: {$item['medication']}\n";
    echo "Dosage: {$item['dosage']}\n";
    echo "Frequency: {$item['frequency']}\n";
    echo "Duration: {$item['duration']}\n";
    echo "---\n";
}

// Count medications
$medicationCount = count($prescription->items);

// Add a new item to existing prescription
$items = $prescription->items;
$items[] = [
    'medication' => 'Paracetamol',
    'dosage' => '500mg',
    'frequency' => 'Cada 6 horas',
    'duration' => '3 días',
];
$prescription->update(['items' => $items]);

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Querying Prescriptions

// Get all prescriptions for a patient
$patientPrescriptions = Prescription::where('patient_id', 1)
    ->with('doctor')
    ->orderBy('created_at', 'desc')
    ->get();

// Get prescriptions by a specific doctor
$doctorPrescriptions = Prescription::where('doctor_id', 5)
    ->with(['patient', 'consultation'])
    ->get();

// Get recent prescriptions
$recentPrescriptions = Prescription::where('created_at', '>=', now()->subDays(30))
    ->with(['patient', 'doctor'])
    ->get();

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Searching for Specific Medications

// Find prescriptions containing a specific medication
$amoxicillinPrescriptions = Prescription::whereJsonContains('items', [
    ['medication' => 'Amoxicilina']
])->get();

// Using whereRaw for more complex JSON queries
$prescriptions = Prescription::whereRaw(
    "JSON_SEARCH(items, 'one', ?) IS NOT NULL",
    ['%Ibuprofeno%']
)->get();

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Creating Prescription with Consultation

use App\Models\Consultation;

$consultation = Consultation::find(1);

// Create prescription directly from consultation
$prescription = $consultation->prescription()->create([
    'patient_id' => $consultation->patient_id,
    'doctor_id' => $consultation->doctor_id,
    'items' => [
        [
            'medication' => 'Metformina',
            'dosage' => '850mg',
            'frequency' => 'Dos veces al día',
            'duration' => 'Continuo',
        ],
    ],
    'general_instructions' => 'Tomar con las comidas principales',
]);

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Updating a Prescription

$prescription = Prescription::find(1);

// Update general instructions
$prescription->update([
    'general_instructions' => 'Tomar con abundante agua. Evitar alcohol.',
]);

// Update specific medication dosage
$items = $prescription->items;
$items[0]['dosage'] = '1000mg'; // Update first medication dosage
$prescription->update(['items' => $items]);

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Eager Loading Complete Prescription Data

// Load prescription with all related information
$prescription = Prescription::with([
    'patient' => function ($query) {
        $query->select('id', 'full_name', 'allergies');
    },
    'doctor' => function ($query) {
        $query->select('id', 'name');
    },
    'consultation' => function ($query) {
        $query->select('id', 'diagnosis', 'treatment_plan');
    }
])->find(1);

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Generating Prescription Report

$prescription = Prescription::with(['patient', 'doctor', 'consultation'])
    ->find(1);

// Format for display or PDF generation
$report = [
    'prescription_id' => $prescription->id,
    'date' => $prescription->created_at->format('d/m/Y'),
    'patient' => [
        'name' => $prescription->patient->full_name,
        'age' => $prescription->patient->birth_date->age ?? null,
    ],
    'doctor' => [
        'name' => $prescription->doctor->name,
    ],
    'diagnosis' => $prescription->consultation->diagnosis,
    'medications' => $prescription->items,
    'instructions' => $prescription->general_instructions,
];

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Patient Medication History

// Get all medications ever prescribed to a patient
$patientId = 1;
$medicationHistory = Prescription::where('patient_id', $patientId)
    ->with('consultation')
    ->orderBy('created_at', 'desc')
    ->get()
    ->flatMap(function ($prescription) {
        return collect($prescription->items)->map(function ($item) use ($prescription) {
            return array_merge($item, [
                'prescribed_date' => $prescription->created_at,
                'diagnosis' => $prescription->consultation->diagnosis ?? null,
            ]);
        });
    });

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Validation Example

// Validate prescription items structure
$validated = $request->validate([
    'consultation_id' => 'required|exists:consultations,id',
    'patient_id' => 'required|exists:patients,id',
    'doctor_id' => 'required|exists:users,id',
    'items' => 'required|array|min:1',
    'items.*.medication' => 'required|string',
    'items.*.dosage' => 'required|string',
    'items.*.frequency' => 'required|string',
    'items.*.duration' => 'required|string',
    'general_instructions' => 'nullable|string',
]);

$prescription = Prescription::create($validated);

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