feat(bot): veteran daily check-in, medication reminders and rule reactions
Daily check-in (mood → dose → sleep/nightmares → alcohol → free text with extract_checkin, buttons win over the LLM, progressive upsert of daily_checkins), medication reminder flow (taken / skip with reason / side effects → doses + daily_checkins), medication question menu via med_qa, med_info rule reactions from the drug instruction excerpt, «записаться раньше» request recorded for lane B, friendly intros for scheduled scales. actions.py: additive med_info handler hook. Refs #37 Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
This commit is contained in:
Claude Opus 5.5
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"""Medication flow (#37, case scenario «управление приёмом лекарств»). Module-agnostic: every patient with a
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prescription gets it, whatever the clinical module.
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system:med_reminder {dose_id, drug, dose}
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──▶ «Принял» → dose taken, check-in med_taken = true
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──▶ «Пропущу» → dose skipped, med_taken = false ──▶ reason:
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забыл / побочки (→ side effects) / решил бросить (quit_intent) / другое
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──▶ «Есть побочные эффекты» → code buttons (тошнота, бессонница, …) or «Другое» → free text
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→ check-in side_effects (+ dose.side_effects) → «А препарат сегодня приняли?»
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menu «Вопрос о лекарстве" ──▶ meds.question (free text) ──▶ med_qa (instruction excerpt) or «уточните у врача»
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rule action med_info (actions.py hook) ──▶ instruction excerpt for the rule topic + fixed notice
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Everything the patient answers is written to the clinical DB (`doses`, `daily_checkins`) and the step asks the
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engine to run monitoring (`notify_monitoring`): the rules (lane B, ADR-007) decide alerts and further actions
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(quit intent → delayed-onset explanation, missed doses → caring contact). Nothing here decides risk.
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Reminder buttons carry fixed data ("med:taken", ...) so they are plain idle triggers; the dose they refer to is
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kept in `dialog_state.data["med_pending"]` ({dose_id, drug, dose, day}) — a button from an earlier day is stale.
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"""
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from datetime import date, timedelta
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from functools import lru_cache
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from pathlib import Path
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from typing import Any
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import yaml
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from pydantic import BaseModel, ConfigDict
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from sqlalchemy import select
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from app.config import get_settings
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from app.core.privacy import scrub
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from app.core.rules import Action
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from app.db import repo
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from app.db.clinical import DailyCheckin, Dose
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from app.db.clinical import Prescription as PrescriptionRow
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from app.dialog.actions import register_med_info_handler
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from app.dialog.contracts import Button, Event, Reply
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from app.dialog.flows.core import menu_reply
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from app.dialog.fsm import Ctx, Step, get_trigger, handler_for, state, trigger
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from app.integrations.base import integrations
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from app.llm.med_qa import fallback_text, med_qa
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QUESTION_STATE = "meds.question"
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SIDE_EFFECT_TEXT_STATE = "meds.side_effect_text"
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SIDE_EFFECT_CODES = ("nausea", "insomnia", "headache", "dizziness", "agitation", "other")
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SKIP_REASONS = ("forgot", "side_effects", "quit", "other")
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# ------------------------------------------------------------------------------------------- texts
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class _Strict(BaseModel):
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model_config = ConfigDict(extra="forbid", frozen=True)
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class ReminderTexts(_Strict):
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text: str
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text_no_drug: str
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taken: str
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skip: str
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side_effects: str
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class SkipTexts(_Strict):
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question: str
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reasons: dict[str, str]
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ack: dict[str, str]
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class SideEffectTexts(_Strict):
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question: str
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options: dict[str, str]
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questions: dict[str, str]
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describe: str
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ack: str
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repeat: str
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ask_dose: str
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dose_yes: str
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dose_no: str
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class CheckinMedTexts(_Strict):
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question: str
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question_no_drug: str
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yes: str
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no: str
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later: str
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class QuestionTexts(_Strict):
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prompt: str
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no_prescription: str
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class MedInfoTopic(_Strict):
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section: str # med_qa section code (side_effects | onset | alcohol | ...)
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question: str
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lead: str = ""
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fallback: str
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notice: str = ""
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class MedsTexts(_Strict):
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status: str
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reminder: ReminderTexts
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taken_ack: str
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stale: str
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skip: SkipTexts
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side_effects: SideEffectTexts
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checkin: CheckinMedTexts
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question: QuestionTexts
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med_info: dict[str, MedInfoTopic]
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def meds_texts_path() -> Path:
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return get_settings().config_dir / "texts" / "meds.yaml"
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@lru_cache
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def load_meds_texts(path: Path | None = None) -> MedsTexts:
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path = path or meds_texts_path()
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return MedsTexts.model_validate(yaml.safe_load(path.read_text(encoding="utf-8")))
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# ------------------------------------------------------------------------------------------- data helpers
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class Rx(BaseModel):
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"""Active prescription as the dialog needs it (drug INN + dose exactly as the doctor wrote them)."""
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id: int | None
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drug: str
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dose: str
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async def current_prescription(ctx: Ctx) -> Rx | None:
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"""Latest prescription active today: clinical DB first, then the МИС integration (demo: in-memory)."""
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today = ctx.now.date()
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rows = await ctx.session.scalars(
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select(PrescriptionRow).where(PrescriptionRow.token == ctx.token).order_by(PrescriptionRow.id.desc())
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)
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for row in rows:
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if (row.start_date is None or row.start_date <= today) and (row.end_date is None or row.end_date >= today):
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return Rx(id=row.id, drug=row.drug, dose=row.dose)
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for p in await integrations.prescriptions.get_prescriptions(ctx.token):
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if (p.start_date is None or p.start_date <= today) and (p.end_date is None or p.end_date >= today):
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return Rx(id=None, drug=p.drug, dose=p.dose)
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return None
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async def checkin_of(ctx: Ctx, day: date) -> DailyCheckin | None:
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return await ctx.session.scalar(
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select(DailyCheckin).where(DailyCheckin.token == ctx.token, DailyCheckin.day == day)
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)
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async def save_checkin(ctx: Ctx, **fields: Any) -> DailyCheckin:
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return await repo.upsert_checkin(ctx.session, token=ctx.token, day=ctx.now.date(), now=ctx.now, **fields)
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def pending_dose(ctx: Ctx) -> dict[str, Any] | None:
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"""Today's reminder the patient is answering, or None (no reminder / reminder from an earlier day)."""
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pending = ctx.data.get("med_pending")
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if isinstance(pending, dict) and pending.get("day") == ctx.now.date().isoformat():
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return pending
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return None
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async def _dose_row(ctx: Ctx, pending: dict[str, Any] | None) -> Dose | None:
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if not pending or pending.get("dose_id") is None:
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return None
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row = await ctx.session.get(Dose, pending["dose_id"])
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return row if row is not None and row.token == ctx.token else None
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async def record_dose(ctx: Ctx, taken: bool, *, status: str | None = None) -> None:
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"""Dose answer → `doses` row of today's reminder (if any) + `daily_checkins.med_taken` (rules read both)."""
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row = await _dose_row(ctx, pending_dose(ctx))
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if row is not None:
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row.status = status or ("taken" if taken else "skipped")
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row.answered_at = ctx.now
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await save_checkin(ctx, med_taken=taken)
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async def record_side_effects(ctx: Ctx, codes: list[str]) -> None:
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"""Merge side-effect codes into today's check-in (rule `side_effect_3d` counts days with any code)."""
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today = await checkin_of(ctx, ctx.now.date())
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merged = list(dict.fromkeys([*(today.side_effects if today and today.side_effects else []), *codes]))
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await save_checkin(ctx, side_effects=merged)
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row = await _dose_row(ctx, pending_dose(ctx))
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if row is not None:
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row.side_effects = ",".join(c for c in dict.fromkeys([*(row.side_effects or "").split(","), *codes]) if c)
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async def side_effect_reply(ctx: Ctx, codes: list[str]) -> Reply:
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"""Reaction to newly reported side effects.
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Same effect as yesterday → short support (the instruction was already shown; persistence over 3 days is the
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rules' business). New effect with a known instruction question → the excerpt of the drug instruction
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(med_qa, section side_effects) — never generated advice. Otherwise a plain acknowledgement.
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"""
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t = load_meds_texts().side_effects
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yesterday = await checkin_of(ctx, ctx.now.date() - timedelta(days=1))
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if yesterday is not None and set(codes) & set(yesterday.side_effects or []):
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return Reply(text=t.repeat, kind="info")
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rx = await current_prescription(ctx)
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for code in codes:
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if code in t.questions and rx is not None:
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answer = await med_qa(rx.drug, scrub(t.questions[code]), topic="side_effects")
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if answer is not None:
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return Reply(text=answer.text, kind="info")
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return Reply(text=t.ack, kind="info")
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async def leave_to_idle(ctx: Ctx, event: Event, data: dict[str, Any] | None = None) -> Step:
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"""Abandon the current sub-flow and let the idle state handle the event (menu button, system event...)."""
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step = Step(next_state="idle", data=data or {})
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idle = handler_for("idle")
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return step.then(await idle(ctx, event)) if idle is not None else step
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async def run_trigger_inline(ctx: Ctx, key: str, event: Event) -> Step | None:
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"""Run an idle trigger from inside another flow (e.g. a reminder button pressed during the check-in)."""
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handler = get_trigger(key)
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return await handler(ctx, event) if handler is not None else None
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# ------------------------------------------------------------------------------------------- reminder
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def _reminder_buttons() -> list[list[Button]]:
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t = load_meds_texts().reminder
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return [
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[Button(label=t.taken, data="med:taken")],
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[Button(label=t.skip, data="med:skip")],
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[Button(label=t.side_effects, data="med:side_effects")],
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]
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@trigger("system:med_reminder", replace=True)
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async def _med_reminder(ctx: Ctx, event: Event) -> Step:
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t = load_meds_texts().reminder
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rx = await current_prescription(ctx)
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drug = str(event.params.get("drug") or (rx.drug if rx else ""))
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dose = str(event.params.get("dose") or (rx.dose if rx else ""))
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try:
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dose_id: int | None = int(event.params["dose_id"]) # type: ignore[call-overload]
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except (KeyError, TypeError, ValueError):
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dose_id = None
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if dose_id is None and rx is not None and rx.id is not None:
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# No scheduler row (demo console without #13): create the planned dose so the answer has a record.
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row = Dose(token=ctx.token, prescription_id=rx.id, planned_at=ctx.now, status="pending")
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ctx.session.add(row)
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await ctx.session.flush()
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dose_id = row.id
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pending = {"dose_id": dose_id, "drug": drug, "dose": dose, "day": ctx.now.date().isoformat()}
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text = t.text.format(drug=drug, dose=dose).replace(" ", " ") if drug else t.text_no_drug
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return Step(replies=[Reply(text=text, buttons=_reminder_buttons(), kind="question")], data={"med_pending": pending})
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def _stale(ctx: Ctx) -> Step | None:
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return None if pending_dose(ctx) is not None else Step(replies=[Reply(text=load_meds_texts().stale)])
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@trigger("button:med:taken")
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async def _taken(ctx: Ctx, event: Event) -> Step:
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if (stale := _stale(ctx)) is not None:
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return stale
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await record_dose(ctx, True)
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return Step(replies=[Reply(text=load_meds_texts().taken_ack)], notify_monitoring=True)
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@trigger("button:med:skip")
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async def _skip(ctx: Ctx, event: Event) -> Step:
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if (stale := _stale(ctx)) is not None:
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return stale
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await record_dose(ctx, False, status="skipped")
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t = load_meds_texts().skip
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buttons = [[Button(label=t.reasons[r], data=f"med:skip_reason:{r}")] for r in SKIP_REASONS]
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return Step(replies=[Reply(text=t.question, buttons=buttons, kind="question")], notify_monitoring=True)
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def _side_effect_question() -> Reply:
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t = load_meds_texts().side_effects
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buttons = [[Button(label=t.options[c], data=f"med:se:{c}")] for c in SIDE_EFFECT_CODES]
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return Reply(text=t.question, buttons=buttons, kind="question")
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def _skip_reason(reason: str) -> Any:
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async def handler(ctx: Ctx, event: Event) -> Step:
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if reason == "side_effects":
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return Step(replies=[_side_effect_question()])
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if reason == "quit":
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# «Решил бросить» is the same signal as "брошу" in free text: rule `quit_intent` reacts (alert +
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# delayed-onset explanation through the med_info action).
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await save_checkin(ctx, quit_intent=True)
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return Step(replies=[Reply(text=load_meds_texts().skip.ack["quit"])], notify_monitoring=True)
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return Step(replies=[Reply(text=load_meds_texts().skip.ack[reason])])
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return handler
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for _reason in SKIP_REASONS:
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trigger(f"button:med:skip_reason:{_reason}")(_skip_reason(_reason))
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@trigger("button:med:side_effects")
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async def _side_effects(ctx: Ctx, event: Event) -> Step:
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return Step(replies=[_side_effect_question()])
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async def _after_side_effects(ctx: Ctx, codes: list[str]) -> Step:
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await record_side_effects(ctx, codes)
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replies = [await side_effect_reply(ctx, codes)]
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today = await checkin_of(ctx, ctx.now.date())
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if (today is None or today.med_taken is None) and await current_prescription(ctx) is not None:
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t = load_meds_texts().side_effects
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buttons = [[Button(label=t.dose_yes, data="med:dose:yes")], [Button(label=t.dose_no, data="med:dose:no")]]
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replies.append(Reply(text=t.ask_dose, buttons=buttons, kind="question"))
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return Step(replies=replies, next_state="idle", notify_monitoring=True)
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def _side_effect_code(code: str) -> Any:
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async def handler(ctx: Ctx, event: Event) -> Step:
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if code == "other":
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return Step(
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replies=[Reply(text=load_meds_texts().side_effects.describe)], next_state=SIDE_EFFECT_TEXT_STATE
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)
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return await _after_side_effects(ctx, [code])
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return handler
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for _code in SIDE_EFFECT_CODES:
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trigger(f"button:med:se:{_code}")(_side_effect_code(_code))
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@state(SIDE_EFFECT_TEXT_STATE)
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async def _side_effect_text(ctx: Ctx, event: Event) -> Step:
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if event.type != "text" or ctx.text is None:
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return await leave_to_idle(ctx, event)
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facts = await ctx.gateway.extract_checkin(ctx.text)
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# Store only normalised codes, never the description itself (it stays in the scrubbed message log).
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codes = [str(c) for c in facts.side_effects] if facts is not None and facts.side_effects else ["other"]
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return await _after_side_effects(ctx, codes)
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def _dose_answer(taken: bool) -> Any:
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async def handler(ctx: Ctx, event: Event) -> Step:
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await record_dose(ctx, taken, status=None if taken else "missed")
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return Step(
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replies=[Reply(text=load_meds_texts().taken_ack if taken else load_meds_texts().skip.ack["other"])],
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notify_monitoring=True,
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)
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return handler
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trigger("button:med:dose:yes")(_dose_answer(True))
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trigger("button:med:dose:no")(_dose_answer(False))
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# ------------------------------------------------------------------------------------------- question menu
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@trigger("button:menu:med_question", replace=True)
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async def _menu_question(ctx: Ctx, event: Event) -> Step:
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t = load_meds_texts().question
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if await current_prescription(ctx) is None:
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return Step(replies=[menu_reply(ctx, t.no_prescription)])
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return Step(replies=[Reply(text=t.prompt)], next_state=QUESTION_STATE)
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async def answer_question(ctx: Ctx, rx: Rx | None) -> str:
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"""Answer from the instruction excerpt only (SPEC §7 п.5); dose questions and gaps → «уточните у врача»."""
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if rx is None or ctx.text is None:
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return load_meds_texts().question.no_prescription
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answer = await med_qa(rx.drug, ctx.text)
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return answer.text if answer is not None else fallback_text()
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@state(QUESTION_STATE)
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async def _question(ctx: Ctx, event: Event) -> Step:
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if event.type != "text" or ctx.text is None:
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return await leave_to_idle(ctx, event)
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text = await answer_question(ctx, await current_prescription(ctx))
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return Step(replies=[menu_reply(ctx, text)], next_state="idle")
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# ------------------------------------------------------------------------------------------- rule actions
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async def med_info_reply(ctx: Ctx, action: Action) -> Reply | None:
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"""`med_info` action of a rule (quit_intent → onset, alcohol_3d → alcohol): instruction excerpt framed by
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fixed texts. The rule already decided to say it; this only picks the words. None → engine template."""
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spec = load_meds_texts().med_info.get(str(action.params.get("topic")))
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if spec is None:
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return None
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rx = await current_prescription(ctx)
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answer = await med_qa(rx.drug, scrub(spec.question), topic=spec.section) if rx is not None else None
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body = answer.text if answer is not None else spec.fallback
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return Reply(text="\n\n".join(p for p in (spec.lead, body, spec.notice) if p), kind="info")
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register_med_info_handler(med_info_reply)
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Reference in New Issue
Block a user