tests/test_dialog_meds.py

@@ -0,0 +1,372 @@
+"""Medication flow and check-in units (#37): reminder buttons, skip reasons, side effects, medication question,
+med_info rule reactions, check-in edge cases, text policy of the YAML files."""
+
+from collections.abc import AsyncIterator
+from datetime import datetime, timedelta
+from pathlib import Path
+from typing import Any
+
+import pytest
+import yaml
+from sqlalchemy import select
+
+from app.config import Settings, get_settings
+from app.core import clock
+from app.core.rules import Action
+from app.db import repo, session
+from app.db.bootstrap import init_db
+from app.db.clinical import Dose, Prescription
+from app.dialog.contracts import Event, Reply
+from app.dialog.engine import Engine
+from app.dialog.flows.meds import load_meds_texts
+from app.dialog.flows.veteran_daily import load_daily_texts
+from app.dialog.fsm import Ctx, enter_hook_for
+from app.dialog.scale_session import start_scale
+from app.dialog.texts import load_dialog_texts
+from app.integrations.base import DrugSection, integrations
+from app.llm import med_qa as med_qa_module
+from app.llm.gateway import LLMGateway
+from app.llm.med_qa import fallback_text
+from app.llm.mock import MockTasks
+
+TOKEN = "m" * 32
+MEM = "sqlite+aiosqlite:///:memory:"
+NOW = datetime(2026, 10, 7, 8, 0)
+MEDS = load_meds_texts()
+DAILY = load_daily_texts()
+SECTIONS = {
+    "side_effects": "Тошнота обычно возникает в первые дни приёма и проходит в течение 1–2 недель.",
+    "onset": "Улучшение обычно отмечается через 2–4 недели регулярного приёма.",
+    "alcohol": "Совместный приём с алкоголем не рекомендуется.",
+    "administration": "Препарат принимают один раз в сутки, утром или вечером, независимо от еды.",
+}
+
+
+class FakeDrugInfo:
+    async def sections(self, inn: str) -> list[DrugSection]:
+        return [DrugSection(inn=inn, section=k, text=v, source="синтетика") for k, v in SECTIONS.items()]
+
+
+class ScriptedMonitoring:
+    def __init__(self) -> None:
+        self.calls = 0
+        self.actions: list[Action] = []
+
+    async def after_data_change(self, token: str) -> list[Action]:
+        self.calls += 1
+        out, self.actions = self.actions, []
+        return out
+
+    async def is_in_crisis(self, token: str) -> bool:
+        return False
+
+
+@pytest.fixture
+async def mon(monkeypatch: pytest.MonkeyPatch) -> AsyncIterator[ScriptedMonitoring]:
+    monkeypatch.setattr(clock, "get_settings", lambda: Settings(_env_file=None, demo_clock=True))
+    monkeypatch.setattr(integrations, "drug_info", FakeDrugInfo())
+    monkeypatch.setattr(med_qa_module, "get_gateway", lambda: LLMGateway(MockTasks()))
+    clock.set_now(NOW)
+    await session.configure(identity_url=MEM, clinical_url=MEM)
+    await init_db()
+    async with session.get_clinical_session() as s:
+        await repo.upsert_profile(
+            s, token=TOKEN, doctor_id="doc", modules=["veteran"], sex="m", birth_year=1990, therapy_start=NOW.date()
+        )
+        s.add(Prescription(token=TOKEN, drug="сертралин", dose="50 мг", schedule={"times": ["08:00"]}))
+        await repo.set_dialog_state(s, token=TOKEN, state="idle", data={"consent": True}, now=clock.now())
+    yield ScriptedMonitoring()
+    clock.reset()
+    await session.configure()
+
+
+@pytest.fixture
+def engine(mon: ScriptedMonitoring) -> Engine:
+    return Engine(gateway=LLMGateway(MockTasks()), monitoring=mon)
+
+
+async def press(e: Engine, data: str) -> list[Reply]:
+    return await e.handle(TOKEN, Event(type="button", button=data))
+
+
+async def text(e: Engine, t: str) -> list[Reply]:
+    return await e.handle(TOKEN, Event(type="text", text=t))
+
+
+async def system(e: Engine, kind: str, **params: Any) -> list[Reply]:
+    return await e.handle(TOKEN, Event(type="system", system=kind, params=params))  # type: ignore[arg-type]
+
+
+def buttons(replies: list[Reply]) -> list[str]:
+    return [b.data for r in replies for row in r.buttons for b in row]
+
+
+async def get_state() -> tuple[str, dict[str, Any]]:
+    async with session.get_clinical_session() as s:
+        row = await repo.get_dialog_state(s, TOKEN)
+        assert row is not None
+        return row.state, dict(row.data)
+
+
+async def checkin() -> Any:
+    async with session.get_clinical_session() as s:
+        rows = await repo.list_checkins(s, TOKEN)
+        return rows[-1] if rows else None
+
+
+async def doses() -> list[Dose]:
+    async with session.get_clinical_session() as s:
+        return list((await s.scalars(select(Dose).where(Dose.token == TOKEN).order_by(Dose.id))).all())
+
+
+# ----------------------------------------------------------------------------------------------- reminder
+
+
+async def test_reminder_without_dose_id_creates_dose_and_taken(engine: Engine, mon: ScriptedMonitoring) -> None:
+    r = await system(engine, "med_reminder")
+    assert r[0].text == MEDS.reminder.text.format(drug="сертралин", dose="50 мг")
+    assert buttons(r) == ["med:taken", "med:skip", "med:side_effects"]
+    [dose] = await doses()
+    assert dose.status == "pending"
+    r = await press(engine, "med:taken")
+    assert r[0].text == MEDS.taken_ack and mon.calls == 1
+    [dose] = await doses()
+    assert dose.status == "taken" and dose.answered_at is not None
+    assert (await checkin()).med_taken is True
+
+
+async def test_stale_reminder_button(engine: Engine) -> None:
+    await system(engine, "med_reminder")
+    clock.advance(days=1)
+    r = await press(engine, "med:taken")
+    assert r[0].text == MEDS.stale and await checkin() is None
+
+
+@pytest.mark.parametrize("reason", ["forgot", "other"])
+async def test_skip_simple_reasons(engine: Engine, reason: str) -> None:
+    await system(engine, "med_reminder")
+    r = await press(engine, "med:skip")
+    assert buttons(r) == [f"med:skip_reason:{x}" for x in ("forgot", "side_effects", "quit", "other")]
+    r = await press(engine, f"med:skip_reason:{reason}")
+    assert r[0].text == MEDS.skip.ack[reason]
+    c = await checkin()
+    assert c.med_taken is False and not c.quit_intent
+    assert [d.status for d in await doses()] == ["skipped"]
+
+
+async def test_skip_quit_sets_intent_and_explains(engine: Engine, mon: ScriptedMonitoring) -> None:
+    await system(engine, "med_reminder")
+    await press(engine, "med:skip")
+    mon.actions = [Action(type="med_info", code="quit_intent", params={"topic": "delayed_effect"})]
+    r = await press(engine, "med:skip_reason:quit")
+    assert r[0].text == MEDS.skip.ack["quit"]
+    assert "2–4 недели" in r[1].text and MEDS.med_info["delayed_effect"].notice in r[1].text
+    assert (await checkin()).quit_intent is True
+
+
+async def test_skip_because_of_side_effects_asks_which(engine: Engine) -> None:
+    await system(engine, "med_reminder")
+    await press(engine, "med:skip")
+    r = await press(engine, "med:skip_reason:side_effects")
+    assert "med:se:nausea" in buttons(r) and "med:se:other" in buttons(r)
+
+
+async def test_side_effect_button(engine: Engine, mon: ScriptedMonitoring) -> None:
+    await system(engine, "med_reminder")
+    r = await press(engine, "med:side_effects")
+    assert buttons(r) == [f"med:se:{c}" for c in ("nausea", "insomnia", "headache", "dizziness", "agitation", "other")]
+    r = await press(engine, "med:se:nausea")
+    assert "проходит в течение 1–2 недель" in r[0].text  # instruction excerpt
+    assert r[1].text == MEDS.side_effects.ask_dose and buttons(r[1:]) == ["med:dose:yes", "med:dose:no"]
+    assert (await checkin()).side_effects == ["nausea"]
+    assert (await doses())[0].side_effects == "nausea"
+    r = await press(engine, "med:dose:yes")
+    assert (await checkin()).med_taken is True and (await doses())[0].status == "taken"
+
+
+async def test_side_effect_other_free_text(engine: Engine) -> None:
+    await system(engine, "med_reminder")
+    await press(engine, "med:side_effects")
+    r = await press(engine, "med:se:other")
+    assert r[0].text == MEDS.side_effects.describe and (await get_state())[0] == "meds.side_effect_text"
+    r = await text(engine, "голова болит весь день")
+    assert (await checkin()).side_effects == ["headache"] and (await get_state())[0] == "idle"
+    await press(engine, "med:side_effects")
+    await press(engine, "med:se:other")
+    await text(engine, "какое-то странное ощущение")
+    assert (await checkin()).side_effects == ["headache", "other"]
+
+
+async def test_same_side_effect_as_yesterday_gets_support(engine: Engine) -> None:
+    async with session.get_clinical_session() as s:
+        await repo.upsert_checkin(
+            s, token=TOKEN, day=clock.today() - timedelta(days=1), now=clock.now(), side_effects=["nausea"]
+        )
+    await system(engine, "med_reminder")
+    r = await press(engine, "med:se:nausea")
+    assert r[0].text == MEDS.side_effects.repeat
+
+
+# ----------------------------------------------------------------------------------------------- question menu
+
+
+async def test_med_question_menu(engine: Engine) -> None:
+    r = await press(engine, "menu:med_question")
+    assert r[0].text == MEDS.question.prompt and (await get_state())[0] == "meds.question"
+    r = await text(engine, "можно ли пить алкоголь?")
+    assert "Совместный приём с алкоголем не рекомендуется" in r[0].text and (await get_state())[0] == "idle"
+    await press(engine, "menu:med_question")
+    r = await text(engine, "можно увеличить дозу до 100 мг?")
+    assert r[0].text == fallback_text()
+
+
+async def test_med_question_menu_left_by_button(engine: Engine) -> None:
+    await press(engine, "menu:med_question")
+    r = await press(engine, "menu:checkin")
+    assert r[0].text == DAILY.checkin.start and (await get_state())[0] == "daily.mood"
+
+
+async def test_med_question_without_prescription(engine: Engine) -> None:
+    async with session.get_clinical_session() as s:
+        for row in await s.scalars(select(Prescription)):
+            await s.delete(row)
+    r = await press(engine, "menu:med_question")
+    assert r[0].text == MEDS.question.no_prescription and (await get_state())[0] == "idle"
+
+
+async def test_med_info_without_excerpt_uses_fixed_text(
+    engine: Engine, mon: ScriptedMonitoring, monkeypatch: pytest.MonkeyPatch
+) -> None:
+    class Empty:
+        async def sections(self, inn: str) -> list[DrugSection]:
+            return []
+
+    monkeypatch.setattr(integrations, "drug_info", Empty())
+    mon.actions = [Action(type="med_info", code="alcohol_3d", params={"topic": "alcohol_interaction"})]
+    r = await press(engine, "menu:visit")  # any data-writing step runs monitoring
+    spec = MEDS.med_info["alcohol_interaction"]
+    assert r[0].text == DAILY.visit.requested
+    assert r[1].text == "\n\n".join([spec.lead, spec.fallback, spec.notice])
+    assert (await get_state())[1]["visit_requests"]
+
+
+async def test_idle_free_text_med_question_and_side_effect(engine: Engine, mon: ScriptedMonitoring) -> None:
+    r = await text(engine, "когда подействуют таблетки?")
+    assert "2–4 недели" in r[0].text and "menu:checkin" in buttons(r)
+    r = await text(engine, "подташнивает после таблеток")
+    assert "проходит в течение 1–2 недель" in r[0].text and (await checkin()).side_effects == ["nausea"]
+    assert mon.calls == 1
+
+
+# ----------------------------------------------------------------------------------------------- check-in edges
+
+
+async def test_checkin_asks_dose_when_not_answered_and_typed_mood(engine: Engine) -> None:
+    await system(engine, "daily_checkin")
+    r = await text(engine, "отлично")
+    assert DAILY.checkin.buttons_hint in r[0].text and (await get_state())[0] == "daily.mood"
+    r = await text(engine, "7")
+    assert r[0].text == MEDS.checkin.question.format(drug="сертралин")
+    await press(engine, "daily:med:no")
+    c = await checkin()
+    assert (c.mood, c.med_taken) == (7, False)
+    assert (await get_state())[0] == "daily.sleep"
+
+
+async def test_reminder_during_checkin_keeps_checkin(engine: Engine) -> None:
+    await system(engine, "daily_checkin")
+    r = await system(engine, "med_reminder")
+    assert buttons(r[:1]) == ["med:taken", "med:skip", "med:side_effects"] and r[-1].text == DAILY.checkin.mood.question
+    r = await press(engine, "med:taken")
+    assert r[0].text == MEDS.taken_ack and (await get_state())[0] == "daily.mood"
+    await press(engine, "daily:mood:5")
+    assert (await get_state())[0] == "daily.sleep"  # dose already answered → no med question
+
+
+async def test_unfinished_checkin_dropped_next_day(engine: Engine) -> None:
+    await system(engine, "daily_checkin")
+    await press(engine, "daily:mood:2")
+    clock.advance(days=1)
+    r = await system(engine, "daily_checkin")
+    assert r[0].text == DAILY.checkin.start and (await get_state())[0] == "daily.mood"
+
+
+async def test_checkin_once_a_day(engine: Engine) -> None:
+    await system(engine, "daily_checkin")
+    for b in ("daily:mood:6", "daily:med:yes", "daily:sleep:6-8", "daily:nightmares:no", "daily:alcohol:none"):
+        await press(engine, b)
+    await press(engine, "daily:text:skip")
+    assert await system(engine, "daily_checkin") == []
+    r = await press(engine, "menu:checkin")
+    assert r[0].text == DAILY.checkin.already_done
+
+
+async def test_alcohol_clarify_for_non_veteran(engine: Engine) -> None:
+    async with session.get_clinical_session() as s:
+        await repo.upsert_profile(s, token=TOKEN, modules=["depression"])
+    await system(engine, "daily_checkin")
+    await press(engine, "daily:mood:5")
+    r = await press(engine, "daily:med:yes")
+    assert buttons(r) == ["daily:text:skip"]  # no sleep / alcohol questions outside the veteran module
+    r = await text(engine, "вечером выпил пива с друзьями")
+    assert r[-1].text == DAILY.checkin.alcohol.clarify and (await get_state())[0] == "daily.alcohol_amount"
+    r = await press(engine, "daily:alcohol_amount:more")
+    assert r[0].text == DAILY.checkin.done and (await checkin()).alcohol_bucket == "more"
+
+
+async def test_buttons_win_over_llm(engine: Engine) -> None:
+    await system(engine, "daily_checkin")
+    for b in ("daily:mood:5", "daily:med:yes", "daily:sleep:6-8", "daily:nightmares:no", "daily:alcohol:none"):
+        await press(engine, b)
+    await text(engine, "почти не спал, кошмары, брошу таблетки")
+    c = await checkin()
+    assert (c.sleep_bucket, c.nightmares, c.alcohol_bucket, c.quit_intent) == ("6-8", False, "none", True)
+    assert c.free_text_scrubbed
+
+
+async def test_scale_intro_not_added_to_onboarding(engine: Engine, mon: ScriptedMonitoring) -> None:
+    await system(engine, "scale_due", scale="dar5", scheduled=True)
+    state, data = await get_state()
+    assert state == "scale.dar5" and data["scales"]["dar5"]["intro"] == DAILY.scale_intros.scheduled["dar5"]
+
+    async with session.get_clinical_session() as s:
+        ctx = Ctx(
+            token=TOKEN,
+            state="idle",
+            data={},
+            now=clock.now(),
+            session=s,
+            gateway=LLMGateway(MockTasks()),
+            monitoring=mon,
+            texts=load_dialog_texts(),
+        )
+        step = await start_scale(ctx, "pcl5", return_state="veteran.onboarding.phq9")
+        ctx.data.update(step.data)
+        ctx.state = "scale.pcl5"
+        hook = enter_hook_for("scale.pcl5")
+        assert hook is not None
+        entered = await hook(ctx)
+    assert DAILY.scale_intros.scheduled["pcl5"] not in entered.replies[0].text
+
+
+# ----------------------------------------------------------------------------------------------- text policy
+
+
+def _strings(node: Any) -> list[str]:
+    if isinstance(node, str):
+        return [node]
+    if isinstance(node, dict):
+        return [s for v in node.values() for s in _strings(v)]
+    if isinstance(node, list):
+        return [s for v in node for s in _strings(v)]
+    return []
+
+
+@pytest.mark.parametrize("name", ["meds.yaml", "veteran_daily.yaml"])
+def test_texts_policy(name: str) -> None:
+    path: Path = get_settings().config_dir / "texts" / name
+    raw = path.read_text(encoding="utf-8")
+    assert "черновик, утверждает психиатр (#8)" in raw.splitlines()[2]
+    values = " ".join(_strings(yaml.safe_load(raw))).lower()
+    for word in ("учёт", "учет", "контрол", "надзор", "диагноз", "птср", "депресси", "увеличьте доз", "мг"):
+        assert word not in values, (name, word)

tests/test_dialog_veteran_days.py

@@ -0,0 +1,388 @@
+"""Acceptance: 13 days of the veteran Andrey (docs/product/01_demo_persona.md) through the real dialog engine.
+
+Andrey is set up post-onboarding directly in the DBs (no dependency on #36): modules veteran + depression,
+therapy day 0, sertraline 50 mg at 08:00, consent. Each day: the dose reminder (as the scheduler would send it)
+→ button; the daily check-in → buttons + the free text from the table.
+
+Lane B's MonitoringService (#38) is replaced by a double that builds a `PatientSnapshot` from the clinical DB,
+runs the REAL `app.core.rules.evaluate`, persists alert/crisis actions (so dedup works) and returns the dialog
+actions — the same split as the frozen contract (ADR-007). Drug instruction excerpts are synthetic (FakeDrugInfo).
+"""
+
+from collections.abc import AsyncIterator
+from datetime import date, datetime, timedelta
+from typing import Any
+
+import pytest
+from sqlalchemy import func, select
+
+from app.config import Settings
+from app.core import clock
+from app.core.rules import Action, DailyCheckin, DoseRecord, PatientSnapshot, ScalePoint, evaluate, patient_status
+from app.core.scales import load_scale
+from app.core.types import AlertLevel
+from app.db import identity_repo, repo, session
+from app.db.bootstrap import init_db
+from app.db.clinical import Dose, Message, Prescription
+from app.dialog.contracts import Event, Reply
+from app.dialog.engine import Engine
+from app.dialog.flows.meds import load_meds_texts
+from app.dialog.flows.veteran_daily import load_daily_texts
+from app.integrations.base import DrugSection, integrations
+from app.llm import med_qa as med_qa_module
+from app.llm.gateway import LLMGateway
+from app.llm.mock import MockTasks
+from app.services import contracts as monitoring_contracts
+
+TOKEN = "e" * 32
+MEM = "sqlite+aiosqlite:///:memory:"
+DAY0 = datetime(2026, 10, 5, 8, 0)  # visit day; reminders at 08:00, check-ins at 20:00 (Europe/Moscow)
+SRC = "ГРЛС: тестовая выдержка (синтетика)"
+SERTRALINE = {
+    "side_effects": (
+        "Наиболее частые нежелательные реакции в начале терапии: тошнота, диарея, сухость во рту. "
+        "Тошнота обычно возникает в первые дни приёма и проходит в течение 1–2 недель. "
+        "Для уменьшения тошноты препарат принимают после еды."
+    ),
+    "onset": (
+        "Терапевтический эффект развивается постепенно. "
+        "Улучшение обычно отмечается через 2–4 недели регулярного приёма. "
+        "Суточная доза может увеличиваться врачом до 200 мг."
+    ),
+    "alcohol": (
+        "Совместный приём с алкоголем не рекомендуется. "
+        "Алкоголь может ухудшать сон и настроение и усиливать побочные эффекты."
+    ),
+}
+
+# Persona table: day → (dose taken, mood, sleep, nightmares, alcohol, free text). "" = skip the free text.
+TABLE: dict[int, tuple[bool, int, str, bool, str, str]] = {
+    1: (True, 4, "4-6", True, "none", ""),
+    2: (True, 4, "4-6", True, "none", "подташнивает с утра"),
+    3: (True, 4, "4-6", True, "none", "опять тошнит"),
+    4: (True, 3, "4-6", False, "none", "тошнота не проходит"),
+    5: (False, 3, "4-6", False, "none", "от таблеток только хуже, брошу"),
+    6: (True, 4, "6-8", False, "none", "врач позвонил, продолжаю"),
+    7: (True, 4, "6-8", False, "none", ""),
+    8: (True, 4, "<4", True, "1-2", "снится одно и то же"),
+    9: (True, 4, "<4", True, "more", ""),
+    10: (True, 4, "<4", True, "more", "без пива не могу уснуть"),
+    11: (True, 3, "4-6", False, "1-2", ""),
+    12: (True, 3, "4-6", False, "none", ""),
+    13: (True, 2, "<4", True, "none", "всё бессмысленно, устал от всего"),
+}
+# Expected dashboard colour at the end of each day (persona: 🟢🟢🟢🟡🟡🟢🟢🟢🟢🟡🟡🟡🔴).
+COLORS = ["green"] * 3 + ["yellow"] * 2 + ["green"] * 4 + ["yellow"] * 3 + ["red"]
+
+
+class FakeDrugInfo:
+    async def sections(self, inn: str) -> list[DrugSection]:
+        if inn != "сертралин":
+            return []
+        return [DrugSection(inn=inn, section=k, text=v, source=SRC) for k, v in SERTRALINE.items()]
+
+
+class RuleMonitoring:
+    """Test double of lane B's MonitoringService: real rules over a snapshot of the clinical DB."""
+
+    def __init__(self) -> None:
+        self.fired: list[str] = []
+
+    async def _snapshot(self, s: Any, token: str) -> PatientSnapshot:
+        now = clock.now()
+        profile = await repo.get_profile(s, token)
+        assert profile is not None and profile.therapy_start is not None and profile.birth_year is not None
+        checkins = [
+            DailyCheckin(
+                day=c.day,
+                mood=c.mood,
+                med_taken=c.med_taken,
+                sleep_hours_bucket=c.sleep_bucket,  # type: ignore[arg-type]
+                alcohol=c.alcohol_bucket,  # type: ignore[arg-type]
+                side_effects=list(c.side_effects or []),
+                quit_intent=bool(c.quit_intent),
+                nightmares=c.nightmares,
+            )
+            for c in await repo.list_checkins(s, token)
+        ]
+        results = [r for r in await repo.list_scale_results(s, token) if r.complete]
+        doses = (await s.scalars(select(Dose).where(Dose.token == token, Dose.status != "pending"))).all()
+        cssrs = [r for r in results if r.scale == "cssrs_screen"]
+        last_in = await s.scalar(select(func.max(Message.ts)).where(Message.token == token, Message.direction == "in"))
+        return PatientSnapshot(
+            token=token,
+            as_of=now,
+            age=now.year - profile.birth_year,
+            sex=profile.sex,  # type: ignore[arg-type]
+            modules=set(profile.modules),  # type: ignore[arg-type]
+            therapy_day=(now.date() - profile.therapy_start).days,
+            checkins=checkins,
+            scale_results=[
+                ScalePoint(scale=r.scale, ts=r.ts, total=r.total, item9=r.item9, scheduled=r.scheduled)
+                for r in results
+                if r.scale != "cssrs_screen"
+            ],
+            doses=[DoseRecord(planned_at=d.planned_at, status=d.status) for d in doses],  # type: ignore[arg-type]
+            cssrs_risk=cssrs[-1].severity if cssrs else None,  # type: ignore[arg-type]
+            weapon_access=False,
+            last_patient_message_at=last_in,
+            open_alert_codes=await repo.open_alert_codes(s, token),
+        )
+
+    async def after_data_change(self, token: str) -> list[Action]:
+        async with session.get_clinical_session() as s:
+            actions = evaluate(await self._snapshot(s, token))
+            for a in actions:
+                if a.creates_alert:
+                    assert a.level is not None
+                    await repo.add_alert(
+                        s, token=token, level=a.level, code=a.code, reason=a.reason_ru, ts=clock.now(), params=a.params
+                    )
+        self.fired += [a.code for a in actions]
+        return [a for a in actions if a.type != "alert"]
+
+    async def is_in_crisis(self, token: str) -> bool:
+        async with session.get_clinical_session() as s:
+            alerts = await repo.list_alerts(s, token=token, open_only=True)
+        return any(a.level == "acute" for a in alerts)
+
+
+# ----------------------------------------------------------------------------------------------- fixtures
+
+
+@pytest.fixture
+async def andrey(monkeypatch: pytest.MonkeyPatch) -> AsyncIterator[RuleMonitoring]:
+    monkeypatch.setattr(clock, "get_settings", lambda: Settings(_env_file=None, demo_clock=True))
+    monkeypatch.setattr(integrations, "drug_info", FakeDrugInfo())
+    monkeypatch.setattr(med_qa_module, "get_gateway", lambda: LLMGateway(MockTasks()))
+    clock.set_now(DAY0)
+    await session.configure(identity_url=MEM, clinical_url=MEM)
+    await init_db()
+    now = clock.now()
+    async with session.get_identity_session() as s:
+        await identity_repo.create_patient(
+            s,
+            token=TOKEN,
+            display_name="Андрей С. (синтетика)",
+            snils="000-000-000 00",
+            clinic_id="c1",
+            doctor_id="doc-smirnova",
+            now=now,
+            birth_year=1992,
+            sex="m",
+        )
+        await identity_repo.record_consent(s, token=TOKEN, version="v1", now=now)
+    async with session.get_clinical_session() as s:
+        await repo.upsert_profile(
+            s,
+            token=TOKEN,
+            doctor_id="doc-smirnova",
+            modules=["veteran", "depression"],
+            therapy_start=now.date(),
+            next_visit=now.date() + timedelta(days=28),
+            birth_year=1992,
+            sex="m",
+        )
+        s.add(
+            Prescription(
+                token=TOKEN, drug="сертралин", dose="50 мг", schedule={"times": ["08:00"]}, start_date=now.date()
+            )
+        )
+        screening = now - timedelta(days=3)  # day −3 screening (persona)
+        for scale, total in (("pcptsd5", 4), ("pcl5", 46), ("phq9", 14), ("auditc", 3)):
+            await repo.add_scale_result(
+                s,
+                token=TOKEN,
+                scale=scale,
+                total=total,
+                severity="-",
+                complete=True,
+                ts=screening,
+                item9=0 if scale == "phq9" else None,
+            )
+        await repo.set_dialog_state(s, token=TOKEN, state="idle", data={"consent": True, "adult": True}, now=now)
+    mon = RuleMonitoring()
+    monitoring_contracts.get_monitoring()  # import lane B's module first if it exists, then override it
+    previous = monitoring_contracts._factory
+    monitoring_contracts.register_monitoring(lambda: mon)
+    yield mon
+    monitoring_contracts.register_monitoring(previous)
+    clock.reset()
+    await session.configure()
+
+
+# ----------------------------------------------------------------------------------------------- helpers
+
+
+class Andrey:
+    def __init__(self) -> None:
+        self.engine = Engine(gateway=LLMGateway(MockTasks()))  # monitoring resolved via register_monitoring
+
+    async def text(self, t: str) -> list[Reply]:
+        return await self.engine.handle(TOKEN, Event(type="text", text=t))
+
+    async def press(self, data: str) -> list[Reply]:
+        return await self.engine.handle(TOKEN, Event(type="button", button=data))
+
+    async def system(self, kind: str, **params: Any) -> list[Reply]:
+        return await self.engine.handle(TOKEN, Event(type="system", system=kind, params=params))  # type: ignore[arg-type]
+
+    async def answer_scale(self, scale_id: str, values: list[int]) -> list[Reply]:
+        out: list[Reply] = []
+        for item, value in zip(load_scale(scale_id).items, values, strict=True):
+            out += await self.press(f"scale:{scale_id}:{item.id}:{value}")
+        return out
+
+
+def buttons(replies: list[Reply]) -> list[str]:
+    return [b.data for r in replies for row in r.buttons for b in row]
+
+
+def joined(replies: list[Reply]) -> str:
+    return "\n".join(r.text for r in replies)
+
+
+async def state() -> tuple[str, dict[str, Any]]:
+    async with session.get_clinical_session() as s:
+        row = await repo.get_dialog_state(s, TOKEN)
+        assert row is not None
+        return row.state, dict(row.data)
+
+
+async def open_alerts() -> list[Any]:
+    async with session.get_clinical_session() as s:
+        return list(await repo.list_alerts(s, token=TOKEN, open_only=True))
+
+
+async def ack_all() -> None:
+    async with session.get_clinical_session() as s:
+        for a in await repo.list_alerts(s, token=TOKEN, open_only=True):
+            await repo.ack_alert(s, alert_id=a.id, doctor_id="doc-smirnova", ts=clock.now())
+
+
+async def new_dose(day: date) -> int:
+    """What the scheduler (#13) does before sending the reminder: a planned dose row."""
+    async with session.get_clinical_session() as s:
+        rx = await s.scalar(select(Prescription).where(Prescription.token == TOKEN))
+        assert rx is not None
+        row = Dose(token=TOKEN, prescription_id=rx.id, planned_at=clock.now(), status="pending")
+        s.add(row)
+        await s.flush()
+        return row.id
+
+
+# ----------------------------------------------------------------------------------------------- the 13 days
+
+
+async def test_andrey_13_days(andrey: RuleMonitoring) -> None:
+    a = Andrey()
+    meds = load_meds_texts()
+    daily = load_daily_texts()
+    log: dict[int, list[Reply]] = {}
+    colors: list[str] = []
+
+    for day in range(1, 14):
+        taken, mood, sleep, nightmares, alcohol, free_text = TABLE[day]
+        clock.set_now(DAY0 + timedelta(days=day))
+        if day == 6:
+            await ack_all()  # the doctor called Andrey after the day-5 alerts and acknowledged them
+        r: list[Reply] = []
+
+        # --- 08:00 dose reminder
+        dose_id = await new_dose(clock.today())
+        reminder = await a.system("med_reminder", dose_id=dose_id, drug="сертралин", dose="50 мг")
+        assert "сертралин 50 мг" in reminder[0].text
+        assert buttons(reminder) == ["med:taken", "med:skip", "med:side_effects"]
+        if taken:
+            r += await a.press("med:taken")
+        else:
+            skip = await a.press("med:skip")
+            assert "med:skip_reason:quit" in buttons(skip)
+            r += skip + await a.press("med:skip_reason:quit")
+
+        # --- day 7: scheduled scales (PCL-5 = 44, PHQ-9 = 13, item 9 = 0) with friendly intros
+        if day == 7:
+            first = await a.system("scale_due", scale="pcl5", scheduled=True)
+            assert daily.scale_intros.scheduled["pcl5"] in first[0].text
+            await a.system("scale_due", scale="phq9", scheduled=True)  # queued behind PCL-5
+            after_pcl = await a.answer_scale("pcl5", [2] * 16 + [3] * 4)
+            assert daily.scale_intros.scheduled["phq9"] in after_pcl[-1].text
+            await a.answer_scale("phq9", [2] * 5 + [1] * 3 + [0])
+            assert (await state())[0] == "idle"
+
+        # --- 20:00 daily check-in
+        clock.set_now(DAY0 + timedelta(days=day, hours=12))
+        start = await a.system("daily_checkin")
+        assert start[0].text == daily.checkin.start and buttons(start)[0] == "daily:mood:0"
+        r += await a.press(f"daily:mood:{mood}")  # dose already answered by the reminder → no med question
+        assert "daily:sleep:<4" in buttons(r[-1:])
+        r += await a.press(f"daily:sleep:{sleep}")
+        r += await a.press(f"daily:nightmares:{'yes' if nightmares else 'no'}")
+        r += await a.press(f"daily:alcohol:{alcohol}")
+        assert buttons(r[-1:]) == ["daily:text:skip"]
+        r += await a.text(free_text) if free_text else await a.press("daily:text:skip")
+        log[day] = r
+        if day == 10:  # «записаться раньше» offered by rule alcohol_3d
+            visit = await a.press("menu:visit")
+            assert visit[0].text == daily.visit.requested and (await state())[1]["visit_requests"]
+
+        if day == 13:
+            break  # the crisis path is checked below
+        assert (await state())[0] == "idle"
+        colors.append(patient_status(AlertLevel[x.level.upper()] for x in await open_alerts()).color)
+
+    # Day 2: first nausea → instruction excerpt (med_qa, section side_effects), not generated advice.
+    assert "По инструкции к препарату" in joined(log[2]) and "проходит в течение 1–2 недель" in joined(log[2])
+    # Day 3: same effect again → short support, the instruction is not repeated.
+    assert meds.side_effects.repeat in joined(log[3]) and "По инструкции" not in joined(log[3])
+    # Day 5: «решил бросить» → rule quit_intent → delayed onset + do not stop on your own + doctor notified.
+    day5 = joined(log[5])
+    assert "2–4 недели" in day5 and "не прекращайте" in day5 and meds.med_info["delayed_effect"].notice in day5
+    assert "200 мг" not in day5  # dosing sentences of the instruction are never quoted
+    # Day 10: sleep < 4 h ×3 + alcohol ×3 → interaction info + «записаться раньше».
+    day10 = joined(log[10])
+    assert "Совместный приём с алкоголем не рекомендуется" in day10
+    assert buttons(log[10])[-1] == "menu:visit"
+    # Day 11: alerts still open → the rule stays silent (no repeated interaction text).
+    assert "Совместный приём с алкоголем" not in joined(log[11]) and "menu:visit" not in buttons(log[11])
+    assert colors == COLORS[:12]
+
+    # Day 13: «всё бессмысленно» → POSSIBLE → C-SSRS screen (buttons only) took over the free text.
+    day13 = log[13]
+    assert day13[-1].kind == "question" and "scale:cssrs_screen:cssrs_1:0" in buttons(day13[-1:])
+    r = await a.answer_scale("cssrs_screen", [0] * 6)
+    # Back in the check-in: the message counts as the answer → check-in closed → mood ≤ 3 three days →
+    # unscheduled PHQ-9 with its own intro.
+    assert daily.checkin.done in joined(r) and daily.scale_intros.unscheduled["phq9"] in r[-1].text
+    st, data = await state()
+    assert st == "scale.phq9" and data["scales"]["phq9"]["scheduled"] is False
+    r = await a.answer_scale("phq9", [2] * 8 + [2])  # total 18, item 9 = 2
+    assert any(x.kind == "crisis" for x in r) and any(x.kind == "safety_plan" for x in r)
+    st, data = await state()
+    assert data["crisis"]["open"] is True and st in ("crisis", "scale.cssrs_screen")
+    acute = [x for x in await open_alerts() if x.level == "acute"]
+    assert [x.code for x in acute] == ["phq9_item9"]
+    assert patient_status(AlertLevel[x.level.upper()] for x in await open_alerts()).color == COLORS[12]
+
+    # Stored check-ins match the persona table.
+    async with session.get_clinical_session() as s:
+        rows = {c.day: c for c in await repo.list_checkins(s, TOKEN)}
+        doses = (await s.scalars(select(Dose).where(Dose.token == TOKEN).order_by(Dose.id))).all()
+        phq = list(await repo.list_scale_results(s, TOKEN, "phq9"))
+    for day, (taken, mood, sleep, nightmares, alcohol, _text) in TABLE.items():
+        c = rows[(DAY0 + timedelta(days=day)).date()]
+        assert (c.med_taken, c.mood, c.sleep_bucket, c.nightmares, c.alcohol_bucket) == (
+            taken,
+            mood,
+            sleep,
+            nightmares,
+            alcohol,
+        ), day
+    for day in (2, 3, 4):
+        assert "nausea" in rows[(DAY0 + timedelta(days=day)).date()].side_effects
+    assert rows[(DAY0 + timedelta(days=5)).date()].quit_intent is True
+    assert rows[(DAY0 + timedelta(days=13)).date()].free_text_scrubbed is None  # taken over by the C-SSRS
+    assert [d.status for d in doses] == ["skipped" if d == 5 else "taken" for d in range(1, 14)]
+    assert [(p.total, p.item9, p.scheduled) for p in phq] == [(14, 0, True), (13, 0, True), (18, 2, False)]
+    for code in ("side_effect_3d", "quit_intent", "sleep_lt4_3n", "alcohol_3d", "mood_low_3d", "phq9_item9"):
+        assert code in andrey.fired, code