Merge pull request #5818 from simpledotorg/master

Author: tramline-github[bot]

CHANGELOG.md

@@ -7,6 +7,10 @@
 - Bump Coroutines to v1.11.0
 - Bump Gradle to v9.5.1
 
+### Changes
+
+- Update Titration nudge threshold for diabetic patients in SriLanka from `140/90` to `130/80`
+
 ## 2026.05.11
 
 ### Internal

app/src/androidTest/java/org/simple/clinic/bp/BloodPressureRepositoryAndroidTest.kt

@@ -453,8 +453,8 @@ class BloodPressureRepositoryAndroidTest {
     val newestBpForPatient3 = TestData.bloodPressureMeasurement(
         uuid = UUID.fromString("3d948d3b-6d8f-4608-bde0-d8750fef75d4"),
         patientUuid = patient3Uuid,
-        systolic = 150,
-        diastolic = 90,
+        systolic = 135,
+        diastolic = 85,
         createdAt = Instant.parse("2000-01-01T00:03:00Z"),
         recordedAt = Instant.parse("2000-01-01T00:03:00Z"),
         updatedAt = Instant.parse("2000-01-01T00:03:00Z"),
@@ -475,9 +475,9 @@ class BloodPressureRepositoryAndroidTest {
     ))
 
     // when
-    val isNewestBpEntryHighForPatient1 = repository.isNewestBpEntryHigh(patient1Uuid).blockingFirst()
-    val isNewestBpEntryHighForPatient2 = repository.isNewestBpEntryHigh(patient2Uuid).blockingFirst()
-    val isNewestBpEntryHighForPatient3 = repository.isNewestBpEntryHigh(patient3Uuid).blockingFirst()
+    val isNewestBpEntryHighForPatient1 = repository.isNewestBpEntryHigh(patient1Uuid, isDiabeticPatient = false, isSriLankaEnabled = false).blockingFirst()
+    val isNewestBpEntryHighForPatient2 = repository.isNewestBpEntryHigh(patient2Uuid, isDiabeticPatient = true, isSriLankaEnabled = false).blockingFirst()
+    val isNewestBpEntryHighForPatient3 = repository.isNewestBpEntryHigh(patient3Uuid, isDiabeticPatient = true, isSriLankaEnabled = true).blockingFirst()
 
     // then
     assertThat(isNewestBpEntryHighForPatient1).isTrue()

app/src/main/java/org/simple/clinic/bp/BloodPressureMeasurement.kt

@@ -252,20 +252,25 @@ data class BloodPressureMeasurement(
     fun purgeBloodPressureMeasurementWhenPatientIsNull(): Int
 
     @Query("""
-      SELECT
-        CASE
-            WHEN (COUNT(BP.uuid) >= 1) THEN 1
-            ELSE 0
-        END
-      FROM BloodPressureMeasurement BP
-      WHERE
-        BP.patientUuid = :patientUuid AND
-        date(BP.recordedAt) == :currentDate AND
-        (BP.systolic >= 140 OR BP.diastolic >= 90) AND
-        BP.deletedAt IS NULL
-      ORDER BY BP.recordedAt DESC
-      LIMIT 1
-    """)
-    fun isNewestBpEntryHigh(patientUuid: UUID, currentDate: LocalDate): Observable<Boolean>
+    SELECT
+      CASE
+          WHEN (COUNT(BP.uuid) >= 1) THEN 1
+          ELSE 0
+      END
+    FROM BloodPressureMeasurement BP
+    WHERE
+      BP.patientUuid = :patientUuid AND
+      date(BP.recordedAt) == :currentDate AND
+      (BP.systolic >= :systolicThreshold OR BP.diastolic >= :diastolicThreshold) AND
+      BP.deletedAt IS NULL
+    ORDER BY BP.recordedAt DESC
+    LIMIT 1
+""")
+    fun isNewestBpEntryHigh(
+        patientUuid: UUID,
+        currentDate: LocalDate,
+        systolicThreshold: Int,
+        diastolicThreshold: Int
+    ): Observable<Boolean>
   }
 }

app/src/main/java/org/simple/clinic/bp/BloodPressureRepository.kt

@@ -166,9 +166,25 @@ class BloodPressureRepository @Inject constructor(
         )
   }
 
-  fun isNewestBpEntryHigh(patientUuid: UUID): Observable<Boolean> {
+  fun isNewestBpEntryHigh(
+      patientUuid: UUID,
+      isDiabeticPatient: Boolean,
+      isSriLankaEnabled: Boolean
+  ): Observable<Boolean> {
+
     val currentDate = LocalDate.now(utcClock)
 
-    return dao.isNewestBpEntryHigh(patientUuid = patientUuid, currentDate = currentDate)
+    val systolicThreshold =
+        if (isSriLankaEnabled && isDiabeticPatient) 130 else 140
+
+    val diastolicThreshold =
+        if (isSriLankaEnabled && isDiabeticPatient) 80 else 90
+
+    return dao.isNewestBpEntryHigh(
+        patientUuid = patientUuid,
+        currentDate = currentDate,
+        systolicThreshold = systolicThreshold,
+        diastolicThreshold = diastolicThreshold
+    )
   }
 }

app/src/main/java/org/simple/clinic/summary/PatientSummaryEffectHandler.kt

@@ -401,14 +401,38 @@ class PatientSummaryEffectHandler @AssistedInject constructor(
       effects
           .observeOn(schedulersProvider.io())
           .switchMap {
+
             val patientUuid = it.patientUuid
-            bloodPressureRepository.isNewestBpEntryHigh(patientUuid).map { Pair(patientUuid, it) }
+
+            val hasDiabetes =
+                medicalHistoryRepository.historyForPatientOrDefaultImmediate(
+                    defaultHistoryUuid = uuidGenerator.v4(),
+                    patientUuid = patientUuid
+                ).diagnosedWithDiabetes == MedicalHistoryAnswer.Yes
+
+            val isSriLanka =
+                country.isoCountryCode == Country.SRI_LANKA
+
+            bloodPressureRepository.isNewestBpEntryHigh(
+                patientUuid = patientUuid,
+                isDiabeticPatient = hasDiabetes,
+                isSriLankaEnabled = isSriLanka
+            ).map { isNewestBpEntryHigh ->
+              Pair(patientUuid, isNewestBpEntryHigh)
+            }
           }
           .switchMap { (patientUuid, isNewestBpEntryHigh) ->
-            prescriptionRepository.hasPrescriptionForPatientChangedToday(patientUuid).map { Pair(isNewestBpEntryHigh, it) }
+            prescriptionRepository
+                .hasPrescriptionForPatientChangedToday(patientUuid)
+                .map { hasPrescriptionsChangedToday ->
+                  Pair(isNewestBpEntryHigh, hasPrescriptionsChangedToday)
+                }
           }
           .map { (isNewestBpEntryHigh, hasPrescriptionsChangedToday) ->
-            ClinicalDecisionSupportInfoLoaded(isNewestBpEntryHigh, hasPrescriptionsChangedToday)
+            ClinicalDecisionSupportInfoLoaded(
+                isNewestBpEntryHigh,
+                hasPrescriptionsChangedToday
+            )
           }
     }
   }

app/src/test/java/org/simple/clinic/summary/PatientSummaryEffectHandlerTest.kt

@@ -652,7 +652,14 @@ class PatientSummaryEffectHandlerTest {
     // given
     val patientUuid = UUID.fromString("44daeb85-de4c-4807-8b31-6a88bf597cc7")
 
-    whenever(bloodPressureRepository.isNewestBpEntryHigh(patientUuid)).doReturn(Observable.just(true))
+    val medicalHistory = TestData.medicalHistory()
+
+    whenever(medicalHistoryRepository.historyForPatientOrDefaultImmediate(
+        defaultHistoryUuid = uuidGenerator.v4(),
+        patientUuid = patientUuid
+    )) doReturn medicalHistory
+
+    whenever(bloodPressureRepository.isNewestBpEntryHigh(patientUuid, medicalHistory.diagnosedWithDiabetes == Yes, false)).doReturn(Observable.just(true))
     whenever(prescriptionRepository.hasPrescriptionForPatientChangedToday(patientUuid)).doReturn(Observable.just(true))
 
     // when

app/src/test/java/org/simple/clinic/summary/PatientSummaryScreenLogicTest.kt

@@ -24,8 +24,7 @@ import org.simple.clinic.cvdrisk.calculator.NonLabBasedCVDRiskCalculator
 import org.simple.clinic.drugs.DiagnosisWarningPrescriptions
 import org.simple.clinic.drugs.PrescriptionRepository
 import org.simple.clinic.facility.FacilityRepository
-import org.simple.clinic.feature.Feature
-import org.simple.clinic.feature.Features
+import org.simple.clinic.medicalhistory.Answer
 import org.simple.clinic.medicalhistory.MedicalHistoryRepository
 import org.simple.clinic.overdue.Appointment.Status.Cancelled
 import org.simple.clinic.overdue.AppointmentCancelReason
@@ -35,11 +34,9 @@ import org.simple.clinic.patient.PatientRepository
 import org.simple.clinic.patient.businessid.Identifier
 import org.simple.clinic.patient.businessid.Identifier.IdentifierType.BpPassport
 import org.simple.clinic.patientattribute.PatientAttributeRepository
-import org.simple.clinic.remoteconfig.DefaultValueConfigReader
 import org.simple.clinic.summary.OpenIntention.LinkIdWithPatient
 import org.simple.clinic.summary.OpenIntention.ViewExistingPatient
 import org.simple.clinic.summary.OpenIntention.ViewNewPatient
-import org.simple.clinic.util.NoOpRemoteConfigService
 import org.simple.clinic.util.RxErrorsRule
 import org.simple.clinic.util.TestUserClock
 import org.simple.clinic.util.TestUtcClock
@@ -104,16 +101,17 @@ class PatientSummaryScreenLogicTest {
         .atZone(userClock.zone)
         .toInstant()
 
-    whenever(bpRepository.isNewestBpEntryHigh(patientUuid)) doReturn Observable.just(true)
+    val medicalHistory = TestData.medicalHistory(uuid = medicalHistoryUuid)
+    whenever(medicalHistoryRepository.historyForPatientOrDefaultImmediate(
+        defaultHistoryUuid = uuidGenerator.v4(),
+        patientUuid = patientUuid
+    )) doReturn medicalHistory
+    whenever(bpRepository.isNewestBpEntryHigh(patientUuid, isDiabeticPatient = medicalHistory.diagnosedWithDiabetes == Answer.Yes, isSriLankaEnabled = false)) doReturn Observable.just(true)
     whenever(patientRepository.patientProfile(patientUuid)) doReturn Observable.just(Optional.of(patientProfile))
     whenever(patientRepository.latestPhoneNumberForPatient(patientUuid)) doReturn Optional.empty()
     whenever(appointmentRepository.lastCreatedAppointmentForPatient(patientUuid)) doReturn Optional.empty()
     whenever(bpRepository.hasBPRecordedToday(patientUuid, today)) doReturn Observable.just(true)
     whenever(facilityRepository.facility(assignedFacilityUuid)) doReturn Optional.of(TestData.facility())
-    whenever(medicalHistoryRepository.historyForPatientOrDefaultImmediate(
-        defaultHistoryUuid = uuidGenerator.v4(),
-        patientUuid = patientUuid
-    )) doReturn TestData.medicalHistory(uuid = medicalHistoryUuid)
     whenever(prescriptionRepository.newestPrescriptionsForPatientImmediate(patientUuid)) doReturn emptyList()
   }