Dose syntax implementation guidance for FHIR STU3

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd), two to be taken once a week, start one week before travel and continue until 4 weeks after return

Product-based prescription (AMP) using patient instruction for start and duration.

Complex because the instruction to “start one week before travel and continue until 4 weeks after return” cannot be a coded instruction so is conveyed as free-text within patientlInstruction.

<MedicationRequest xmlns="http://hl7.org/fhir">
    <id value="1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98" />
    <contained>
        <Medication>
            <id value="med1" />
            <code>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="3727711000001102" />
                    <display value="Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)" />
                </coding>
            </code>
        </Medication>
    </contained>
    <status value="active" />
    <intent value="order" />
    <medicationReference>
        <reference value="#med1" />
    </medicationReference>
    <subject>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9999999999" />
        </identifier>
    </subject>
    <dosageInstruction>
        <patientInstruction value="start one week before travel and continue until 4 weeks after return" />
        <timing>
            <repeat>
                <frequency value="1" />
                <period value="1" />
                <periodUnit value="wk" />
            </repeat>
        </timing>
        <doseQuantity>
            <value value="2" />
            <unit value="tablet" />
            <system value="http://snomed.info/sct" />
            <code value="428673006" />
        </doseQuantity>
    </dosageInstruction>
</MedicationRequest>

{
    "resourceType": "MedicationRequest",
    "id": "1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98",
    "contained":  [
        {
            "resourceType": "Medication",
            "id": "med1",
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "3727711000001102",
                        "display": "Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)"
                    }
                ]
            }
        }
    ],
    "status": "active",
    "intent": "order",
    "medicationReference": {
        "reference": "#med1"
    },
    "subject": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9999999999"
        }
    },
    "dosageInstruction":  [
        {
            "patientInstruction": "start one week before travel and continue until 4 weeks after return",
            "timing": {
                "repeat": {
                    "frequency": 1,
                    "period": 1,
                    "periodUnit": "wk"
                }
            },
            "doseQuantity": {
                "value": 2,
                "unit": "tablet",
                "system": "http://snomed.info/sct",
                "code": "428673006"
            }
        }
    ]
}
MedicationRequest.id[0]1d0bc824-f2bf-42c8-b7f9-954e7f6bbd98
MedicationRequest.contained[0].id[0]med1
MedicationRequest.contained[0].code[0].coding[0].system[0]http://snomed.info/sct
MedicationRequest.contained[0].code[0].coding[0].code[0]3727711000001102
MedicationRequest.contained[0].code[0].coding[0].display[0]Avloclor 250mg tablets (Alliance Pharmaceuticals Ltd)
MedicationRequest.status[0]active
MedicationRequest.intent[0]order
MedicationRequest.medication[0].reference[0]#med1
MedicationRequest.subject[0].identifier[0].system[0]https://fhir.nhs.uk/Id/nhs-number
MedicationRequest.subject[0].identifier[0].value[0]9999999999
MedicationRequest.dosageInstruction[0].patientInstruction[0]start one week before travel and continue until 4 weeks after return
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0]1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0]wk
MedicationRequest.dosageInstruction[0].dose[0].value[0]2
MedicationRequest.dosageInstruction[0].dose[0].unit[0]tablet
MedicationRequest.dosageInstruction[0].dose[0].system[0]http://snomed.info/sct
MedicationRequest.dosageInstruction[0].dose[0].code[0]428673006
MedicationRequest
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