Implementation guide for digital medicines

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

Worked Examples

Example A

VTM = Oxytetracycline | 22969001

Dose = 250 milligram

Step 1: Get child products (VMPs and AMPs) of the VTM

There are five valid and available VMPs. None are flagged in a way that require additional AMPs to be listed.

dm+d concept Product
VMP Oxytetracycline 100mg/5ml oral suspension
VMP Oxytetracycline 125mg/5ml oral suspension
VMP Oxytetracycline 250mg tablets
VMP Oxytetracycline 250mg/5ml oral suspension
VMP Oxytetracycline 500mg/5ml oral suspension

Step 2: Calculate the required quantity of each VMP to fulfil the requested dose

dm+d concept Product Quantity Calculation Unit of Measure
VMP Oxytetracycline 100mg/5ml oral suspension 250 / (20/1) = 12.5 ml
VMP Oxytetracycline 125mg/5ml oral suspension 250 / (25/1) = 10 ml
VMP Oxytetracycline 250mg tablets 250 / (250) = 1 tablet
VMP Oxytetracycline 250mg/5ml oral suspension 250 / (50) = 5 ml
VMP Oxytetracycline 500mg/5ml oral suspension 250 / (100/1) = 2.5 ml

Step 3: Order the list of products in a clinically suitable order

Product Quantity (to fulfil 250 milligrams)
Oxytetracycline 250mg tablets 1 tablet
Oxytetracycline 250mg/5ml oral suspension 5 ml
Oxytetracycline 125mg/5ml oral suspension 10 ml
Oxytetracycline 500mg/5ml oral suspension 2.5 ml
Oxytetracycline 100mg/5ml oral suspension 12.5 ml

Example B

VTM = Salbutamol | 91143003

Dose = 200 micrograms

Route = Inhalation | 18679011000001101

Step 1: Get child products (VMPs and AMPs) of the VTM

There are two valid and available VMPs, but both are flagged as Caution - AMP level prescribing advised so we also query for valid and available AMPs.

dm+d concept Product
VMPSalbutamol 100micrograms/dose breath actuated inhaler CFC free
-- AMPAiromir 100micrograms/dose Autohaler (Teva UK Ltd)
-- AMPSalamol 100micrograms/dose Easi-Breathe inhaler (CST Pharma Ltd)
-- AMPSalamol 100micrograms/dose Easi-Breathe inhaler (Teva UK Ltd)
VMPSalbutamol 100micrograms/dose inhaler CFC free
-- AMPAiromir 100micrograms/dose inhaler (Teva UK Ltd)
-- AMPSalamol 100micrograms/dose inhaler CFC free (Teva UK Ltd)
--AMPVentolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd)

Step 2: Calculate the required quantity of each VMP to fulfil the requested dose

dm+d concept Product Quantity Calculation Unit of Measure
VMP Salbutamol 100micrograms/dose breath actuated inhaler CFC free 200 / (100) = 2 dose
-- AMPAiromir 100micrograms/dose Autohaler (Teva UK Ltd) 200 / (100) = 2 dose
-- AMPSalamol 100micrograms/dose Easi-Breathe inhaler (CST Pharma Ltd) 200 / (100) = 2 dose
-- AMPSalamol 100micrograms/dose Easi-Breathe inhaler (Teva UK Ltd) 200 / (100) = 2 dose
VMPSalbutamol 100micrograms/dose inhaler CFC free 200 / (100) = 2 dose
-- AMPAiromir 100micrograms/dose inhaler (Teva UK Ltd) 200 / (100) = 2 dose
-- AMPSalamol 100micrograms/dose inhaler CFC free (Teva UK Ltd) 200 / (100) = 2 dose
--AMPVentolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd) 200 / (100) = 2 dose

Step 3: Order the list of products in a clinically suitable order

As all products can be used with the same quantity, the order could be alphabetical or ordered as per any local formulary.

Product Quantity (to fulfil 200 micrograms)
Salbutamol 100micrograms/dose breath actuated inhaler CFC free
Note: Caution - AMP level prescribing advised
2 dose
Airomir 100micrograms/dose Autohaler (Teva UK Ltd) 2 dose
Salamol 100micrograms/dose Easi-Breathe inhaler (CST Pharma Ltd) 2 dose
Salamol 100micrograms/dose Easi-Breathe inhaler (Teva UK Ltd) 2 dose
Salbutamol 100micrograms/dose inhaler CFC free
Note: Caution - AMP level prescribing advised
2 dose
Airomir 100micrograms/dose inhaler (Teva UK Ltd) 2 dose
Salamol 100micrograms/dose inhaler CFC free (Teva UK Ltd) 2 dose
Ventolin 100micrograms/dose Evohaler (GlaxoSmithKline UK Ltd) 2 dose

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