Getting Strength and Dose Information Separately from SNOMED CT Drug Concept

General enquiries
1

Hi all. I would like quick clarification. Can the FHIR Terminology server API help in getting Product, Strength, Dose from given SNOMED CT Code. eg Paracetamol 100 mg tablets. In that I would like to get Each information separately like Paracetamol, 100mg,tablets. If possible can you guide me with links, so that I can go through it. Thanks in Advance.

2

Hello @Bhargav_V

NHS dictionary of medicines and devices (dm+d) is the preferred drug data to use if you are working in the NHS environment. This post details where you can get further information about dm+d and the terminology server. I will do another post detailing how to get the relevant information you are after.

Further information on dm+d is available:

To understand the structure of dm+d I would advise watching this video: An introduction to dm+d 5-box data model

dm+d is available on the Terminology Server and a video on how to query dm+d (for picking lists) on the terminology server is available here: dictionary of medicines and devices (dm+d) - NHS England Digital.

Finally see the technical document detailing all the dm+d data in the terminology server.

3

Hello again @Bhargav_V

This post assumes you understand the dm+d structure if not watch An introduction to dm+d 5-box data model.

In the UK there is not a Paracetamol 100mg tablet so I will use the example of paracetamol 500mg tablet. I will use a naming convention of displaying the dm+d code and the description of that code in between pipe symbols (vertical lines like this |), for example 42109611000001109 |Paracetamol 500mg tablets|.

42109611000001109 |Paracetamol 500mg tablets| is a VMP and this shows the drug, strength of form. Drug = Paracetamol, strength (of paracetamol) = 500mg and form = tablets.

  1. Drug: There are two ways of getting the drug dependant on what you want:
  • VTM: the VMP will have 2 parent codes one telling you it is a “VMP” and another will link to the VTM, the parent of this drug will be 777067000 |Paracetamol|
  • Active ingredient: the VMP has a property VPI which holds the active ingredient and its strength (the next part of what you want). Note: for some drugs the active ingredient might be a more specific salt than the more generic VTM. To get active ingredient strength see dm+d code system in NHS Terminology Server section “Ingredient Data – sub-properties” (page 9).

  1. Strength: A VMP has active ingredient strength information held against the VPI property. To get active ingredient strength see dm+d code system in NHS Terminology Server section “Ingredient Data – sub-properties” (page 9).

  2. Form: The form of a drug is held at the VMP level against a property called FORMCD. When you query this field on the terminology server it will return the “code” and the “system” the code is defined in. To get the description of the code you will then need to re-query the terminology server, with the “system” and “code” data to get the display.

I hope this helps.

4

Hi. Thanks for the reply. I will go through the links and understand it and will come back. Yes our product is going to be built in NHS Environment.

5

Just been re-reading the query again. I should have added that the VMPs in SNOMED CT UK Drug Extension do not have active ingredient strength information. However we are currently doing a big piece of work to align UK drug data with SNOMED international drug model and the active ingredient strength should be appearing at some point. For further information see UK Medicines Terminology Futures - NHS England Digital.