Virtual v ActualĪ description starting with “actual” is a real product description: it describes a medicine or device that has been made available by a specific manufacturer or supplier, much like when a doctor prescribes by brand.Ī description starting with “virtual” is an abstract description: it describes a general class of medicine or device that may be available as an “actual” product, much like when a doctor prescribes generically. There are a bewildering number of data fields in NHS dm+d we describe the most important ones here. Summary level descriptions of most important concepts We have already started to implement new analyses utilising this structured data, such as our recent herbal measure. The dm+d makes more advanced filtering possible, such as listing all medicines delivered by injection, or all drugs not allowed to be prescribed in primary care. We previously described a simple but really useful feature of the dm+d, allowing us to show user-friendly names of medicines on OpenPrescribing. At OpenPrescribing, we have linked prescribing data to dm+d, which means we can make use of the richer data that it provides. The stated primary use of the NHS dm+d is to improve ‘Interoperability’, which means computers talking to each other in the manner described above - but there are lots of other uses. All NHS systems will soon be using dm+d, facilitating the transfer of medicines data between software and computers across the entire NHS. Fortunately, the NHS has now mandated the use of dm+d. This is one reason why your GP can’t see what medicines you have been prescribed on a hospital ward. ![]() Last month over 62 million prescriptions were sent through the Spine, all facilitated by dm+d.īy contrast, a large hospital may have anywhere between 50 and 100 clinical software systems, each using a different coding system, which means they cannot talk or transfer information easily between them. The dm+d code and quantity is transferred securely over the NHS “Spine”, which delivers it to your pharmacy computer for dispensing. For example, when your doctor generates a prescription on their computer, they select the items you need from the dm+d. ![]() All computer systems in primary care now communicate by exchanging dm+d codes with each other. These codes and descriptions are very important when dealing with large amounts of data, to allow computers to operate consistently. Why is it important to have a standard NHS Dictionary of Medicines and Devices? At last count it contained over 150,000 packs of medicines and devices. It contains standardised codes, descriptions, and metadata (such as price and pack size) for every entry. What is the NHS Dictionary of Medicines and Devices (dm+d)?ĭm+d is the standard dictionary for the medicines and devices used across the NHS. This blog post sets out to describe dm+d for the benefit of the wider prescribing analytics community and others. We also discuss the CIOMS initiative on Standardised MedDRA Queries and describe the work of CIOMS in producing standard definitions for adverse reactions terms.Over the past year we have been increasingly using NHS Dictionary of Medicines and Devices (dm+d). We briefly consider various approaches to database searches and data retrieval, with an outline of some of the problems relating to data analysis and tabulation. We present details of the structure and principal conventions used in MedDRA, together with an outline of how term selection is performed. MedDRA is a large hierarchical multi-axial terminology that includes terms for medical diagnoses, signs and symptoms, syndromes, qualitative investigation findings, medical and surgical procedures, and social circumstances. We present the regulatory requirements for the use of MedDRA, with information about the maintenance of the dictionary and how new terms are added and other changes effected. These adverse reactions dictionaries and disease classifications have been widely used in the pharmacovigilance environment in the past, but following the adoption of the Medical Dictionary for Regulatory Activities (MedDRA®) as an international standard in many organizations, the use of some of them in this context has declined. We also briefly cover the SNOMED Disease Nomenclature. ![]() We present the structure and hierarchy of the WHO Adverse Reaction Terminology, as well as the elements of the International Classifications of Diseases (ICD 9, ICD 9-CM, and ICD 10). Here we review the features and applications of some dictionaries used for classifying medicines, adverse reactions, and medical conditions, and briefly explore the concept of the anatomical–therapeutic–chemical classification of drugs, the structure of the World Health Organization's drug dictionary, and the EudraVigilance Medicinal Product Dictionary.
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