During April and May 2023
Initial consultation with users by feedback survey and follow up calls where required.
A small sample of five ‘enema’ VMPs that had the drug form of ‘foam’ and the route of ‘rectal’ were updated in dm+d to the form of Rectal foam in Week 18, Release 5.0.0. These were:
- Budesonide 2mg foam enema
- Hydrocortisone 1% / Pramocaine 1% foam enema - all Actual Medicinal Products (AMPs) discontinued
- Hydrocortisone 10% foam enema - all AMPs discontinued
- Mesalazine 1g/application foam enema
- Prednsiolone 20mg/application foam enema
Website update with examples of new forms.
Further engagement with stakeholders and the opportunity for stakeholders and users to provide feedback on the proposals.
July 2023 - 2 drug forms were identified as only requiring their description to be updated – Paint and Wash.
- Paint (3095111000001104) became Cutaneous paint (3095111000001104)
- Wash (3097511000001104) became Cutaneous wash (3097511000001104)
Where the new form has been agreed the SNOMED code and description of the form will appear in the NHS dm+d Lookup XML file however these descriptions and codes will not be attached to VMPs until the date confirmed (see below).
Updating the ‘<DRUG_FORM>’ attribute will begin with a sample batch. The sample batch will include the new drug forms for ‘Ointment’ and will be updated in the TRUD extract Monday 28 August 2023.
What will happen with the Ointment Sample Batch
Below is a table showing the existing forms of ‘Ointment’ in NHS dm+d and the new Ointment forms that were released in TRUD extract Monday 31 July 2023:
|Inhalation vapour ointment
|Cutaneous or nasal ointment
The sample batch will result in all VMPs that have the coded form of 385101003 ointment being reviewed. The VMP will either:
- retain the existing form of ointment
- will be updated to one of the new ‘ointment forms’
- will be updated to an existing ointment form if that is more appropriate
Retain the existing form of ointment
The following VMPs will retain the existing form of ointment:
- where the VMP has 3 or more ‘routes’, such as Lidocaine ointment
- where the VMP has the route ‘Route of Administration not applicable’, such as combination products and special order products
- where there is no route information (Nil), such as ointments that are medical devices
- invalid concepts will not be updated and so will retain their existing form
Updated to a ‘new form’
The following will be updated to a 'new form':
- where the VMP has a route of auricular the VMP drug form will be updated to ear ointment
- where the VMP has a route of cutaneous the VMP drug form will be updated to cutaneous ointment
- where the VMP has the routes cutaneous and nasal the VMP drug form will be updated to cutaneous or nasal ointment
- where the VMP has a route of transdermal the VMP drug form will be updated to transdermal ointment
Updated to an ‘existing form’
The following will be updated to an 'existing form':
- where the VMP has the routes of Cutaneous and Rectal the VMP drug form will be updated to Rectal ointment
The dm+d definition of transdermal is under review as it no longer aligns with the EDQM definition.
EDQM transdermal use is for systemic effect only whilst dm+d allows local and systemic effect. dm+d intends to align to the EDQM definition which will result in:
- 1 ‘ointment’ VMP having the new drug form of transdermal ointment
- a number of special order ‘ointment’ products that currently have the route of transdermal will have this route removed and the route of ‘Route of administration not applicable’ applied - these VMPs will then retain the existing form of ‘ointment’
- 3 other ‘ointment’ VMPs that currently have the route of transdermal will have this route removed and the route of cutaneous added (as they are applied to obtain a local effect) and these will become cutaneous ointments.
The exact date that the updating of the forms will occur has yet to be finalised but this information is to provide advance notice to users to allow them to make any preparations for the changes.
We are planning for the ‘<DRUG_FORM>’ changes to be made in 2 phases. Phase 1 is expected to take place towards the end of 2023 and will consist of:
The remaining‘<DRUG_FORM>’ changes (Phase 2) are expected to take place in early 2024.