Some inconsistencies in dm+d strength denominator

[richiecroker]

While writing the view to provide conversion from e.g. grams to milligrams, I found some small inconsistencies in denominator strengths.

One issue was that all versions of macrogol unit dose sachets (e.g. Macrogol compound oral powder sachets NPF sugar free) have a denominator value of 1 litre, and a numerator value of various values, e.g. 105g of macrogol.

I'm assuming this is because e.g. Cosmocol has 13.125g of macrogol, to be made up with 125ml of water, giving a concentration of 105g/l.

However, this is different to other unit dose sachets that require constitution appear on dm+d, e.g.
Amoxicillin 3g oral powder sachets sugar free
Fosfomycin 3g granules sachets
Ispaghula husk 3.5g granules sachets gluten free sugar free

It may be due to macrogol having multiple chemical substances in it, but it would be useful to check.

[richiecroker]

Emailed BSA on June 20th, and chased on July 3rd:

Original email:

Hi dm+d team

We use the features of dm+d a lot at OpenPrescribing, and have started to use it to classify our numerators and denominators, rather than BNF codes, as we can allow for changes in prescribing habits (e.g. our updated pregabalin measure uses dm+d to calculate mg strengths, meaning that any new product, e.g. pregabalin tablets, are picked up). This has been a real enhancement to our work, so thank you.

I’ve just got a couple of queries on specific drugs, and would be grateful for your input:

Macrogol sachets
One issue I have found is that all versions of macrogol unit dose sachets (e.g. Macrogol compound oral powder sachets NPF sugar free) have a denominator value of 1 litre, and a numerator value of various values, e.g. 105g of macrogol. I'm assuming this is because e.g. Cosmocol has 13.125g of macrogol, to be made up with 125ml of water, giving a concentration of 105g/l.
However, this is different to other unit dose sachets that require constitution appear on dm+d, e.g.
Amoxicillin 3g oral powder sachets sugar free
Fosfomycin 3g granules sachets
Ispaghula husk 3.5g granules sachets gluten free sugar free
It may be due to macrogol having multiple chemical substances in it, but it would be useful to check what the rationale is for this, and why it’s different to other sachets.

Inhaler naming

We’ve been trying to create a measure identifying an increased use of refills of inhalers where possible, in line with the Greener NHS agenda. One way we were trying to do it was via a partial string match in the VMP. However, there appears to be some inconsistency in naming of some inhalers in dm+d where both device and refill versions exist.
For example:
Olodaterol 2.5micrograms/dose inhalation solution cartridge CFC free
vs
Olodaterol 2.5micrograms/dose solution for inhalation cartridge with device CFC free
Therefore using partial string matching (everything prior to the "with device") would not identify the refill in this case, or some others.
I was wondering whether this is deliberate, and if not, if there was the possibility of a name change, as we won’t be able to identify refills without it.

Many thanks in advance.

[richiecroker]

Reply following chase on 3rd July:

Hi

Sorry no not even read it yet Richard.
I’m the only full-time pharmacist at the NHSBSA who works on dm+d.
I’ve just got to write a paper for the DHSC next and then I’ll have a look with some Band 4/Band 5 staff.

Sincere apologies.