Identifying updates to the VMP <DRUG_FORM> code attribute in Dictionary of medicines and devices (dm+d)

This update gives guidance on how to identify the new drug forms and the Virtual Medicinal Products (VMPs) that have been linked to the new drug forms. Appendix 1 New drug forms, lists the new drug forms and the relevant less detailed existing drug forms.

The existing drug forms are still valid forms and will continue to exist and be used for example, where the VMP:

• has the route ‘Route of administration not applicable’
• has no route information
• where the VMP has 3 or more routes

No drug forms will be removed from the XML files although some may no longer be associated with any VMPs.

There are 2 phases to this work, the drug forms being changed in each phase are identified in Appendix 1.

It is assumed that users:

1. Understand dm+d terminology and know what VTMs, VMPs, etc. concepts are.
2. Already get dm+d data and have access.
3. Know how to write queries in their environment whether a database, querying the Terminology Server or some other method.

Additional information is available:

• NHSBSA dm+d
• NHS England dm+d
• the NHS England Terminology Server 

 dm+d data is available from:

• TRUD, NHS England’s web site for downloading Terminology data. These are the data files that can be loaded into a database or similar
• the Terminology Server: a Web API that can be queried directly. The Terminology Server is kept up to date by sourcing the data from TRUD as it becomes available

Examples of how to query the relevant dm+d data sources to identify VMPs with the new or existing drug form codes are given below.

The drug form is recorded in dm+d within the VMP concept class.

The whole of dm+d data is released each week therefore this document describes how to retrieve only VMPs with a specific drug form code. To identify the new drug form codes, see Appendix 1.

The entity relationship diagram below is the basic structure of linking VMP concepts to their assigned form.

This is an example SQL statement that will enable most SQL databases to query the above structure.

This code list of FORMCD codes should contain the codes of the newly created forms that you are interested in for example 420692007 Oral capsule.

This section advises how the history data might be used along with the identifying new drug form codes and the new drug form codes found in Appendix 1.

Over time the code allocated to a VMP concept in dm+d may have been been updated as dm+d aligns to the SNOMED CT data. dm+d holds the history of VMP codes, using the history data it is possible to identify if the Form Code is likely to have changed.

By getting all the historic codes for a given VMP code we can identify the earliest start date that the VMP concept was added to dm+d, if this date is earlier than the dates below it is likely that the VMP changed from an existing Drug Form code to a new Drug Form code

• Sample batch, ointment extraction date Monday 28 August 2023
• Phase 1 extraction date from dm+d Monday 20 November 2023
• Phase 2 extraction date from dm+d over several weeks in Quarter 1 2024

See dm+d History Data File Guide for detailed information about the history data.

The entity relationship diagram below is the basic structure of linking VMP concepts to the VMP history data.

SQL code that will get the oldest start date for a VMP concept. This date can then be used to identify if it is before the relevant date. In the SQL below replace <VMP.VPID> with the current VMP identifier.

The terminology server will return a list of all the codes for a VMP, to identify the earliest start date will require processing in the local programming language.

See dm+d Code System in NHS Terminology Server for more detail about dm+d history code data in the terminology server.

The following information will allow the querying of the Terminology Server to return all historic VMP code information for the current VMP identifier. In the URL below replace <VMP.VPID> with the current VMP identifier, 1 or more codes will be returned.

If any further information is required contact [email protected].

The following codes were correct at the time the document was published.

There are two phases to the drug forms work.

This table lists the existing drug forms and the new drug forms which are being used to update VMP concepts. Please note that for VMPs with no route information, route of administration not applicable, where there are 3 or more routes or VMPs marked as invalid, these VMPs will retain the existing drug form.

Code 385049006 Capsule

Code 385099005 Cream 

Code 421166008 Foam 

Code 385100002 Gel 

Code 385043007 Granules 

Code 385101003 Ointment 

Code 739002006 Paste 

Code 385055001 Tablet 

The tables below list the existing drug forms and the new drug forms which are being used to update VMP concepts. Please note that for VMPs with no route information, route of administration not applicable, where there are 3 or more routes or VMPs marked as invalid, these VMPs will retain the existing drug form.

Code 385286003 Implant

Code 16602411000001103 Implantation suspension

Code 3092911000001109 Irrigation

*The code {42550811000001100} was released in the dm+d extract 15 January 2024 with the description ‘Powder and solvent for intraocular instillation irrigation‘. The description was renamed ‘Powder and solvent for solution for intraocular irrigation’ in the dm+d extract 29 January 2024.

Code 16605211000001107 Irrigation solution

Code 739005008 Powder

Code 420699003 Liquid