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Medications

Medications HTML view
Section code Section name TPP EMIS Vision Microtest
MED Medications Yes Yes Yes Yes

Clinical narrative

A drug or other form of medicine that is used to treat or prevent disease.

Purpose

The purpose of this section is to provide a history of medication prescribing as recorded.

Sections and subsections

Contains one main section, and five subsections:

Section title

The section title MUST be ‘Medications’.

Date filter

A date filter is applicable to this section. The date filter MUST be applied to the All Medication and All Medication Issues subsections only. All other subsections MUST return all records as defined in the subsection descriptions below, subject to exclusions.

Section content banner

Provider message describing at a summary level how they have populated this section.

Acute Medication (Last 12 Months)

Clinical narrative

A list of acute medicines that are currently being, or have recently been, used to treat or prevent disease for the patient. The provider MUST include all acute medication whose Start Date (the date the prescription is expected to start) is greater than the current date minus 365 days.

This is aligned to the Acute Medications section in Summary Care Records (SCR).

Purpose

The purpose of this section is to provide a view of acute medications that the patient has recently been taking, which informs the clinical decision-making process.

Subsection title

The subsection title MUST be ‘Acute Medication (Last 12 Months)’.

Date filter

All relevant records MUST be returned.

Subsection content banner

Provider message describing at a summary level how they have populated this subsection.

Providers MUST return the following message, if applicable:

<div>
	<p>Scheduled End Date is not always captured in the source; where it was not recorded, the displayed date is calculated from start date and days duration</p>
</div>

Table columns

Providers MUST return all the columns as described in the table below, sorted by Start Date descending:

Order Name Description Value details
1 Type Type of medication issued (for example, Acute, Acute Post-Dated, Acute - [Prescribing Agency Type]1). free-text
2 Start Date The date of issue of the acute medications, except where:
  • the medication is post-dated it MUST be the post date
  • the medication is prescribed elsewhere it MUST be the expected start date if known, else the entered date
dd-Mmm-yyyy
3 Medication Item Descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
4 Dosage Instruction Dosage instructions for the medication item. As a minimum, this MUST include:
  • Dosage Rate
  • Schedule (when / how often)

for example, two to be taken daily

free-text
5 Quantity Quantity details for the medication item. As a minimum, this MUST include:
  • Quantity
  • Quantity unit

for example, 14 capsule

free-text
6 Scheduled End Date The date the prescription is expected to finish. dd-Mmm-yyyy
7 Days Duration Duration of medication issued in days. integer
8 Additional Information If the medication record includes the information, the following details MUST be included (each item MUST be separated with a line break):
  • CONTROLLED DRUG label in bold text
  • CANCELLED: label with cancellation date and reason
  • Reason for the medication
  • Linked problems / diagnoses
  • Other supporting information

The provider MAY include labels in addition to the ones specified to support additional text (for example, Linked Problem : Ear Infection).

free-text

1 Where the medication was Prescribed Elsewhere the prescribing agency (type of organisation responsible for authorising and issuing the medication) MUST be included with the Type, for example, ‘Acute – Dentist’. If the medication item is identifiable as prescribed elsewhere but the type of organisation who prescribed it is not recorded, then the Type MUST be returned as ‘Acute – Unknown Prescriber’.

Current Repeat Medication

Clinical narrative

A list of repeat drugs or other forms of medicines that are currently being used to treat or prevent disease for the patient. This may also include PRN occasional use medication - for example, EpiPen, antihistamines, monitoring or continence products.

The provider MUST include all repeat and repeat dispensed medications (templates/plans/courses NOT individual issues) which have not been discontinued or otherwise ended. Repeat medications (including repeat dispense) which have not been discontinued are considered current where the Effective End Date (the date the cycle of prescriptions is expected to end) is either greater than the current date or is null. This MUST include those which have been authorised but not yet issued (Last Issued and Number Issued will be null).

Purpose

The purpose of this section is to provide a view of all repeat medications that the patient is currently prescribed, which informs the clinical decision-making process.

This is aligned to the Repeat Medications section in Summary Care Records (SCR).

Subsection title

The subsection title MUST be ‘Current Repeat Medication’.

Date filter

All relevant records MUST be returned (that is, no time limit/filtering is to be applied).

Subsection content banner

Provider message describing at a summary level how they have populated this subsection.

Providers MUST return the following message, if applicable:

<div>
	<p>The Review Date is that set for each Repeat Course. Reviews may be conducted according to a diary event which differs from the dates shown</p>
</div>

Table columns

Providers MUST return all the columns as described in the table below, sorted by Start Date descending:

Order Name Description Value details
1 Type Type of medication issued (for example, Repeat, Repeat Dispense, Repeat – [Prescribing Agency Type]). free-text
2 Start Date The original date of authorisation of the repeat medication (if a provider system allows re-authorisation of a repeat medication the start date MUST be the first authorisation). If this is not known (for example, for prescribed elsewhere) then date of entry of the repeat medication record MUST be returned. dd-Mmm-yyyy
3 Medication Item Descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
4 Dosage Instruction Dosage instructions for the medication item. As a minimum, this MUST include:
  • Dosage Rate
  • Schedule (when / how often)

for example, two to be taken daily

free-text
5 Quantity Quantity details for the medication item. As a minimum, this MUST include:
  • Quantity
  • Quantity unit

for example, 14 capsule

free-text
6 Last Issued Date The last issue date. If the medication is repeat dispense or prescribed elsewhere this MUST be null. dd-Mmm-yyyy
7 Number of Prescriptions Issued This MUST be the number issued up to the current date inclusive. For a repeat dispense this will be null. This MUST be null where no issues of the repeat have been made at the current date. If the medication is repeat dispensed or prescribed elsewhere this MUST be null. integer
8 Max Issues The maximum number of issues the repeat prescription has authorised. integer
9 Review Date The date the repeat medication is due for review. dd-Mmm-yyyy
10 Additional Information If the medication record includes the information, the following details MUST be included (each item MUST be separated with a line break):
  • CONTROLLED DRUG label in bold text
  • Reason for the medication
  • Linked problems / diagnoses
  • For Repeat Dispense, the date of the last authorisation and the number of prescription issues authorised
  • Other supporting information

The provider MAY include labels in addition to the ones specified to support additional text (for example, Linked Problem : Heart Failure).

free-text
Note: If the provider system allows the repeat medication (course/template) details to be amend so it differs from the latest prescription issued, then
  • the latest details for the medication (course/template) MUST be returned by the provider
  • a subsection banner message MUST be added such as: the medication below is taken from a list of Repeat Medication Templates in the patient record which may have been amended since they were last issued. See the All Medication Issues subsection for all repeat prescriptions issued.

Discontinued Repeat Medication

Clinical narrative

A list of discontinued repeat drugs or other forms of medicines. This may also include PRN occasional use medication - for example, EpiPen, antihistamines, monitoring or continence products.

Purpose

The purpose of this section is to provide a view of all discontinued repeat medications that the patient has been prescribed and the circumstances for discontinuing the medication, which informs the clinical decision-making process.

This MUST include repeat medications discontinued by a clinician action.

This MUST NOT include repeat medications expired by system processes, for example, automatically expiring a medication which has not been issued for a given period of time.

This is aligned to the Discontinued Repeat Medications section in SCR, but is not limited to six months.

Subsection title

The subsection title MUST be ‘Discontinued Repeat Medication’.

Date filter

All relevant records MUST be returned (that is, no time limit/filtering is to be applied).

Subsection content banner

Provider message describing at a summary level how they have populated this subsection.

Providers MUST return the following message:

<div>
	<p>All repeat medication ended by a clinician action</p>
</div>

Table columns

Providers MUST return all the columns as described in the table below, sorted by Last Issued Date descending:

Order Name Description Value details
1 Type Type of medication issued (for example, Repeat, Repeat Dispense, Repeat – [Prescribing Agency Type]). free-text
2 Last Issued Date The last issue date. If the medication is repeat dispense or prescribed elsewhere this MUST be null. dd-Mmm-yyyy
3 Medication Item Descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
4 Dosage Instruction Dosage instructions for the medication item. As a minimum, this MUST include:
  • Dosage Rate
  • Schedule (when / how often)

for example, two to be taken daily

free-text
5 Quantity Quantity details for the medication item. As a minimum, this MUST include:
  • Quantity
  • Quantity unit

for example, 14 capsule

free-text
6 Discontinued Date The date the medication item was discontinued. This should be the date the clinician has entered as the discontinuation date if available, otherwise the system date of the discontinuation action. dd-Mmm-yyyy
7 Discontinuation Reason The coded reason for the ending of the medication returned as its text description and/or free text narrative as available. free-text
8 Additional Information If the medication record includes the information, the following details MUST be included (each item MUST be separated with a line break):
  • CONTROLLED DRUG label in bold text
  • Reason for the medication
  • Linked problems / diagnoses
  • For Repeat Dispense, the date of the last authorisation and the number of prescription issues authorised
  • Other supporting information

The provider MAY include labels in addition to the ones specified to support additional text (for example, Linked Problem : Heart Failure).

free-text

All Medication

Clinical narrative

A history view of drugs or other forms of medicines that have been used to treat or prevent disease for the patient.

Purpose

The purpose of this subsection is to provide a distinct list of all the medications recorded for the patient and to present the list alphabetically to make it easier to view for specific medication items. The list is also presented alphabetically to enable easier identification of changes to a medication over time, for example, change in dosage.

Items included in the Recent Acute Medication and Current Repeat Medication MUST also be included within this subsection, as well as past medications.

Subsection title

The subsection title MUST be ‘All Medication’.

Date filter

If a consumer submits a date filter for this subsection the dates will be applied as follows (this applies equivalent rules to structured medication date filtering):

  1. If the medication has an effective period (a start date and a scheduled end date), filter using the effective period:
    1. The provider system MUST return the medication summary data items for all medications whose effective periods overlap the date range (inclusive) sent by the consuming system.
  2. If the medication has an effective start date, does not have an effective end date and is repeat (repeat prescribed, repeat dispensed or prescribed elsewhere repeat), treat the effective period as ongoing for the filter:
    1. The provider system MUST return the medication summary data items for all medications whose effective start date is during or before the date range (inclusive) sent by the consuming system.
    2. Where the medication is prescribed elsewhere and does not identify itself as acute or repeat then treat it as repeat for the filter to ensure the clinician has higher likelihood of visibility of the item and can decide themselves if it is relevant.
  3. If the medication has an effective start date, does not have an effective end date and is acute (acute or prescribed elsewhere acute), filter using the effective start date:
    1. The provider system MUST return the medication summary data items for all medications whose effective start date is during the date range (inclusive) sent by the consuming system.
  4. If the medication does not have an effective start date (for example, prescribed elsewhere), filter using the date it was recorded on the local system:
    1. The provider system MUST return the medication summary data items for all medications whose recorded date is during the date range (inclusive) sent by the consuming system.
    2. Where no effective period is available use the date the item was recorded on the system.

Subsection content banner

Provider message describing at a summary level how they have populated this section.

Table columns

Providers MUST return all the columns as described in the table below.

It MUST be grouped by Medication Item, with Medication Item repeated as a distinct group title, then sorted alphabetically. Medication Items listed within a group MUST be sorted by Start Date descending.

Please see the HTML view and Example view for a coded example of displaying this subsection.

Order Name Description Value details
Medication Item Grouped distinct descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
1 Type Type of medication issued (for example, Acute, Repeat, Repeat Dispense, Acute - [Prescribing Agency Type], Repeat - [Prescribing Agency Type]). free-text
2 Start Date The date the medication was first prescribed. If this is not known (for example, for prescribed elsewhere) then date of entry MUST be used. dd-Mmm-yyyy
3 Medication Item Descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
4 Dosage Instruction Dosage instructions for the medication item. As a minimum, this MUST include:
  • Dosage Rate
  • Schedule (when / how often)

for example, two to be taken daily

free-text
5 Quantity Quantity details for the medication item. As a minimum, this MUST include:
  • Quantity
  • Quantity unit

for example, 14 capsule

free-text
6 Last Issued Date The last issue of the medication item (acute or repeat). If the medication is repeat dispense or prescribed elsewhere this MUST be null. dd-Mmm-yyyy
7 Number of Prescriptions Issued The sum of the number of issues of the medication – actual issues not the max issues. If this is not known (for example, for medication prescribed elsewhere or repeat dispense, this MUST be null). integer
8 Discontinuation Details

CANCELLED: label with cancellation date and reason (acute) or DISCONTINUED: label with discontinued date and discontinuation reason (repeat)

Details will be equivalent to the combined discontinued date and discontinuation reason columns in Discontinued Repeat Medication, but will apply to Acute medication (labelled cancelled) as well as repeat.

free-text
9 Additional Information If the medication record includes the information, the following details MUST be included (each item MUST be separated with a line break):
  • CONTROLLED DRUG label in bold text
  • For Repeat Dispense, the date of the last authorisation and the number of prescription issues authorised
  • Reason for the medication
  • Linked problems / diagnoses
  • Other supporting information

The provider MAY include labels in addition to the ones specified to support additional text (for example, Linked Problem : Heart Failure).

free-text

All Medication Issues

Clinical narrative

A history view of drugs or other forms of medicines that have been used to treat or prevent disease for the patient.

Purpose

The purpose of this section is to provide a historical view of all issues (prescribed elsewhere and repeat dispense are not included as their issues are not recorded on the GP system).

This is the only subsection to include the individual issues of a repeat medication.

Subsection title

The subsection title MUST be ‘All Medication Issues’.

Date filter

If a consumer submits a date filter for this section the dates will be applied as follows:

The provider MUST return all medication issues which relate to the medication items returned for the All Medication subsection. This may result in records which have an issue date outside of the consumer date filter range.

Subsection content banner

Providers message describing at a summary level how they have populated this section.

Table columns

Providers MUST return all the columns as described in the table below.

It MUST be grouped by Medication Item, with Medication Item repeated as a distinct group title, then sorted alphabetically. Medication Items listed within a group MUST be sorted by Issue Date descending.

Please see the HTML view and Example view for a coded example of displaying this subsection.

Order Name Description Value details
Medication Item Grouped distinct descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
1 Type Type of medication issued (for example, Acute, Repeat). free-text
2 Issue Date The date the medication item was issued. dd-Mmm-yyyy
3 Medication Item Descriptive name of medication item (including dosage) (for example, Ibuprofen 400mg tablets). free-text
4 Dosage Instruction Dosage instructions for the medication item. As a minimum, this MUST include:
  • Dosage Rate
  • Schedule (when / how often)

for example, two to be taken daily

free-text
5 Quantity Quantity details for the medication item. As a minimum, this MUST include:
  • Quantity
  • Quantity unit

for example, 14 capsule

free-text
6 Days Duration Duration of the medication issued in days. integer
7 Additional Information If the medication record includes the information, the following details MUST be included (each item MUST be separated with a line break):
  • CONTROLLED DRUG label in bold text
  • Reason for the medication
  • Linked problems / diagnoses
  • Other supporting information

The provider MAY include labels in addition to the ones specified to support additional text (for example, Linked Problem : Ear Infection).

free-text

Additional medication information

Ended medications

It is extremely important for the details regarding the ending of a medication to be available to a clinician, as this will highlight any clinical issues (for example, stopping a medication due to an allergy) and allow the clinician to make an efficient and informed clinical decision.

Details of change to follow as a comment:

  • Naturally ended: Medication naturally came to an end, that is, no manual intervention via the user (auto system transition)
  • Cancelled: Actively stopped acute medication by user
  • Discontinued: Actively stopped repeat medication by user

Naturally Ended medications MUST NOT be included in the Discontinued Repeat Medication subsection and end date and reason MUST NOT be included in Additional Information in Recent Acute Medications or the Discontinuation Details in All Medication.

If a system provider cannot differentiate between naturally ended, discontinued and cancelled section/subsection, banner message(s) MUST be included as appropriate to describe the extent or limitation of compliance.

Prescribed elsewhere

All subsections (except All Medication Issues) MUST include items which are recorded on the system as a prescription but prescribed elsewhere (for example, hospitals or special clinics) or ‘Over The Counter’ drugs taken by the patient and recorded on the system as a prescription. This Type column will identify a medication item as prescribed elsewhere by including the Agency Type after the medication type (Acute / Repeat) or ‘Unknown Prescriber’ where an agency type cannot be determined.

GP2GP transfer

Repeat medications transferred as part of GP2GP MUST only be included in the Current Repeat Medications subsection if authorised by a clinician at the new practice, otherwise they are treated as not current. Therefore, they appear in All Medication and All Medication Issues, but not in Current Repeat Medication.

HTML view

The following content highlights the expected HTML tags and format providers MUST use when generating the HTML content:

<div>
   <h1>Medications</h1>
   <div class="gptransfer-banner">
      <p>
         <!-- GP transfer banner -->
      </p>
   </div>
   <div class="content-banner">
      <p>
         <!-- Content banner -->
      </p>
   </div>
   <div>
      <h2>Acute Medication (Last 12 Months)</h2>
      <div class="content-banner">
         <p>
            <!-- Content banner -->
         </p>
      </div>
      <div class="exclusion-banner">
         <p>
            <!-- Exclusion banner -->
         </p>
      </div>
      <table id="med-tab-acu-med">
         <thead>
            <tr>
               <th>Type</th>
               <th>Start Date</th>
               <th>Medication Item</th>
               <th>Dosage Instruction</th>
               <th>Quantity</th>
               <th>Scheduled End Date</th>
               <th>Days Duration</th>
               <th>Additional Information</th>
            </tr>
         </thead>
         <tbody>
            <tr>
               <!-- the <tr>...</tr> element will repeat for each current medication issue-->
               <td>{{medication.type}}</td>
               <td class="date-column">{{medication.startDate}}</td>
               <td>{{medication.drug}}</td>
               <td>{{medication.dosageInstruction}}</td>
               <td>{{medication.quantity}}</td>
               <td class="date-column">{{medication.scheduledEndDate}}</td>
               <td>{{medication.daysDuration}}</td>
               <td>{{medication.additionalInformation}}</td>
            </tr>
         </tbody>
      </table>
   </div>
   <div>
      <h2>Current Repeat Medication</h2>
      <div class="content-banner">
         <p>
            <!-- Content banner -->
         </p>
      </div>
      <div class="exclusion-banner">
         <p>
            <!-- Exclusion banner -->
         </p>
      </div>
      <table id="med-tab-curr-rep">
         <thead>
            <tr>
               <th>Type</th>
               <th>Start Date</th>
               <th>Medication Item</th>
               <th>Dosage Instruction</th>
               <th>Quantity</th>
               <th>Last Issued Date</th>
               <th>Number of Prescriptions Issued</th>
               <th>Max Issues</th>
               <th>Review Date</th>
               <th>Additional Information</th>
            </tr>
         </thead>
         <tbody>
            <tr>
               <!-- the <tr>...</tr> element will repeat for each current repeat medication-->
               <td>{{medication.type}}</td>
               <td class="date-column">{{medication.startDate}}</td>
               <td>{{medication.drug}}</td>
               <td>{{medication.dosageInstruction}}</td>
               <td>{{medication.quantity}}</td>
               <td class="date-column">{{medication.lastIssuedDate}}</td>
               <td>{{medication.numberIssued}}</td>
               <td>{{medication.maxIssues}}</td>
               <td class="date-column">{{medication.reviewDate}}</td>
               <td>{{medication.additionalInformation}}</td>
            </tr>
         </tbody>
      </table>
   </div>
   <div>
      <h2>Discontinued Repeat Medication</h2>
      <div class="content-banner">
         <p>
            <!-- Content banner -->
         </p>
      </div>
      <div class="exclusion-banner">
         <p>
            <!-- Exclusion banner -->
         </p>
      </div>
      <table id="med-tab-dis-rep">
         <thead>
            <tr>
               <th>Type</th>
               <th>Last Issued Date</th>
               <th>Medication Item</th>
               <th>Dosage Instruction</th>
               <th>Quantity</th>
               <th>Discontinued Date</th>
               <th>Discontinuation Reason</th>
               <th>Additional Information</th>
            </tr>
         </thead>
         <tbody>
            <tr>
               <!-- the <tr>...</tr> element will repeat for each discontinued repeat medication-->
               <td>{{medication.type}}</td>
               <td class="date-column">{{medication.lastIssuedDate}}</td>
               <td>{{medication.drug}}</td>
               <td>{{medication.dosageInformation}}</td>
               <td>{{medication.quantity}}</td>
               <td class="date-column">{{medication.discontinuedDate}}</td>
               <td>{{medication.discontinuedReason}}</td>
               <td>{{medication.additionalInformation}}</td>
            </tr>
         </tbody>
      </table>
   </div>
   <div>
      <h2>All Medication</h2>
      <div class="content-banner">
         <p>
            <!-- Content banner -->
         </p>
      </div>
      <div class="date-banner">
         <p>
            <!-- Date banner -->
         </p>
      </div>
      <div class="exclusion-banner">
         <p>
            <!-- Exclusion banner -->
         </p>
      </div>
      <table id="med-tab-all-sum">
         <thead>
            <tr>
               <th>Type</th>
               <th>Start Date</th>
               <th>Medication Item</th>
               <th>Dosage Instruction</th>
               <th>Quantity</th>
               <th>Last Issued Date</th>
               <th>Number of Prescriptions Issued</th>
               <th>Discontinuation Details</th>
               <th>Additional Information</th>
            </tr>
         </thead>
         <tbody>
            <tr>
               <!-- the <tr>...</tr> element will group and display each distinct medication item-->
               <td colspan="9" class="med-item-column"> <strong>{{medication.drug}}</strong></td>
            </tr>
            <tr>
               <!-- the <tr>...</tr> element will repeat for each medication in the group-->
               <td>{{medication.type}}</td>
               <td class="date-column">{{medication.startDate}}</td>
               <td>{{medication.drug}}</td>
               <td>{{medication.dosageInstruction}}</td>
               <td>{{medication.quantity}}</td>
               <td class="date-column">{{medication.lastIssuedDate}}</td>
               <td>{{medication.numberIssued}}</td>
               <td>{{medication.discontinuedDetails}}</td>
               <td>{{medication.additionalInformation}}</td>
            </tr>
         </tbody>
      </table>
   </div>
   <div>
      <h2>All Medication Issues</h2>
      <div class="content-banner">
         <p>
            <!-- Content banner -->
         </p>
      </div>
      <div class="date-banner">
         <p>
            <!-- Date banner -->
         </p>
      </div>
      <div class="exclusion-banner">
         <p>
            <!-- Exclusion banner -->
         </p>
      </div>
      <table id="med-tab-all-iss">
         <thead>
            <tr>
               <th>Type</th>
               <th>Issue Date</th>
               <th>Medication Item</th>
               <th>Dosage Instruction</th>
               <th>Quantity</th>
               <th>Days Duration</th>
               <th>Additional Information</th>
            </tr>
         </thead>
         <tbody>
            <tr>
               <!-- the <tr>...</tr> element will group and display each distinct medication item-->
               <td colspan="7" class="med-item-column"> <strong>{{medication.drug}}</strong></td>
            </tr>
            <tr>
               <!-- the <tr>...</tr> element will repeat for each medication in the group-->
               <td>{{medication.type}}</td>
               <td class="date-column">{{medication.issueDate}}</td>
               <td>{{medication.drug}}</td>
               <td>{{medication.dosageInstruction}}</td>
               <td>{{medication.quantity}}</td>
               <td>{{medication.daysDuration}}</td>
               <td>{{medication.additionalInformation}}</td>
            </tr>
         </tbody>
      </table>
   </div>
</div>
</div>

Example view

See the Pen Medications by gp_connect (@tford70) on CodePen.


All content is available under the Open Government Licence v3.0, except where otherwise stated