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DLM 400 - 10/05/2012

Gemscript Replaces the Multilex Drug Dictionary

DLM 400 includes an important change in Prescribing and Decision Support; Vision will no longer use the Multilex drug dictionary provided by First Data Bank. In its place we have integrated a new drug dictionary called Gemscript that is maintained by another Cegedim company, RESIP UK.

Gemscript is an integrated dm+d drug dictionary. This means that Gemscript adheres to NHS standards to provide clear and unambiguous information to uniquely identify the specific medicines and devices used in the diagnosis or treatment of patients. Gemscript will be at the heart of improvements in the efficiency and effectiveness of Vision prescribing and will allow the reliable electronic exchange of information on medicines and devices between healthcare organisations.

INPS has worked closely with RESIP UK on the Gemscript integration project and we believe this close working relationship will be beneficial to practices as we will be able to respond more quickly to changes in the availability of pharmaceutical products.

It is anticipated that the installation of the new drug dictionary will have minimum impact on your practice as the changes to the way you use the dictionary are relatively minor and can be found below, throughout the Therapy topic or in the DLM 400 user guide (http://www.inps4.co.uk/my_vision/vua/dlm/index.html).

Gemscript Drug Dictionary Updates

Future drug dictionary updates will be delivered to your practice via the usual drug dictionary DLM download. The initial Gemscript drug dictionary will be delivered to your practice before you receive DLM 400.

The new drug dictionary will be ready for use as soon as DLM 400 is installed.

You can check drug dictionary versioning from Help – About Vision on the Vision front screen. You can also see a bulletin of the monthly drug dictionary additions and deletions on the INPS website at http://www.inps4.co.uk/my_vision/vua/drug-dictionary-dlm.

dm+d Mapping – Name Replace

The Gemscript installation process will not update current scripts or active repeat masters so there is a chance that you will receive drug name mismatch warnings when you attempt to re-authorise existing repeat masters if the drug description has changed. INPS recommends that you run the dm+d mapping utility to update non-dm+d drug names, quantities and preparations for existing items that become mapped to Gemscript. See the DLM 400 user guide or Drug Dictionary Utilities on-screen help for further information.

Note – dm+d mapping is required due to changing to full dm+d terminology and is not a direct cause of changing to Gemscript.

Selecting a Drug

It is anticipated that the installation of the new drug dictionary will have a minimal impact on your practice. However, drugs may appear in a different order in the selection list because Gemscript uses dm+d descriptions so when searching for a drug the format is name-strength-form (i.e. Aspirin 75mg tablets) instead of name-form–strength (i.e. Aspirin tab 75mg).

Formulary Maintenance

All practices with a drug formulary are advised to check their formulary list for items which have no dm+d equivalent. These items are no longer available to prescribe from Consultation Manager but still appear in your formulary list in Drug Dictionary Utilities. You are advised to locate such items and add an alternative dm+d item from the Gemscript dictionary where necessary. You can remove these items from the formulary list from the Search and Reports module. See Drug Dictionary Utilities On-screen help.

Review Guidelines and Searches

After Gemscript is installed Drug Action Group categories will be referred to as Drug Classes throughout Vision. In some cases there is no exact match between Gemscript Drug Classes and existing Drug Action Group categories so you are advised to review any practice Guidelines which contain drug filters or drug regimes and any ad-hoc searches which contain Drug Action Group (particularly appliance drug action groups) search criteria.

Although you will not notice many significant changes with the new Gemscript drug dictionary, please note the following differences and enhancements (further details can be found in the Therapy topic.):

  • Drug Dictionary Versioning – New versioning labels for Gemscript.
  • dm+d Terminology - You may find that the details of certain drugs are slightly different or are in a different order compared to your previous drug dictionary.
  • Drug List changes:
    • New Special Preparations filter and special items are now marked with S in formulary maintenance.
    • High Risk replaces the Toxic notification.
  • Drug Information Changes:
    • Changes to the drug information headings and content.
    • More details in the drug status information bar.
    • Drug items and their details now only pertain to your country (ie black lists, nurse prescribing etc should only be relevant to the country you are in).
    • New Support for Independent Prescribers – For nurse independent prescribers and non-GP non-nurse independent prescribers, items which they cannot prescribe are now filtered from the drug list.
  • Drug Check Changes:
    • Prescriber warnings now display all or none (depending on your settings in Options - Setup). This is because the patient context element to drug checking is included in contraindications and precautions.
    • Old drug items, ie non-dm+d items or those that have not been mapped from a previous system, now no longer prevent the drug check from being performed. Instead, they are displayed within the Drug Check Results screen.
    • Excipients are now included in the drug and allergy checks.
  • Drug Allergy Changes:
    • Old drug items recorded within the allergy SDA ie non-dm+d items or those that have not been mapped from a previous system, are now displayed in the alerts pane under the heading Degraded Allergies. From here, you can double click and update them using the new drug dictionary.
    • Unrecognised drug items are now also flagged and listed in the allergy warning screens.
  • Settings in Consultation Manager (Consultation - Options – Set-up):
    • Normalex Drug Defaults setting has been replaced with Gemscript Posology Defaults.
    • Context Sensitivity flag has been removed.
    • Prescriber Warning option list is now a check box. This is because the patient context element to drug checking is included in contraindications and precautions.
    • Interaction settings - Drug Doubling options have been renamed and Drug to Drug options for Scotland now allow you to select High.

Other Changes

  • Nurse and Pharmacist Independent Prescribers - From DLM 400, following advice from the Department of Health, Nurse and Pharmacist Independent Prescribers are able to prescribe any controlled drug listed in schedules 2-5 for any medical condition within their competence, except diamorphine, cocaine and dipipanone for the treatment of addiction (nurse independent prescribers are able to prescribe other controlled drugs for the treatment of addiction).
  • Repeat Dispensing Reauthorisation – When reauthorizing a repeat dispensing item, the prescribing and repeat until dates are now updated according to the issue date. See Repeat Dispensing.

    This also applies to England EPS2 Repeat Dispensing Reauthorisation and Scottish CMS Reauthorisation.