Computable dose instructions standards
Published on: 26th January 2018 | Updated on: 11th August 2026
The NHS Dictionary of Medicines and Devices (dm+d) helps healthcare systems identify medicines using nationally recognised descriptions and codes.
But when it comes to dosage instructions, such as “Take two tablets three times a day”, there is still no nationally adopted standard format used across all clinical systems.
Instead, these instructions are usually recorded as free text. While this works in many situations, it can create challenges when information is shared between different systems, as each system may store or interpret the instructions in a different way.
Developing and adopting standards for dosage instructions could improve interoperability, support patient safety, and make it easier for health and care professionals to exchange prescribing information accurately and efficiently.
Standardised computable dose instructions allow dosage information to be recorded in a structured, coded format. This means information can be transferred electronically and used by different clinical systems in a consistent way.
Potential benefits include:
- Improving patient safety by reducing the risk of misinterpretation;
- Supporting more accurate sharing of prescribing information between care settings;
- Reducing the need for manual transcription and re-entry of dose instructions; and
- Enabling systems to calculate doses and quantities more effectively.
Research published in the International Journal of Pharmacy Practice reviewed prescription dosage instructions and found:
- 39.9% of prescriptions contained dosage instructions requiring intervention;
- 25.2% of items required editing in the pharmacy to improve clarity;
- 14.7% required extensive rewriting;
- The instruction ‘as directed’ appeared in 3% of items; and
- Latin abbreviations were present in 2% of items.
The study concluded that there was an urgent patient safety need for a standardised dosage instruction format within the Electronic Prescription Service (EPS).
At present, EPS messages use free text for dosage instructions. This can create challenges when medicines information is transferred between community pharmacy, GP practice, hospital and other care settings.
The Professional Record Standards Body (PRSB) highlighted the importance of standardised dose syntax within its e-Medication Standards Requirement. It noted that structured dosage instructions are needed to support the safe reuse of medication information across different care settings.
In summary, an effective dose syntax standard could:
- Improve patient safety;
- Support better medicines-related data analysis;
- Reduce the administrative burden associated with transferring dosage information; and
- Help create more seamless medicines information sharing across the health and care system.
The Professional Record Standards Body (PRSB) has worked with NHS England, Community Pharmacy England, healthcare professionals, IT system suppliers and other stakeholders to develop standards for medication dosage instructions and timings.
The PRSB website includes information about this work within its digital medicines programme.
Community Pharmacy England, the Community Pharmacy IT Group (CP ITG) and other stakeholders continue to support adoption of these standards across community pharmacy, GP practice and other clinical systems.
As the NHS moves towards greater interoperability, structured medicines data is expected to become increasingly important. This aligns with wider NHS ambitions for improved data sharing, integrated care records and the future Single Patient Record.
GP IT Futures and the NHS Digital Services for Integrated Care (DSIC) may not currently set out that alignment to the dose standard is needed.
GP practice and pharmacy system alignment to the standard is currently limited.
Further information
- Community Pharmacy IT Group (CP ITG);
- Electronic Prescription Service (EPS);
- Interoperability and standards;
- NHS Dictionary of Medicines and Devices (dm+d); and
- Professional Record Standards Body (PRSB).
For more information on this topic please email it@cpe.org.uk
