Understanding why PGDs cannot be used for dose adjustments

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This article outlines why PGDs cannot be used to adjust the dosage of a medicine already in an individual's possession.

Legislation

Patient Group Directions (PGDs) do not give a legal framework for healthcare professionals to adjust a dose of a medicine already in an person’s possession and must not be used for this purpose.

Alternative mechanisms for dosage adjustments

Written protocols

Some medicines, such as insulin, anticoagulants or diuretics, may require doses to be titrated or adjusted according to the individual’s response.

If the requirement to adjust the dose is explicit in the prescription for the medicine then a locally developed written protocol could be considered to allow suitably trained and competent healthcare professional to adjust the dosage. For more information see Managing dosage adjustments for prescribed medicines

Independent or supplementary prescribing

Organisations may need to consider the role of independent or supplementary prescribers within pathways where medication dose adjustments are routinely required. Consider if independent or supplementary prescribing would allow more individualised care.

Update history

  1. Page updated and referenced to new supporting webpage Managing dosage adjustments for prescribed medicines. Removed content now contained within new webpage.
  1. Minor formatting updates
  1. Page reviewed - no changes required
  2. Published

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