Practical examples GDS

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1 Starting medication in GDS

An elderly patient is prescribed metoprolol on 2 January.

MA 2 January: metoprolol 100 mg MR tablet (succinate), 1 tablet once daily, from today

TA 2 January: PCH metoprolol 95 mg MR tablet, 1 tablet once daily, from today

The patient is using so many different medicines that he no longer has a good overview of them. On 6 February, the prescriber and supplier agree that the patient’s medication will henceforth be provided via GDS. For metoprolol, the process is as follows:
To start GDS, on 7 February the supplier selects a dosing interval for the patient and creates a new TA. A technical stop-TA is also created. The RegistrationDateTime is 7 February. It takes a few days to start GDS, so the startDateTime is 11 February.

TA 7 February: PCH metoprolol 95 mg MR tablet, 1 tablet once daily in the morning with breakfast, from 11 February

The medication is dispensed via GDS every two weeks from 11 February. In the VV data element DistributionForm of each MVE is indicated that GDS is used.

2 Adding medication to GDS

On 12 October, the GP prescribes dabigatran to a patient for the prevention of CVA and systemic embolism in atrial fibrillation. The patient must start this medication immediately.

MA: dabigatran etexilate 150 mg capsule, 1 capsule twice daily

The patient receives their medication via GDS. In the data element AdditionalInformation of the MA, the prescriber notes: 'Directly on administration list or in GDS'.
The next medication roll change occurs five days later. The supplier bridges the interim period with a separate supply of the new medicine and creates a TA for this, with endDateTime set to the date of the next medication roll change. She also creates a TA for the GDS supply, with startDateTime set to the date of the next medication roll change.

TA: CF dabigatran etexilate 150 mg capsule (in strip), 1 capsule twice daily, from 12 October for 5 days

TA GDS: CF dabigatran etexilate 150 mg capsule (in GDS), from 17 October

3 GDS supplier delivers a different trade product

The supplier creates a (future) TA for a patient on 1 July for metoprolol.

TTA1 1 July: PCH metoprolol 95 mg MR tablet, 1 tablet once daily, from 4 July

The patient receives this medicine via GDS. On 3 July, however, the GDS supplier delivers a different trade product. Because this has a different HPK, the TA needs to be modified. A technical cancelation-TTA is created since it concerned a future supply.

TTA2 3 July: Sandoz metoprolol 95 mg MR tablet, 1 tablet once daily, from 4 July

In the data element AdministrationAgreementReasonModificationOrDiscontinuation, the supplier records ‘Drug not available - out of stock’.

4 Parallel administration agreements for GDS and non-GDS dispensing

A patient takes 20 mg pantoprazole from the brand Sandoz two to three times daily for stomach complaints.

TA: Sandoz pantoprazole 20 mg tablet, 1 tablet 2–3 times daily

After some time, it is decided that the patient’s medication will be supplied via GDS. For pantoprazole, this means that the fixed dose of 2 tablets will be supplied in GDS. These are Teva tablets because the GDS supplier does not provide pantoprazole from Sandoz. The third ‘as needed’ tablet continues to be dispensed separately. The supplier modifies the existing TA by recording a technical stop-TA and two new TAs within the same MBH, with the same startDateTime.

technical stop-TA: Sandoz pantoprazole 20 mg tablet, AdministrationAgreementStopType 'Discontinued'

TA: Sandoz pantoprazole 20 mg tablet, 1 tablet once daily as needed

TA GDS: Teva pantoprazole 20 mg tablet, 1 tablet twice daily

5 Parallel administration agreements, one of which is modified

The GP prescribes pantoprazole for a patient with dyspeptic symptoms:

MA: pantoprazole 20 mg tablet, 1 tablet 2–3 times daily

The fixed dose of 2 tablets is supplied via the GDS system and provided by the GDS supplier as Sandoz. The third tablet is for use ‘as needed’ and is dispensed separately as Teva. This results in two parallel TA’s.
At a certain point, the GDS supplier is temporarily unable to provide pantoprazole. The supplier has Teva in stock and modifies the TA for the fixed dose from dispensing in GDS to dispensing in separate packs. Stopping the GDS TA does not affect the ‘as needed’ TA; this continues unchanged.
This results in two parallel TA’s of the same brand, both dispensed separately. However, one contains the fixed dose and the other the ‘as needed’ dose. This way, they remain visible separately on the medication administration record as the fixed dose and the ‘as needed’ dose.
Once pantoprazole can again be supplied via GDS, the supplier will stop the TA for the fixed dose and create a new TA for supply in GDS.

6 Increasing the dose of GDS medication in a new MBH

A patient receives 1 tablet of losartan 50 mg daily. This has insufficient effect, and the prescriber decides to increase the dose to 100 mg once daily. This is a change at the PRK level. Consequently, the prescriber stops the original MA and records the new MA in a new MBH. In the data element AdditionalInformation she indicates 'Direct on the administration list or in GDS'.
However, the patient still has a few days’ supply of 50 mg tablets in their GDS roll. The supplier decides to supplement the GDS medication with 1 separate losartan 50 mg tablet until the medication roll change.
The supplier records a stop-TA and 3 new TAs:

• stop-TA to stop the original TA as a result of the stop-MA.
• TA for the original 50 mg losartan dose in GDS.
• TA for bridging with separate losartan 50 mg tablets.
• TA for the new 100 mg losartan dose in GDS.
  

At the next roll change, the increased dose will be supplied in the GDS roll.

7 Increasing the dose of GDS medication within the same MBH

A patient is administered 1 tablet of furosemide 40 mg every day due to oedema. This has insufficient effect and the prescriber decides to increase the dose to 2 tablets once daily. There is no change at PRK level, so this is a regular modification. The prescriber records a new MA within the same MBH. Along with this, a technical stop-MA is created.
The modification must take effect immediately. However, the medication roll change will not take place until several days later. The supplier therefore decides, until the medication roll change, to supplement the GDS medication with separate furosemide 40 mg tablets.
The supplier records a technical stop-TA and 3 new TA’s:

• technical stop-TA to stop the original TA, as a result of the stop-MA.
• TA for the original dosage of furosemide in GDS.
• TA for the bridging period with separate furosemide 40 mg tablets.
• TA for the new dosage of furosemide 40 mg in GDS.
  

At the next medication roll change, the increased dosage (2 tablets per administration) is supplied in the GDS roll.

8 Increasing the dose of GDS medication with different administration times

A patient is administered 1 tablet of furosemide 40 mg every day at 08:00, due to oedema. This has insufficient effect and the prescriber decides to increase the dose to 1 tablets twice daily, in the morning at 08:00 and in the afternoon at 17:00. There is no change at PRK level, so the new MA and the technical stop-MA are recorded within the same MBH.
The modification must take effect immediately. However, the medication roll change will not take place until several days later. The supplier therefore decides, until the medication roll change, to supplement the GDS medication with separate furosemide 40 mg tablets. The tablet in the GDS roll is still scheduled for 08:00, while the separate tablet will be administered at 17:00 (in data element AdministrationDateTime).
The supplier records a technical stop-TA and 3 new TA’s:

• technical stop-TA to stop the original TA, as a result of the stop-MA
• TA for the original dosage of furosemide in GDS, with administration time 08:00
• TA for the bridging period with separate furosemide 40 mg tablets, with administration time 17:00
• TA for the new dosage of furosemide 40 mg in GDS, with administration times 08:00 and 17:00

At the next medication roll change, the increased dosage (2 tablets per administration) is supplied in the GDS roll.

9 Reducing the dose of GDS medication in a new MBH

A patient receives 1 tablet of losartan 100 mg daily. Due to the patient’s deteriorating renal function, the prescriber decides to reduce the dose to 50 mg once daily. This is a change at the PRK level. Consequently, the prescriber stops the original MA and records the new MA in a new MBH.
The patient still has a few days’ supply of 100 mg tablets in their GDS roll. However, an administrator is not allowed to split tablets. The change must take effect immediately and cannot wait until the medication roll change, which will take place a few days later.
The supplier therefore arranges for the remaining GDS bags to be collected the same day and replaced with a new GDS roll containing the 50 mg tablets. She stops the original TA and records a new TA for the reduced dose.

10 Reducing the dose of GDS medication within the same MBH

A patient is administered 2 tablets of verapamil 240 mg MR every day. The effect is too strong, and the prescriber decides to reduce the dose to 1 tablet once daily. There is no change at PRK level, so the new MA and the associated technical stop-MA are recorded within the same MBH.
The modification must take effect immediately. However, the medication roll change will not occur until several days later. The supplier therefore arranges for the remaining GDS bags to be collected the same day and provide the tablets separately until the next medication roll change.
The supplier records a technical stop-TA and 2 new TA’s:

• technical stop-TA to stop the original TA, as a result of the stop MA
• TA for the bridging period with separate verapamil 240 mg MR tablets
• TA for the new dosage of verapamil 240 mg MR in GDS

At the next medication roll change, the reduced dosage is supplied in the GDS roll.

11 Changing GDS medication to ‘as needed’ medication

A patient uses temazepam for insomnia. The GP has been trying for some time to persuade the patient to stop this sleep medication. The patient now indicates a willingness to try, but wants to have temazepam available for use as needed. The GP changes the dosage from 10 mg temazepam once daily to 10 mg temazepam 'as needed'.
The patient has just received a new two-week medication roll. The GP wants to act on this momentum and decides that the new MA must take effect immediately. The GDS medication must therefore be collected by the pharmacy on the same day.

12 Changing GDS medication to partly GDS and partly ‘as needed’ medication

The GP prescribes diazepam 5 mg twice daily to a patient for anxiety. The effect is too strong, and the prescriber decides to reduce the dose to 1 tablet of diazepam 5 mg once daily in GDS plus 1 tablet ‘as needed’. There is no change at PRK level, so the stop-MA and new MA are recorded within the same MBH.
The modification must take effect immediately. However, the medication roll change will not occur until several days later. The supplier therefore arranges for the remaining GDS bags to be collected the same day and provide the tablets separately until the next medication roll change.
The supplier records a technical stop-TA and 3 new TA’s:

• technical stop-TA to stop the original TA, as a result of the stop-MA
• TA for the bridging period with separate diazepam tablets
• TA for the new dosage of diazepam in GDS
• TA for the new dosage of diazepam as separate tablets

At the next medication roll change, the ‘as needed’ medication is supplied separately, and the reduced regular dose is supplied in the GDS roll.

13 DurationOfUse in the MVE for non-daily GDS medication

A patient takes oral ferrous fumarate 200 mg three times per week for chronic iron-deficiency anaemia. The supplier records a TA for this and supplies the medication via GDS.

TA: CF ferrous fumarate 200 mg tablet, 1 tablet three times per week (on Mon-Wed-Fri)

MVE: CF ferrous fumarate 200 mg tablet; 3 tablets; MedicationDispenseDateTime 8 January yyyy, DurationOfUse 7 days

Although the last dose of the week occurs on day 5, a DurationOfUse of 7 days is recorded in the MVE. This ensures that the medication is only supplied once per week, preventing early intake outside the prescribed weekly schedule.

14 DurationOfUse in the MVE when bridging the period until medication is included in GDS

A patient receives long-term medication via GDS, supplied in fourteen-day cycles. On day 4 of the current GDS roll (8 January), the GP prescribes ferrous fumarate 200 mg to be taken orally twice per week for chronic iron-deficiency anaemia. Because the current GDS roll has already been issued, the new medication cannot be included in this cycle.

The supplier records a TA and provides the ferrous fumarate temporarily as separate tablets for a period of ten days, allowing the patient to start treatment immediately.

TA: CF ferrous fumarate 200 mg tablet (in strip), 1 tablet twice per week (on Mon-Thu), starting immediately for 11 days

MVE: CF ferrous fumarate 200 mg tablet; 3 tablets; MedicationDispenseDateTime 8 January yyyy, DurationOfUse 11 days

At the next GDS delivery, the ferrous fumarate is included in the GDS roll, and an additional TA is recorded to align with the existing two-week GDS cycle.

TA: CF ferrous fumarate 200 mg tablet (in GDS), 1 tablet twice per week (on Mon-Thu), starting on day 12

MVE: CF ferrous fumarate 200 mg tablet; 3 tablets; MedicationDispenseDateTime 19 January yyyy, DurationOfUse 14 days

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15 Document history

Version	Date	Description
9 3.0.0-rc.2	March 2026	for all changes see: *Release notes