Enquiry level guidance

  • Level is independent of the time taken to complete the enquiry. 
  • Level is independent of the method used to communicate the answer.
  • There is a degree of subjectivity when assessing levels; no system can completely remove this. 
  • The way an enquiry is received may partly determine its level. The questioning skills of experienced MI staff may turn an apparently straightforward level 1 enquiry into a level 2 or 3 once the full clinical implications have been teased out.
  • Examples are for guidance only; some categories of enquiry may sometimes fit better into another. E.g. enquiries about drugs in pregnancy and lactation (listed as levels 2 and 3) may sometimes fit into level 1 if the drug concerned is widely used in pregnancy and its safety is well known.
Level Description Guidance notes Examples
Level 1 Simple enquiries or data
• Requests for information which any pharmacist or accredited pharmacy technician would be expected to deal with using readily available sources.
• Enquiries answered solely using sources such as local formulary/guidelines, paediatric formularies, or electronic databases such as Drugdex. Information from such sources passed on to the enquirer without further evaluation or interpretation.
• Requests for standard dosing information and/or administration instructions for licensed, or commonly accepted unlicensed indications.
• Basic information about well-documented adverse effects.
• Identification of foreign drugs.
• Tablet identification where further advice not required.
• ‘Librarian services’ such as finding a particular reference on Medline for which some details are known.
• Requests to contact the pharmaceutical industry for basic information about the availability, or excipient content.
Level 2 Complex enquiries – multiple sources
• Enquiries that require the use of more specialist resources and/or the interrogation of multiple sources.
• Enquiries where application of medicines information skills and knowledge is needed, but sources provide a reasonably clear answer or course of action to offer the enquirer.
• Dosing information for unlicensed indications.
• Intravenous drug compatibilities not found in standard sources e.g. admixtures or Y-site compatibilities.
• Dosing adjustments for commonly-used drugs in organ failure.
• Information about previous case reports of an adverse drug reaction.
• Safety of drugs in pregnancy/lactation where published reviews give clear advice (but see below).
Level 3 Complex enquiries – professional judgement
• Enquiries where the answer relies on the knowledge, experience and skill of the MI practitioner.
• Core concepts of therapeutics, risk management and literature evaluation are applied.
• Complex enquiries that cover situations where individual patients have unusual co-morbidities or drug combinations.
• Identifying the most likely causative agent of an adverse drug reaction and advising how to manage the patient.
• Offering advice on an appropriate therapeutic regimen when standard options have failed and there is no literature consensus.
• Evaluating the safest and most effective treatment where there are multiple contra-indications or cautions.
• Calculating drug doses using the first principles of pharmacokinetics or therapeutic drug monitoring.
• Assessing the appropriateness of new/experimental treatments for a patient by appraising published clinical data.
• Advising on the safest injectable medicines to mix when mixing is unavoidable but there is no directly relevant published compatibility data.

Last Reviewed: Oct 2026