DRUG INFORMATION
Presented by,
Dr. G. Narayana
Associate Professor
Department of Clinical Pharmacy and Pharmacy Practice
School of Pharmacy
Kampala International University (KIU), West Campus, Ugnada
Contents
• Background
• Definitions
• Objectives
• Role of drug information in pharmacy practice
• Requirements for setting up a drug information centre
✓ Sources of drug information
✓ Other requirements
• Organization and provision
✓ Organizational structure
✓ Responding to the query
Background
Addressing the gaps between evidence and practice
So much evidence, so little time
Figure . Classification of different categories of research
Iain Chalmers, Michael B Bracken, Ben Djulbegovic, Silvio Garattini, Jonathan Grant, A Metin Gülmezoglu, David W Howells,
John P A Ioannidis, Sandy Oliver
How to increase value and reduce waste when research priorities are set
Lancet Volume 383, Issue 9912, 2014, 156–165
Historical examples for information gap B/W Research
and Practice
Corticosteroid therapy for pre-term birth
• The first RCT was reported
1972
• Six more RCT are published supporting 1972 findings
1972-
89
• First systematic review published
1989
• Seven more studies reported
1989-91
“All the results are showing that corticosteroid therapy will reduces odds
of dying of children due to complications of preterm birth to around 30 –
50%, but thousands of children died even after 1972 due to unaware of
effectiveness of treatment”.
Flecainide story
Flecainide story (cont..)
Flecainide story (cont..)
Flecainide story (cont..)
Definitions
Drug Information
Drug information is the provision of written and/or verbal information
or advice about drugs and drug therapy in response to a request from
other healthcare providers, organisations, committees, patients or
members of the public.
• Patient specific
• Promote safe and effective use of medicine
Drug information centre
It is a facility specially set to provide drug information
Drug information service
Activities undertaken by pharmacist to provide information to optimise
drug use.
Objectives
➢ Promote evidence-based practice
Objectives
➢ Provide accurate and unbiased drug information
Objectives
➢ Meet the patient need while providing pharmaceutical care
➢ To improve medication adherence/compliance
Objectives
➢ Promote rational drug use
Objectives
➢ Provide an organized database of specialized information on
medicines and therapeutics
Objectives
➢ Provide and distribute Drug Information Bulletin (DIB)
Objectives
➢ Contribute to developing therapeutic guidelines and formulary
Objectives
➢ Provide information to the government agencies in the
decision-making process
➢ Continuous education program (CME, CNE, CPE)
➢ Support R&D in drug literature evaluation
➢ Educational program for patients and community
➢ Assist in DUE
➢ Participate in programs that attempt to prevent ADRs and MEs
Requirements for setting up the DIC
Team (Staffing)
• Pharmacy team
✓ Pharmacist, Pharmacy technicians, and students
• Medical team
✓ Toxicologist
✓ Clinical Pharmacologist
• Supporting team
✓ People trained in library science and having
computer skills
Place and Hardware (One or two rooms 32m2)
• 20m2 /one staff member
• 5-10 m2/one additional member
• Facilities must comply with occupational and safety hazards
• Documentation
• Space for storage of references
Sources
Background Vs Foreground Questions
Sources
Background Question
Sources
Foreground Question
Resources
Primary sources
Primary sources
Secondary sources
Secondary sources
Tertiary sources
Tertiary sources
Classification of scientific literature
Other resources
Drug Information Forms
Drug Information Forms
Drug Information Forms
Drug Information Forms
Contact
Responding to the query
Responding to the query
Responding to the query
Responding to the query
Responding to the query
Responding to the query
Responding to the query
1. Formulate an answerable question
Population • Relevant patients
Intervention or • Management strategy/Diagnostic
Indicator test/Exposure
Comparator • Alternative strategy
Outcome • Patient relevant outcomes
• Synonym 1 OR Synonym
Population
2 AND
Intervention or • Synonym 1 OR Synonym
Indicator 2 AND
• Synonym 1 OR Synonym
Comparator
2 AND
Outcome • Synonym 1 OR Synonym 2
Intervention question
1. Jeff, a smoker of more than 30 years, He tells you he has
tried to quit smoking unsuccessfully in the past. A friend of
his, however, successfully quit with accupuncture. Should he
try it? Other interventions you know about are nicotine
replacement therapy and antidepressants.
Population • Smokers
Intervention or
Indicator
• Accupuncture
Comparator • NRT/Anti Depressants
Outcome • Quit smoking
Intervention question
2. In browsing one of the medical weeklies, you come
across mention of imiquimod cream for treatment of
basal cell carcinomas (BCC). The idea of a cream for BCCs
is surprising, so you wonder about the effectiveness and
particularly the long-term cure rate of imiquimod cream.
Population • Patients with BCC
Intervention or
Indicator
• Imiquimod
Comparator • Conventional methods
Outcome • Long term cure rate
Etiology or Risk factor question
1. George has come in to your surgery to discuss the possibility of
getting a vasectomy. He says he has heard something about
vasectomy causing an increase in testicular cancer later in life. You
know that the risk of this is low but want to give him a more precise
answer.
Population • Adult males
Intervention or
Indicator
• Vasectomy
Comparator • No vasectomy
Outcome • Testicular cancer
Etiology or Risk factor question
2. Susan is expecting her first baby in two months. She has been
reading about the potential benefits and harms of giving newborn
babies vitamin K injections. She is alarmed by reports that vitamin K
injections in newborn babies may cause childhood leukemia. She asks
you if this is true and, if so, what the risk for her baby will be.
Population • Newborn
Intervention or
Indicator
• Vitamin K Inj
Comparator • No vitamin K inj
Outcome • Leukemia
Frequency or Rate question:
1. Mabel is a 6-week-old baby at her routine follow-up. She was born
prematurely at 35 weeks. You want to tell the parents about her
chances of developing hearing problems.
Population • Infants
Intervention or
Indicator
• Premature
Comparator • Full-term
Outcome • Sensorial deafness
Diagnosis:
Julie is pregnant for the second time. She had her first baby when she was
33 and had an amniocentesis to find out if the baby had Down syndrome.
The test was negative but it was not a good experience as she did not get
the result until she was 18 weeks pregnant.
She is now 35, one month pregnant, and asks if she can have a test that
would give her an earlier result. The local hospital offers serum
biochemistry plus ultrasound screening as a first-trimester test for Down
syndrome. You wonder if this combination of tests is as reliable as
conventional amniocentesis.
Population • Pregnant women
Intervention or • serum biochemistry plus
Indicator ultrasound screening
• Conventional
Comparator
amniocentesis
• Accurate diagnosis of downs
Outcome
syndrome
Each question has a study designmeant
for it
Is there a problem and how big is the problem? Cross sectional
Why a problem (risk factor) ? Case control/ Cohort
What happens next (long term follow up)? Cohort
How to prevent/ treat? Randomized controlled trial
Why did this happen? Qualitative
Can we afford? Cost/ economic study
Responding to the query
Responding to the query
Role of Drug Information in Pharmacy Practice
➢ Drug related problems
➢ Rational drug use
➢ Pharmacovigilance
➢ Medication errors
➢ CME
➢ Patient education
➢ Medication adherence
➢ Database framework
➢ Bulletin
➢ Formulary
➢ Provide information to the government agencies in the decision-making
process
➢ Support R&D in drug literature evaluation
➢ Assist in DUE
Thank you