Answer Drug Information Questions Research Articles

A Continuing Pharmacy Education (CPE) Program Assessing Cannabidiol (CBD) Knowledge and Confidence Among Practicing Pharmacists

Background: Increased patient utilization of cannabidiol (CBD) leads to potential drug interactions with various medications and questions posed to pharmacists. Objective: To quantify the knowledge gap of pharmacists on CBD and CBD-containing products and assess the degree a continuing pharmacy education (CPE) program alters pharmacist confidence and competency on CBD knowledge. Methods: A 1-h CPE activity was offered as a home study from May 9, 2022, through September 30, 2022. Subjects were practicing pharmacy preceptors in Alabama who completed the pre-survey and post-survey for inclusion in matched-pair analyses. The primary outcome measure was participant score improvement between the pre-post surveys. Secondary measures involved pre-post comparisons on self-rated Likert questions concerning participant confidence in counseling, answering drug information questions, and ensuring patient safety regarding CBD. Results: A total of 124 participants completed the course. After matched pairing, 64 and 56 individuals were included in the knowledge-based and confidence ranking analyses, respectively. Participant scoring improved on the knowledge-based questions between the pre-post surveys (50.0% vs 87.8%, P < .001). There was a significant confidence improvement of participants from baseline on counseling patients about prescription or over-the-counter CBD products, answering questions from other healthcare professionals about these products, and ensuring patient safety while using these products (Average 5-level Likert scale increases of 1.75, 1.73, 1.70, respectively; all P < .001). Conclusion: Implementation of a CPE program improved practicing pharmacists’ knowledge on information about CBD, which lead to increased competency on counseling patients, answering drug information questions, and promoting patient safety.

Impact of an embedded oncology clinical pharmacist in an outpatient oncology center.

424 Background: Oncology pharmacists are uniquely positioned to improve the quality of care provided to patients with cancer within the team-based setting. Some benefits include providing information that supports safe and cost-effective use of medications relative to supportive care management, drug-drug interaction evaluation, patient counseling, answering drug information questions, and reducing physician workload. The primary objective of this study is to evaluate the benefit of a full-time clinical pharmacist in the ambulatory oncology setting through documenting pharmacist-driven clinical interventions, correspondence of those interventions with cost avoidance, and perceived benefit from provider and patient satisfaction surveys. Methods: Pharmacists were in clinic Monday through Thursday, covering three medical oncologists each day. Interventions were documented through EPIC i-Vents. The categories included: adverse events, drug interactions, lab monitoring, medication reconciliation, order clarification, patient education/counseling, drug information, and supportive care. Pharmacist interventions correlated with cost avoidance benefits based on values from prior publications. Weekly surveys were sent to the providers to assess satisfaction of the program and to improve workflow. Results: The data from this pilot program reflects the study period starting January 9, 2023 through June 1, 2023. The financial impact, as calculated from the pharmacist interventions, cost avoidance values and time spent resulted in the estimated cost avoidance of $169,321.10 based on a total of 839 interventions. Other interventions were made that were not given a cost value. Thus, the estimated cost savings is likely an under-estimation of the true cost savings provided from this service during this five-month study period. Extended providers (n = 5) and medical oncologists (n = 3) surveys indicated an overall strong agreement to the benefits of an oncology pharmacist’s involvement in clinic. The pilot program is currently working on a method to gather patient surveys to assess patient satisfaction. Conclusions: This study demonstrates the clinical and financial benefit of an embedded oncology pharmacist in the outpatient oncology clinic. As we move into an era with increasing approvals of oncology medications, coupled with increasing complexity of care, this service may help address some of the unmet gaps to improve collaborative and comprehensive patient-centered care.

An untapped resource? Opportunities for faculty-librarian collaboration to enhance drug information resource utilization in pharmacy education.

Doctor of pharmacy educational accreditation standards state student pharmacists should be able to evaluate the scientific literature as well as critically analyze and apply information in answering drug information questions. Student pharmacists often struggle with identifying and using appropriate resources to answer medication-related questions. To ensure educational needs were met, a college of pharmacy hired a health sciences librarian to support the faculty and students. The health sciences librarian collaborated with faculty and students throughout the doctor of pharmacy curriculum to identify and address any gaps related to appropriate drug resource utilization. Adding instruction time to the new student pharmacist orientation, coursework throughout the first year of the pharmacy program, and a two-semester evidence-based seminar course provided opportunities for the health sciences librarian to work with student pharmacists in the areas of library resource access, instruction on drug information resources, and evaluation of drug information found on the internet. The deliberate inclusion of a health sciences librarian into the doctor of pharmacy curriculum can benefit faculty and students. Opportunities for collaboration are available throughout the curriculum, such as providing instruction for database utilization and supporting the research activities of both faculty and student pharmacists.

A team-led remote ambulatory care rotation: Creating efficiency without sacrificing quality

Background and purposeAdvanced pharmacy practice experiences (APPEs) are a highly anticipated part of the doctor of pharmacy program. Traditionally, these rotations are offered as full-time, onsite experiences. However, there are situations in which geography, transportation, and housing requirements limit the accessibility of these experiences. Additionally, unexpected changes in rotation schedules or resource limitations may leave students in a difficult situation when completing their rotation hours. Having the ability to provide a remote APPE that results in similar student learning outcomes provides flexibility to experiential directors and ensures students' continued progression towards graduation. Educational activity and settingA group of faculty members and post-graduate trainees collaborated to create a remote, one-month ambulatory care experience for 18 students over three months. Students had access to the electronic health record (EHR) from their homes through a partnership with a local federally qualified health center. Access to the EHR enabled the students to participate in telehealth visits and have meaningful interactions with patients as if they were on-site. Students were also able to participate in topic discussions, answer drug information questions, complete a literature evaluation series, and work on projects remotely through this rotation. Findings and summaryThis remote rotation allowed preceptors to meet the educational needs of students while allowing them to provide patient care through telehealth. Data from summative student evaluations, student evaluations of preceptor and site, and a supplemental survey demonstrate that this remote rotation is a meaningful learning experience for students and is comparable to similar in-person rotations.

Video killed the multiple-choice quiz: capturing pharmacy students’ literature searching skills using a screencast video assignment

Background:In a flipped, required first-year drug information course, students were taught the systematic approach to answering drug information questions, commonly utilized resources, and literature searching. As co-coordinator, a librarian taught three weeks of the course focused on mobile applications, development of literature searching skills, and practicing in PubMed. Course assignments were redesigned in 2019 based on assessment best practices and replaced weekly multiple-choice quizzes used in prior iterations of the course.Case Presentation:Following two weeks of literature searching instruction, students were assigned a drug information question that would serve as the impetus for the search they conducted. Students (n=66) had one week to practice and record a screencast video of their search in PubMed. Students narrated their video with an explanation of the actions being performed and were assessed using a twenty-point rubric created by the course coordinator and librarian. The librarian also created general feedback videos for each question by recording screencasts while performing the literature searches and clarifying troublesome aspects for students. The librarian spent about twenty-four hours grading and six hours writing scripts, recording, and editing feedback videos.Conclusion:Most students performed well on the assignment and few experienced technical difficulties. Instructors will use this assignment and feedback method in the future. Screencast videos proved an innovative way to assess student knowledge and to provide feedback on literature searching assignments. This method is transferrable to any medical education setting and could be used across all health professions to improve information literacy skills.

Multicenter randomized comparative trial of Micromedex, Micromedex with Watson, or Google to answer drug information questions.

Objective:The purpose of this study was to compare pharmacy students’ ability to correctly answer drug information questions using Micromedex with Watson, Micromedex without Watson, or Google.Methods:This multicenter randomized trial compared pharmacy student responses to drug information questions using Micromedex with Watson, Micromedex without Watson, or Google from January to March of 2020. First- to fourth-year pharmacy students at two institutions were included. The primary outcome was the number of correct answers. Secondary outcomes were the time taken to answer the questions and differences in number of correct answers by pharmacy student year and institution.Results:The analysis included 162 participants: 52 students in the Micromedex group, 51 students in the Watson group, and 59 students in the Google group. There was a significant difference among groups in the total number of questions answered correctly (p=0.02). Post-hoc analysis revealed that participants in the Micromedex group answered more questions correctly than those in the Google group (p=0.015). There were no significant differences between Micromedex and Watson groups (p=0.52) or between Watson and Google groups (p=0.22). There was also no difference in time to complete the questions among groups (p=0.72).Conclusion:Utilizing Google did not save students time and led to more incorrect answers. These findings suggest that health care educators and health sciences librarians should further reinforce training on the appropriate use of drug information resources.

Incorporation of a mock drug information telephone call exercise in a health-systems pharmacy laboratory

Background and purposeHospital pharmacists routinely receive and answer drug information questions via telephone while performing order verification. This report describes the development, implementation, and evaluation of a mock learning experience for student performance of these tasks in a health-systems pharmacy laboratory course. Educational activity and settingAn active learning skills-based exercise involving students receiving and answering a standardized drug information question via telephone during an order verification activity, referred to as a cold-call exercise, was developed and implemented. Data collected included student grades on a baseline assessment, the cold call exercise, order verification exercises, and student perceptions from a voluntary post-exercise survey. Student performance on the cold-call exercise was further evaluated via individual sections of the cold-call rubric. Data were summarized using descriptive statistics. Thematic analysis of student opinion and an estimate of faculty time were also executed. FindingsStudent grades on the cold call and order verification exercises were 86.14% and 88.8%, respectively. Students often failed to ask category-specific questions because they did not categorize the ultimate question appropriately. Students found the activity organized and applicable. Time dedicated to creation was extensive, but execution and grading were reasonable. SummaryStudents performed well on the drug information exercise as well as the order verification component. Students and faculty enjoyed the experience, and students found the exercise relevant and challenging. This exercise could be implemented into any pharmacy curriculum in order to prepare students using authentic learning experiences.

Survey of drug information centers in the United States-2018.

To provide a current directory of drug information centers (DICs) in the United States and present information about their characteristics, activities and services, and networking activities. In February 2018, an electronic 23-question survey was delivered to 118 contacts on a distribution list compiled from previous directories of DICs, responses to listserv messages, and an Internet search. DICs, defined as formal centers dedicated to providing drug information services, including but not limited to responding to drug information requests, were asked questions about their characteristics, activities and services, drug information requests, and networking activities. The response rate was 79% (93 of 118 DICs). Of the 93 respondents, 82 (88%) met the definition of a DIC and were included in the directory. Of the 82 included DICs, 37 (45%) belonged to a university or college, while 36 (44%) belonged to a medical center or hospital. Seventy percent of the DICs (n = 57) had been in existence for more than 20 years. Of the 81 respondents reporting activities performed at the DICs, precepting pharmacy students (n = 79, 98%) and training pharmacy residents and/or fellows (n = 68, 84%) were most commonly reported. Nearly 90% reported that answering drug information questions was central to the DIC operations. Most DICs (n = 52, 65%) indicated receiving an average of 50 requests or less on a monthly basis. DICs reported a variety of electronic means of communicating with the DIC community, although 16 (21%) of the 77 respondents reported no need to do so. The survey identified 82 DICs that collectively provide a variety of services to their clienteles. The DIC directory published herein should facilitate networking among DICs.

Assessment and use of drug information references in Utah pharmacies.

Objective:To determine which drug references Utah pharmacists use most frequently. To determine which types of drug information questions are most commonly asked, and whether Utah pharmacists have access to adequate references to respond to these questions.Methods:A 19-question survey was created using Qualtrics, LLC (Provo, Utah) software. An electronic survey link was sent to 1,431 pharmacists with a valid e-mail address listed in the Department of Professional Licensing database. Questions focused on available references in the participant’s pharmacy, how current the references are, and the participant’s use of the references. Surveys were analyzed for participants practicing in either community or hospital pharmacies in the state of Utah.Results:A total of 147 responses were included in the analysis. Approximately 44% of respondents practiced in the community, and 56% practiced in a hospital setting. The most commonly used references by Utah pharmacists are Micromedex, Lexicomp, UpToDate, Clinical Pharmacology, and Drug Facts & Comparisons. Pharmacists in the community frequently receive questions related to adverse drug reactions, drug interactions, and over-the-counter medications. Pharmacists in the hospital frequently receive questions relating to dosage and administration, drug interactions, and adverse drug reactions. About 89% of community pharmacists and 96% of hospital pharmacists feel available references are adequate to answer the questions they receive.Conclusions:Utah pharmacists generally use large reference suites to answer drug information questions. The majority of pharmacists consider the references available to them to be adequate to answer the questions they receive.

Drug information at your fingertips

With many health care providers now using smartphones and 72% of Internet users turning to the Web for some health information, 1 a custom-based drug information application can potentially help patients and health care providers get answers quickly. Ashish Advani, PharmD, a drug information pharmacist at Mercer University College of Pharmacy, founded InpharmD, an online subscription platform to answer drug information questions; the platform is also available as a mobile application, currently only for Apple devices. 2

Associations of gender and age groups on the knowledge and use of drug information resources by American pharmacists

To explore knowledge and use of drug information resources by pharmacists and identify patterns influenced by gender and age-group classification. A survey questionnaire was mailed nationwide to 1,000 practitioners working in community (n = 500) and hospital (n = 500) settings who answer drug information questions as part of their expected job responsibilities. Responses pertaining to drug information resource use and knowledge of different types of drug-related queries, resource media preferences, and perceived adequacy of resources maintained in the pharmacy were analyzed by gender and age group. The t statistic was used to test for significant differences of means and percentages between genders and between age groups. Descriptive statistics were used to characterize other findings. Gender and age group classification influenced patterns of knowledge and use of drug information resources by pharmacists. They also affected pharmacists' perceptions of the most common types of questions prompting them to consult a drug information reference, as well as the resources consulted. Micromedex, exclusively available in electronic format, was the most commonly consulted resource overall by pharmacists. Lexi-Comp Online was the leading choice by women, preferred over Micromedex, but was not one of the top two resources selected by men. This study successfully identified the influence of gender and age-group classification in assessing drug information resource knowledge and use of general and specific types of drug-related queries.

Practice site interview with Jennifer Kelly

Describe your role as a psychiatric pharmacist. What did you need to change after starting your practice to make it work the way it does now? Currently, my practice area in the VA hospital has been established for less than two years. My predecessor was in the process of getting things off the ground before leaving for another opportunity in the private sector, so I have had the opportunity to set up clinics and work with our providers and patients in such a way that it is helpful for everyone involved. I am able to hold my own clinics, educational sessions, and balance other duties required by my department. I had to slowly integrate myself into working with our multi-disciplinary teams at first, and then figure out where my services would be most helpful for our providers, staff, and – most importantly – patients. I’ve had the opportunity to show staff and patients that my skills as a pharmacist not only include dispensing and/or counseling to patients but other functions such as monitoring drug therapy, making appropriate recommendations, and seeing patients one-to-one when necessary. The providers and staff utilize my expertise to further provide safe care for our Veterans. Safe medication use has had a positive impact on patient care and emphasizes safety while a patient is enrolled in one of the programs offered at the facility, as safe and appropriate use of medications is a primary concern in all of the residential care programs. I have had flexibility to carve out my time with the tasks I do daily to best help our patients and assist our providers. In this aspect, it has been nice being able to create my own clinics and use my time in ways I think will best benefit care for our patients. Describe a typical day in your practice setting. Every day is different, but I make daily rounds to each of the residential care units located in Albuquerque in the mornings. I work in five different programs, four of which are located in Albuquerque. The fifth residential treatment program focusing in substance abuse treatment is in Gallup, NM, which I travel to once monthly with the VA’s dietician and recreational therapist.

Integration of Pharmacy Students Within a Level II Trauma Center

To integrate fourth-year doctor of pharmacy (PharmD) students within a level II trauma center team to improve their patient care and professional communication skills. PharmD students completed 2 consecutive 4-week internal medicine APPEs during the course of their fourth year, which included approximately 5 weeks working on an interprofessional trauma team. During patient rounds with the interprofessional trauma team, students provided patient care in a stepwise approach, drug information responses, patient counseling, and other services requested by team members. Ability-based outcomes (ABOs) assessment, faculty evaluations, and student self-assessment were conducted in the following areas: effective communication, drug therapy assessment and decision making, critical thinking and problem solving, and drug information retrieval. Students' mean score in these areas was 3.8 on a 5-point scale. Areas in which students needed improvement included: providing recommendations in a timely manner, self-confidence, identifying opportunity to verbally communicate with other team members, and addressing insecurities when answering drug information questions posed by the team. Integrating fourth-year PharmD students within a trauma and acute surgery team and use of ABO assessment allowed for identification of areas of the curriculum in which improvements were needed, resulting in a more targeted approach earlier in the curriculum to improve students' abilities to provide appropriate and effective patient care in an interprofessional setting.

Principles of Drug Literature Evaluation for Observational Study Designs

Clinical pharmacists must often interpret and use data derived from observational studies when making clinical decisions and recommendations, answering drug information questions, and educating patients about drug therapy. This is the third article in a three-part series intended to enhance clinical pharmacists' understanding of methods frequently used in such research and their application to patient care. Principles for critical evaluation of published observational studies are presented. Issues of bias and confounding that must be taken into account when assessing the data derived from observational studies are explained. Finally, examples of applications in pharmacy practice are presented.

Effect of Drug Information Request Templates on Pharmacy Student Compliance with the Modified Systematic Approach to Answering Drug Information Questions

The modified systematic approach to answering drug information questions is a technique used in drug information practice and in teaching pharmacy students to effectively provide drug information. Drug information request templates were developed to prompt students and other trainees to ask appropriate background questions and perform an effective search. An evaluation was conducted to determine whether use of drug information templates by fourth-year pharmacy students during their drug information experiential rotation improved compliance with the modified systematic approach. Fifty documented drug information requests, including 25 prior to template implementation (August 2005-August 2006) and 25 after template implementation (August 2007-August 2008), were randomly selected for evaluation. Each question was evaluated for completeness of background information obtained, categorization and identification of the ultimate question, completeness of references searched, and formulation of a concise response and an evidence-based recommendation. Background information was complete in 16% of pre-template questions and 92% of post-template questions (p < 0.001). Eighty-four percent of pre-template questions and 96% of post-template questions were appropriately categorized (p = 0.349). The requestor's ultimate question was clearly identified in 68% of pretemplate questions and 92% of post-template questions (p = 0.074). All necessary references were searched in 36% of pre-template questions and 88% of post-template questions (p < 0.001). A concise response was documented in 80% of pretemplate questions and 92% of post-template questions (p = 0.417). In questions determined to require a specific recommendation among the pre-template (n = 20) and post-template groups (n = 14), a clear and evidence-based recommendation was described in 40% (p = 0.038) and 79% (p = 0.038), respectively. Use of drug information request templates improves students' compliance with the modified systematic approach, most notably in obtaining background information and searching necessary references including primary literature.

Drug information specialists

All pharmacists provide some level of drug information, whether to other clinicians or to patients. In fact, a recent survey found that 96.4% of 491 hospitals have staff pharmacists who routinely answer drug information questions,[1][1] and a separate survey of colleges of pharmacy showed that 89%

Management of adolescent and adult inpatients with cystic fibrosis

A program in which pharmacists help care for cystic fibrosis patients is described. The Egleston Cystic Fibrosis Center at Emory University houses outpatient clinic facilities and a 10-bed inpatient unit and is affiliated with Egleston Children's Hospital. The center provides full-service care for nearly 500 patients. Patients with mild to moderate exacerbations of pulmonary problems can receive their entire course of therapy at the center, and those with severe illness may complete their hospital stay there. A care team consisting of pharmacists, physicians, nurses, and others provides preventive and acute care. Patients can choose a "care partner" who will assist them with their care during any hospitalizations and at home. Both patient and care partner are taught drug administration, nutrition, and physical therapy and meet regularly with the care team. Patients must receive their medication education from a pharmacist before they can administer their own drugs. Pharmacists at the center also evaluate serum drug concentrations, stock the automated dispensing device, monitor for drug interactions, answer drug information questions, and attend multidisciplinary rounds. Pharmacy residents can work with the care team through rotations and clinic experience. Pharmacists at a cystic fibrosis center provide clinical services to patients and promote self-care.

A Review of the Three Types of Biomedical Literature and the Systematic Approach to Answer a Drug Information Request

The pharmacist is relied upon to provide drug information on a daily basis for patients and health care professionals. Performing drug information tasks requires the ability to efficiently search, critically analyze, and objectively evaluate the biomedical literature. Pharmacists and pharmacy students need to understand the biomedical literature and an organized method to answer drug information questions. Therefore, the tertiary, secondary, and primary literature resources are defined and examples are presented. In addition, the modified systematic approach to answer a drug information request is reviewed. Understanding the different types of literature and applying the systematic approach assists practitioners in efficiently supplying drug information. The purpose of this article is to assist the pharmacist and pharmacy student in determining the strengths and limitations of the various types of literature and applying the systematic approach to a drug information inquiry.

Diagnosis and Treatment of Five Parasites

General descriptions and monographs of the five parasites most likely to be seen in U. S. patients are presented. The appended monographs are designed to be a starting reference for answering drug information questions regarding these parasites. The drugs covered in the monographs are listed in the order of suggested use.