Information Pharmacists Research Articles

Problem-oriented drug monographs developed for physicians in Northern Ireland

Monographs prepared by a drug information pharmacist at a government hospital in Northern Ireland were evaluated by hospital and community physicians. The monographs related drug information to both the primary medical problem (e.g., angina) and secondary problems of individual patients (e.g., renal or hepatic dysfunction). The pharmacokinetic and pharmacodynamic properties of various agents in a drug group were compared. The initial monograph about beta blockers was evaluated by 13 pharmacists in government hospitals. The monograph was then revised and two additional monographs were written on the use of benzodiazepines in anxiety and insomnia and the use of organic nitrates in cardiovascular disease. The three monographs were distributed to 122 hospital physicians and 67 community physicians for evaluation of the information and the manner in which it was presented. Questionnaires were returned by 46% of the hospital physicians and 39% of the community physicians. Almost 50% of the responding prescribers said the monographs gave them new information. The lack of cost information in the monographs was cited as a problem by 25% of respondents. The most frequently suggested topics for additional monographs were antibiotics, analgesics, nonsteroidal anti-inflammatory agents, bronchodilators, and antidepressants. Physicians considered the monographs a useful source of education about selection of appropriate drug therapy.

Evaluating a restrictive formulary system by assessing nonformulary-drug requests

Nonformulary-drug requests were used to evaluate a restrictive formulary system in a large university hospital, and a telephone survey of eight similar hospitals was conducted to assess the restrictiveness of their formulary systems. Nonformulary-drug requests were evaluated by two drug information pharmacists over a 12-month period (January-December 1984) to assess the frequency with which nonformulary items were ordered, the costs associated with the procurement of nonformulary drug products, and the rationales given by physicians when ordering nonformulary products. Of all nonformulary requests, 65% were for drugs previously evaluated by the pharmacy and therapeutics committee and denied admission to the formulary. A cost savings of $1887 would have resulted if formulary alternates had been used instead of nonformulary products. Excluding 22% of nonformulary items that were requested for the continuation of preadmission drug therapy, only 13% of the rationales for the remaining requests were appropriate. Although the eight other hospitals surveyed said they had restrictive formularies, all had frequent requests and procedures for procuring nonformulary items and some formularies included most available drugs. The formulary system at the study hospital was considered restrictive, but procedures for nonformulary-drug requests limited the effectiveness of the system. If any benefit is to result from formulary systems, hospitals must strengthen their enforcement of formulary restrictions.

A survey of patient sources of prescription drug information.

A national telephone survey of 1,104 adults who had recently obtained a new prescription was undertaken to determine the nature and amount of drug information obtained. Sixty percent stated that physicians provided directions for use information with the pharmacy reported as about half as active. Only 3 to 6 per cent said they asked the physician or pharmacist for information. However, one in six respondents said they looked up the prescription in a drug reference book such as the Physicians Desk Reference.

The oral contraceptive PPI: its effect on patient knowledge, feelings, and behavior.

The distribution of the PPI by pharmacists is at best controversial. Although most health professionals agree that the patient has a right to receive information about drugs, they disagree on the best way to provide that information. Since the oral contraceptive PPI has been in routine use for approximately 10 years, a large data base exists that can be used to determine not only patient acceptance of the PPI, but also knowledge, feelings, and behavior secondary to the PPI. In this study, 50 women of childbearing age completed a questionnaire, and it was learned that 84 percent had taken or were currently taking oral contraceptives, and 90 percent of those received a PPI; however, only 61 percent of these women read all of it. The women performed poorly on the knowledge exam (mean +/- SD, 44.5 +/- 21.2, range, 0-83 percent); those who read all of the PPI or who were white had higher scores (p less than 0.02 and p less than 0.001, respectively). Thirty-eight percent of the women thought that the PPI information was inadequate, suggesting that it needs to be rewritten and/or supplemented with information from pharmacists. After reading the PPI, 12 percent contacted their pharmacist for additional information. Pharmacists are in a unique position to provide oral contraceptive information that enables women to make informed judgments regarding benefit:risk ratios on a personal basis.

Drug Information Centers: Meeting Future needs for Drug Information

Future trends in drug information services are discussed. Drug information centers (DICs) have developed from being the first clinical pharmacy service 20 years ago to providing a necessary support role for clinical pharmacy practitioners today. The necessary training for drug information pharmacists is described, and continued involvement of these pharmacists in clinical practice is recommended. The shift of health care from hospitals to outpatient clinics means that DICs will have to provide drug information services to community practitioners in the future. Alternative funding sources for DICs, including fee-for-service payment plans, must be developed. The merits of establishing regional DICs and marketing services directly to patients are outlined.

Drug information centers: ASHP's role and effect of clinical pharmacy

The role of the American Society of Hospital Pharmacists in fostering the drug information movement is described, and the effects of clinical pharmacy practice on drug information centers are outlined. ASHP has been an early and consistent supporter of the pharmacists' role in providing drug information. In 1968 the Society adopted a statement that outlined the role and expected competencies of drug information specialists. Accreditation standards for specialized residencies in drug information practice were adopted in 1982. On a broad scale, drug information pharmacists foster rational drug therapy through input on pharmacy and therapeutics committees. In general, when decentralized drug distribution and clinical pharmacy services are implemented in a hospital, the number of questions asked of a drug information center decreases, but the type of question changes. Drug information pharmacists working with clinical pharmacists provide a communication system for providing other health-care practitioners with information necessary for optimal drug therapy in particular patients. To increase the efficiency of drug information centers, drug information pharmacists must incorporate computer technology into their practice sites.

Hiring drug information personnel

An analysis of the functions performed at a drug information center (DIC) is described as the basis for hiring personnel. A functional job analysis demonstrated a division in the duties of DIC personnel. The workload demanded a drug literature specialist (DLS) to access, store, and retrieve drug information, and a practitioner in drug information (PDI) to analyze this information and make the appropriate clinical judgements. The DIC hired a DLS with a background in library science and experience with computer searching techniques to work with the PDI. It is suggested that the combination of a qualified librarian and a drug information pharmacist can provide the DIC with the optimal personnel. The analysis was a valuable tool in selecting personnel who possess the appropriate skills, job understanding, attitude, and innovative abilities.

Drug information network in the United Kingdom National Health Service

The drug information network is the United Kingdom National Health Service (NHS) is described. The NHS was reorganized in 1974 resulting in the creation of 14 regions, which were further divided into areas. Drug information services provided within the regions and coordination between regions have evolved into a decentralized national drug information network. In this network, regional centers provide support to their area centers; difficult questions received by area centers may be referred to the regional center. Additionally, some regional centers have become specialized in particular fields. All regional centers have access to data held by other regional centers. Activity is further coordinated by a literature abstracting service in which each regional center has certain responsibilities; a code of practice for drug information pharmacists; production of specialty bulletins; and standardized education and training. Future plans for expanded services are described.

The British drug information service

This paper describes the type of drug information service available in the UK, its scope, limitations and possible future development. A survey was carried out in which information pharmacists in the sixteen major drug information centres in the UK were interviewed. All centres have access to a large number of information resources and, in addition, have developed a resource which reduces the delay before published information is retrievable from their own system. Some centres receive large numbers of enquiries and have little time for active dissemination of information whilst other centres with few enquiries actively disseminate information to hospital staff. Some centres send bulletins to general practitioners, retail pharmacists and community nurses. Most information pharmacists refer enquiries concerning drug therapy in patients with which they may have difficulties to clinical pharmacologists or other medically qualified personnel. General practitioners use drug information services less often than hospital doctors. Most information pharmacists plan to extend their services to medical and paramedical staff in the community. In the future, information pharmacists plan to use improved technology to provide a more efficient service, open for longer hours, provide clinical opinion with the help of clinical pharmacologists and increase the functions of drug information centres (e.g. adverse drug reaction monitoring).

Chelating agent in non-USP calcium gluconate injection

Journal Article Chelating agent in non-USP calcium gluconate injection Get access Dennis Welch, Dennis Welch Supervisor The North Carolina Memorial Hospital University of North Carolina Chapel Hill, NC 27514 Search for other works by this author on: Oxford Academic Google Scholar Renee Scoratow, Pharm.D. Renee Scoratow, Pharm.D. Drug Information Pharmacist The North Carolina Memorial Hospital University of North Carolina Chapel Hill, NC 27514 Search for other works by this author on: Oxford Academic Google Scholar American Journal of Hospital Pharmacy, Volume 37, Issue 2, 1 February 1980, Page 174, https://doi.org/10.1093/ajhp/37.2.174 Published: 01 February 1980

A 'mini-residency' in drug information for the practicing pharmacist.

Continuing education "mini-residencies" in drug information services were sponsored by the University of Washington School of Pharmacy's Division of Continuing Education and the University of Washington Drug Information Service (DIS) in August of 1976, 1977, and 1978. Each mini-residency covered a two-week period (a total of 80 hours) and was divided into didactic and experimential sessions. The university's DIS was the major resource for the residents. The two-week residency was designed to provide education and experience in the areas of drug information retrieval, analysis, and dissemination. The program was assessed through pre- and post-testing and a midcourse evaluation session. The residency format of the program allowed practicing pharmacists to return to the university to develop their skills in the area of drug information. The article presents a model for other drug information pharmacists who may want to offer similar training programs.

Community, Hospital and Clinical Pharmacists and Drug Information Centers as Physician Drug Information Sources

The use of drug information centers and clinical, hospital and community pharmacists by university and community practice physicians in North Carolina was examined. Questionnaires were sent to 674 nonfederal physicians with a response rate of 203 (35.5%). Approximately half of the sample were staff members of a university hospital. The questionnaire covered eight types of drug information. Significant results were reported at the p = 0.05 level. Physicians sought specific drug information approximately one to four times a month. University hospital-affiliated physicians rated clinical and hospital pharmacists significantly higher than community pharmacists for six subject areas, and they also ranked clinical pharmacists over hospital pharmacists on four subject areas and considered them more reliable than other pharmacy drug information sources. Physicians associated with community hospitals ranked hospital pharmacists over community pharmacists as sources of information for four areas and rated them more reliable than other pharmacy drug information sources; this group preferred to use community pharmacists for information on product availability. It appears that clinical pharmacists are used by university-associated physicians as drug information sources. Use in community hospitals of the hospital pharmacist as a drug information source is better than the literature might suggest.

The regional drug information service: a factor in health care?

Most regional health authorities throughout the United Kingdom have established drug information units to provide health service staff with a wide range of information about drugs and drug use. The units, which are staffed by drug information pharmacists, provide their service mainly by answering inquiries, although some disseminate information more positively through lectures and bulletins.An analysis of inquiries received by regional information units during 1976 showed that most were submitted by hospital doctors or pharmacists; comparatively few were received from general practitioners. Topics of inquiry included adverse effects of drugs, source of supply and identification, current treatment, dosage, route, precautions, and pharmaceutical problems such as stability or formulation of drug preparations. A more detailed analysis of the inquiries received by the North-western Regional Drug Information Service at Manchester over three years showed that the number of inquiries gradually increased and that more were received from general practitioners after a programme of lectures had been introduced to tell them about the service. The North-western service also received more requests from hospital pharmacists than other units, though many originated from clinicians.The regional drug information units consulted widely with clinical and other specialists in answering questions, but about a quarter of all inquiries were pharmaceutical, relating to stability and incompatibility. A multidisciplinary approach therefore seems necessary to provide a comprehensive and advisory drug information service.

DRUG-INFORMATION SYSTEMS FOR HOSPITAL PHARMACISTS

Summary The hospital pharmacist found himself fulfilling a drug-information role and produced impromptu systems to deal with his needs. It is argued that the designing and setting up information systems is a specialist's job (System Analyst or Information Scientist's), and that the information pharmacist should free himself to provide, and where appropriate, evaluate information.

Conceptual framework for drug usage review, medical audit and other patient care review procedures

The following concepts are discussed: (1) quality assurance programs, (2) drug usage review, (3) utilization review, (4) peer review, (5) medical audit, (6) patient care audit and (7) medical care evaluation studies. A framework within which all types of hospital quality assurance mechanisms can be constructed is proposed and their interrelationships are described. The pharmacist's particpiation in the hospital's overall quality assurance program is stressed in two main areas-drug usage review, performed jointly with the medical staff, and quality assurance of pharmaceutical services, a peer review function of the pharmacy profession. These services are primarily drug distribution and control, drug information, clinical pharmacy, continuing education, and other pharmacy and pharmacist functions. Both functions may be viewed as parts of the pharmacy audit, one of several patient care audits within the facility. Pharmacists in skilled nursing facilities have quality assurance responsibilities similar to those of hospital-based pharmacists.

Developing drug reports for the pharmacy and therapeutics committee

The role of a drug information center in working with a pharmacy and therapeutics committee is discussed. In order to add a drug to the formulary, physicians must complete a special form which asks for justification for the addition. In preparing a report for the pharmacy and therapeutics committee, the drug information pharmacist evaluates the request as it relates to: (1) the effectiveness of the drug in the stated anticipated uses, and (2) studies comparing the requested drug with similar drugs already in the formulary. Use of the form permits the pharmacist to focus on the specific claims made by the physician who is requesting the formulary addition.

Drug usage review in a community hospital

A simple and effective manual drug usage review program in a community hospital is described. Fifteen randomly selected charts are screened each month by a drug information pharmacist. Charts demonstrating questionable drug therapy are forwarded to a physician member of the pharmacy and therapeutics committee; those showing questionable drug administration practices are referred to the nurse member of the committee. These committee members screen the questionable charts and refer to the entire committee those cases which require further follow-up. The committee categorizes the problems and communicates its recommendations to the individual practitioners involved. Recommendations focus on the legal ramifications of FDA-unapproved drug usage. During the first two years of the program, 341 charts were screened for drug usage; 62 of these were referred to the pharmacy and therapeutics committee for further review. In 20 cases, the committee sent a letter to the prescribing physician or his department chairman; in 16 cases, letters were sent to nursing administration.