Drug Information Resources

Introduction

• Pharmacists need to respond to drug information requests daily.
• Pharmacists can choose the easiest and most familiar information resources.
• The resource used to respond to a question depends on the requestor type.
• Consumer/patient requests should be answered using tertiary resources.
• Prescriber requests for disease state management details should be answered using primary literature.
• The best method to find information should include a stepwise approach.

Information Resource Types

• Tertiary resources are review articles, textbooks, and full-text databases.
• Secondary resources are indexing or abstracting services.
• Primary resources are clinical studies.
• Tertiary resources provide general information to familiarize practitioners with a topic.
• Secondary resources are useful when tertiary information is not recent or comprehensive enough.
• Secondary databases guide readers to primary literature for more insight on a topic.
• Primary literature offers current and in-depth information about a topic.
• Analyzing and critiquing study methodology is possible using primary literature to determine conclusion validity.
• Primary resources serve as information source for secondary and tertiary resources
• Consult news reports or internet sites to get background information before searching.
• Other resources such as experts in particular practice areas may be consulted.
• Information search does not always require all three types of resources.
• Commercial availability of a product formulation can be found using tertiary literature.
• Mechanism of action can be found using tertiary resources.
• Clinical trials supporting off-label use in a specific population can be found using primary literature.

Tertiary Resources

• Tertiary resources consist of information which has been summarized by an editor or author to make a quick and easy summary of a topic.
• Examples: textbooks, compendia, review articles, and general internet information.
• Problems: Errors in transcription, human bias, incorrect interpretation of information, and lack of expertise by authors
• A tertiary resource is an initial place to identify information.
• Tertiary resources are convenient, easy to use, and familiar to most practitioners.
• Most information that a practitioner needs is in these resources.
• Disadvantages: Lag time associated with publication, less current or out of date information, incomplete information, space limitations, and incomplete literature searches by the author.

Examples of Tertiary Resources

• American Society of Health-System Pharmacists (AHFS) Drug Information.
• Clinical Pharmacology
• Drugdex® System
• Drug Facts and Comparisons
• Drug Information Handbook
• Handbook of Clinical Drug Data
• Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care
• Physicians' Desk Reference
• USP DI Volumes I, II, and III
• Meyler's Side Effects of Drugs
• Red Book
• American Drug Index
• Handbook on Injectable Drugs
• King Guide to Parenteral Admixtures.
• Applied Therapeutics: The Clinical Use of Drugs
• Cecil Medicine
• Harrison's Principles of Internal Medicine
• The Merck Manual of Diagnosis and Therapy
• Pharmacotherapy: A Pathophysiological Approach
• Pharmacotherapy Principles and Practice
• Textbook of Therapeutics
• Pediatrics: Harriet Lane...
• Iv admixtures: Trissel's..

Secondary Resources

• Direct users to primary literature through references that index or abstract them.
• Indexing provides bibliographic citation information (title, author, article citation).
• Abstracting includes a brief information description (or abstract) provided by the cited resource or article.
• Secondary resources are available electronically and in print.
• Systems do not index all terms the same.
• Terms a database is using is necessary to determine in order to conduct a successful search.
• Databases through the National Library of Medicine index terms by their Medical Subject Heading (MeSH term).
• Iowa Drug Information System uses the United States Adopted Name and the International Classification of Diseases.
• Variety of terms need to be utilized for search strategy for the sample question "Is clonidine effective in the treatment of attention deficit hyperactivity disorder (ADHD) in adolescents?"
• Key terms for search strategy include clonidine, ADHD, and adolescents.
• Recognize that different databases might require different search terms.
• AND: will combine two terms, returning only citations containing both of those concepts or terms.
• OR: will have an equal or greater number of returns since it will include any citation where either term is used.
• NOT: will always decrease the number of responses, since it eliminates any references having the term that follows that operator.

Examples of Secondary Databases

• Biological Abstracts/ Biosis Previews: Thompson Medical (http://www.scientific.thomson.com) -> Biological and biomedical information.
• Cancerlit: National Cancer Institute -> Oncology (http://www.cancer.gov/)
• CINAHL: CINAHL Information Systems (http://www.cinahl.com) -> Nursing and allied health.
• Cochrane Library: Cochrane Library (http://www.cochrane.org) -> Medical treatments, conditions, and alternative therapies.
• Iowa Drug Information System (IDIS): University of Iowa (http://itsnt14.its.uiowa.edu/).
• Journal Watch: Massachusetts Medical Society (http://www.jwatch.org).
• LexisNexis: LexisNexis Academic & Library Solutions (http://www.lexisnexis.com) -> Medical, legal, and business news.
• Medline: National Library of Medicine (http://www.nlm.nih.gov) -> Basic and clinical sciences as well as nursing, dentistry, veterinary medicine
• Pharmacoeconomics & Outcomes News Weekly: Adis International (http://www.adis.com).

Primary Resources

• Clinical research, basic research studies, and reports that are both published and unpublished.
• Controlled trials, cohort studies, case series, and case reports are all primary resources.
• Primary resources offer access to detailed information about a topic.
• Primary resources provide the ability to personally assess the study result validity and applicability.
• Primary resources are more recent than tertiary or secondary literature.
• Misleading conclusion can occur if only one trial is looked at without the context of other researches .
• Good skills in medical literature evaluation.
• Time needed is high to evaluate a large volume of literature available.
• PubMed links to open access journal publications & articles.

Alternative Resources

• Evaluate the quality of all information provided on Internet resources.
• Sites maintained by educational institutions, not-for-profit medical organizations, or the U.S. government division are likely to contain high quality information.
• Information maintained by a company selling or promoting a specific product is more questionable.
• Criteria should be used when determining quality of online material.
• Sources should be credible, and not have a vested interest in promoting treatment or product?
• Information, accurate, and current.
• Site links to other nonaffiliated sites.
• Information appropriately detailed and referenced.
• Possible to contact site author for additional comments or questions.
• Identify an affiliated organization with the disease state when looking for recent recommendations regarding treatment of a specific disease state.
• When seeking information about a specific drug therapy, contact product manufacturers via medical information department.