Drug Information Lecture 1 PDF

Drug Information pp701 Clinical pharmacy department 2024/2025  Lecture 1 Introduction  Course Description: Concept of drug information and its need, types of drug information resources (primary, secondary and tertiary literature), computerized an...

Drug Information pp701 Clinical pharmacy department 2024/2025  Lecture 1 Introduction  Course Description: Concept of drug information and its need, types of drug information resources (primary, secondary and tertiary literature), computerized and online drug information, literature evaluation and critical appraisal. The course also aims at providing the students with the professional skills required to effectively and accurately answer medication- related questions in a systematic and evidence-based approach. Definition Drug information is current, critically examined, relevant data about drugs and drug use in a given patient or situation.  Current information uses the most recent, up- to-date sources possible.  Critically examined information should meet the following criteria:  More than one source should be used when appropriate.  The extent of agreement of sources should be determined; if sources do not agree, good judgment should be used.  The plausibility of information, based on clinical circumstances, should be determined.  Relevant information must be presented in a manner that applies directly to the circumstances under consideration (e. g., patient parameters, therapeutic objectives, alternative approaches).  ANSWERING DRUG INFORMATION QUERIES Approach to answering drug information queries: Analyse the type of drug information Understand the background of the question Understand the real need of the physician Follow systematic approach  THE BASIC STEPS TO APPROACHING DRUG INFORMATION ENQUIRIES ARE: 1. Secure demographic details of the requester: *identify the enquirer and obtain sufficient details * the requestor’s profession.(physician, pharmacist, nurse, lay person)-to know education, experience and knowledge base. 2. Obtain background information. General questions for obtaining background information includes * The resources that the requestor already consulted * Whether the request is patient specific or academic * The patient’ diagnosis, medications and related medical information *The urgency of the request. 3. Refine and categorise the ultimate question: * Classification of the request helps in developing a more effective search strategy and in determining the resources that should be used. *This information may help to refine the question and to estimate the time required to achieve an acceptable response. * example of question classification: ▪adverse drug reaction/ contraindications ▪availability ▪Dose ▪Drug compatibility/ stability ▪Drug interaction ▪Drug therapy ▪Drug identification. 4.Develop a strategy and conduct a search: *The pharmacist should select and prioritize resources based on the probability of locating the desired information. Conduct a systematic search: *Be familiar with the three types of information sources in the literature hierarchy *Begin with the established knowledge located within the tertiary literature (e.g., textbooks) due to the condensed, easy-to-use format of the information presented * Progress through the secondary literature (e.g., PubMed, International Pharmaceutical Abstracts [IPA]) to the primary literature (e.g., controlled clinical trails, letters to the editor) 5.Perform evaluation , analysis and synthesis: * The pharmacist should confirm information with other references to assure consistency between various resources and whether clinical research is relevant to your population or specific patient. * The pharmacist should apply his or her techniques and skills for literature evaluation and clinical application for statistical analysis 6.Formulate and provide a response: *answers should be derived only after critically analysing information obtained from a comprehensive search. *provide a formulated response to the enquirer in a timely manner. *present the competing viewpoints along with the reference. *all responses should be documented with the minimum detail necessary to justify the response. 7.Conduct follow-up and document the outcome: * determine the consequence of your advise and any patient outcomes. * advise provided should be recorded in at least one mode of documentation (log book, paper worksheet, computer database). Drug information resources: ✓ Primary sources. ✓ Secondary resources. ✓ Tertiary resources. Primary sources: Primary sources of drug information include unpublished studies and original articles published in reputed peer-reviewed journals reporting original research, ideas or opinions. They form the basis for all other sources of information and provide the most up to-date information on a particular topic. However, the evaluation and interpretation of research articles is difficult and requires time and expertise. Well-conducted randomized controlled trials (RCTs) provide the most reliable source of information. Examples of primary sources of information includes peer- reviewed journals that publish original articles like Annals of Internal Medicine and The Lancet.  Benefits of using primary sources: Clinical trials provide the most current information about drugs and, ideally, should be the source for answering therapeutic questions. Journals enable pharmacists to: 1) Keep up-to-date of professional news. 2) Learn how another clinician handled a particular problem. 3) Distinguish useful from useless or even harmful therapy. 4) Enhance communication with other health care professionals and consumers. 5) Obtain continuing education credits. 6) Share opinions with other health care professionals through letters to the editor. Basic Structure of an article: Abstract/ Summary: An Overview or summary of the work highlighting of results and determine the general statement of significance. Introduction: the background information including history, pathophysiology, and clinical presentation. Also, introduction could include review of the work of others. Moreover, it focusses on the rationale for present study and its aim. Methods/materials & methods/patients & methods: this section includes the study design, subject selection procedures, methods of measurement, and the description of analytic techniques. Results: this section describes what happened and includes graphics, tables, charts, and figures that should summarize the findings. Basic Structure of an article: Discussion/comment/conclusion: This section shows the meanings, significance of work, analysis of the study including limitations and strengths, further analysis, comparison with other work. References/bibliography: This is the last section of an article and includes evidence that work of others has been considered and leads to further exploration of the subject. The article to be published should be enrolled in the process of peer reviewing.  Peer Reviewing Process Limitations of using primary sources: Although publication of an article in a well-known, respected journal enhances the credibility of information contained in an article, this does not guarantee that the data are accurate. Many articles possess inadequacies that become apparent as the ability to evaluate drug information improves. Secondary sources: Secondary sources of drug information refer to indexing and abstracting systems that organize and provide easy retrieval of primary resources. Indexing achieve rapid access to literature information and literature sources. key indexing terms consists of primary indexing terms, descriptive modifying terms, and access number. 1- Primary indexing terms Constitute the appropriate key term under which the information is filled in the relevant literature sources and is considered an efficient method to identify or locate information or answers pertaining directly to the type of information needed. 2- Descriptive modifying terms Which are terms used to modify or describe the primary indexing terms. 3- Access number Used to locate the information or request pertaining to the modifying term. Example: a question was received in a drug information center regarding the adult dose of Ibuprofen to be used by a patient with renal failure. Such question will be indexed as follows: Ibuprofen-Renal Failure, dosage (Adult)….464. Ibuprofen word represents Primary indexing term hyphen and the words “Renal Failure, dosage (Adult)” represents Descriptive modifying indexing term while the number 464 is the access number.  Abstracting Abstracts are summaries of the content of information appearing in published articles, constructed to be a major device for information storage, or retrieval system. Types of abstracts: Indicative abstracts (Non-evaluative or Descriptive abstracts): These are brief outlines of the subjective materials in an article in which details are omitted (50- 100 words). Informative Abstracts (evaluative abstracts): These should contain all key concepts and important information mentioned in the article (about 250 words) Purposes Of Abstract: Quick read ……. whether the full article would be useful to read. Used for separate publication (e.g., by Biological Abstracts or Chemical Abstracts). To provide terminology to assist in literature searches (Key Words). Benefits of secondary resources Quick and selective screening of the primary literature for specific information, data, citation, and articles. Provide sufficient information to serve as references for answering drug information requests.  Limitations Managed by a limited number of journals. Substantial difference in lag time (i.e., the interval between the publication of an article and the citation of that article in an index) among the available services. ( PUBMED ………….. 1 weak – Iowa Drug Information Service ……. 30-60 day). It should not be used as primary sources of information because they are typically interpretations of a study and may be a misinterpretation of important information. Abstracts may not include enough information to critically evaluate the study. Proper training is required for efficient use of these resources.