information resources 1

Information Information ResourcesResourcesSatisfying the Satisfying the Pharmacists' Pharmacists'

Qualification NeedsQualification Needs

Would you please Would you please write down two write down two

questions you have questions you have in mind and want to in mind and want to know where to get know where to get

the answers from??? the answers from???

What is the reason for your What is the reason for your search???!!!!!!!!!!!search???!!!!!!!!!!!

How would you mostly manage it ??!!!!!!!How would you mostly manage it ??!!!!!!!

Would you categorize your question in Would you categorize your question in relation to “types of pharmaceutical relation to “types of pharmaceutical information” ???!!!!!!!!!!information” ???!!!!!!!!!!

StrategiesStrategiesfor for

Evaluation of Evaluation of Information Information

RequestsRequests

Receive the enquiry: Note contact Receive the enquiry: Note contact details (background information, i.e. details (background information, i.e. name, status, phone number….etc)name, status, phone number….etc)Determine and clarify the questionDetermine and clarify the questionClassify the questionClassify the question

SEARCHSEARCHEvaluate (appraise)Evaluate (appraise)Formulate an answerFormulate an answerCommunicate the response Communicate the response

Systematic search approach in dealing Systematic search approach in dealing

with an inquiry:with an inquiry:

To carry out medicines' information To carry out medicines' information

provision roles effectively provision roles effectively

pharmacists need to knowpharmacists need to know

HOW TO

Find Information

Evaluate Information

Put into Practice

Search: Search:

In practice, when we attempt to find In practice, when we attempt to find information information relevant torelevant to a clinical problem a clinical problem our goal is to find the most useful our goal is to find the most useful information information in the shortest timein the shortest time

Usefulness of information = (Relevance * Usefulness of information = (Relevance * validity) / Work to accessvalidity) / Work to access

Search: Search:

Tertiary sources relevant to the topic should Tertiary sources relevant to the topic should be consulted be consulted firstfirst, ,

ThenThen progress via secondary sources to progress via secondary sources to locate primary literature. locate primary literature.

Because journal coverage varies with Because journal coverage varies with different secondary systems, it is important different secondary systems, it is important to to use more than oneuse more than one secondary source for secondary source for a thorough searcha thorough search

Primary sources

Tertiary sources

Secondary sources

Type

s Of

Info

rmat

ion

Resou

rces

Publication of original research that has Publication of original research that has not been interpreted or changed by not been interpreted or changed by othersothers

Primary Literature !!!Primary Literature !!!

Advantages:Advantages:

Current & original informationCurrent & original information


Disadvantages:Disadvantages:

Knowledge of scientific methods and Knowledge of scientific methods and statistics is needed to properly interpret the statistics is needed to properly interpret the

information information


When to use:When to use:

When looking for the most up-to-date When looking for the most up-to-date information information


Examples:Examples:

Scientific journal articles which report Scientific journal articles which report results of case studies, research or results of case studies, research or

clinical trialsclinical trials


Where to find primary literature: Where to find primary literature:

High-quality (peer-reviewed) resources in High-quality (peer-reviewed) resources in particular relevance to pharmacy include:particular relevance to pharmacy include:


Where to find primary literature: Where to find primary literature:

The Pharmaceutical JournalThe Pharmaceutical Journal

Annals of PharmacotherapyAnnals of Pharmacotherapy

International Journal of Pharmacy PracticeInternational Journal of Pharmacy Practice

American Journal of Health-Systems American Journal of Health-Systems PharmacyPharmacy


Resources which provide access to Resources which provide access to primary literatureprimary literature

Secondary Literature !!!Secondary Literature !!!


Provide efficient access to primary literatureProvide efficient access to primary literature



Users need to be familiar with searching Users need to be familiar with searching electronic databaseselectronic databases

Lag timeLag time

Database scopeDatabase scope



When you need to find primary literatureWhen you need to find primary literature


Examples:Examples:

Indexing & abstracting databases such Indexing & abstracting databases such as the as the PubMedPubMed


Collection of data & concepts drawn Collection of data & concepts drawn from primary literaturefrom primary literature

Tertiary Literature !!!Tertiary Literature !!!


Convenient & easy to useConvenient & easy to use

Information is usually well establishedInformation is usually well established



Information may bee too old to be usefulInformation may bee too old to be useful



When you need to find background When you need to find background information information

When you need a quick answerWhen you need a quick answer


Examples:Examples:

Reference booksReference books

Drug monograph collectionsDrug monograph collections

Review articles Review articles


Key Tertiary Drug Key Tertiary Drug Information Resources for Information Resources for

Pharmacy PracticePharmacy Practice

Evaluation tips !!!

1.1. Core resources on medicineCore resources on medicine

1. AHFS Drug Information

Key Tertiary Drug Information Key Tertiary Drug Information Resources for Pharmacy PracticeResources for Pharmacy Practice


2. Martindale: the complete drug reference: the complete drug reference



3. The Merck Manuals

http://www.merck.com/pubs/http://www.merck.com/pubs/



4. Comprehensive pharmacy review



5. British National Formulary (BNF)


Designed as a digest for Designed as a digest for rapid referencerapid reference & it & it may may NOTNOT always contain always contain ALL ALL the information the information necessary for prescribing & dispensingnecessary for prescribing & dispensing

It includes key information on It includes key information on Selection,Selection,

PrescribingPrescribing

Dispensing andDispensing and

Administration of medicinesAdministration of medicines

**British National Formulary** (BNF)


6.6. See also, the See also, the WHO model formularyWHO model formulary 2006 2006

http://www.who.int/emlib/ModelList.aspx?Language=EN&MdType=FORMULARYhttp://www.who.int/emlib/ModelList.aspx?Language=EN&MdType=FORMULARY


2.2. PharmacologyPharmacology

1.1. Goodman and Gilman’s Pharmacological Goodman and Gilman’s Pharmacological Basis of TherapeuticsBasis of Therapeutics


2.2. PharmacologyPharmacology

2. Lippincott’s clinical pharmacology


3.3. Drug interactionsDrug interactions

1.1. Stockely’s Drug InteractionsStockely’s Drug Interactions


4.4. Adverse drug reactionsAdverse drug reactions

1.1. Myeler’s Side Effects of DrugsMyeler’s Side Effects of Drugs


5.5. PharmacotherapyPharmacotherapy

1.1. Avery’s Drug TreatmentAvery’s Drug Treatment



2.2. Drug and Therapeutics BulletinDrug and Therapeutics Bulletin



3.3. Clinical Pharmacy and TherapeuticsClinical Pharmacy and Therapeutics


They usually contain more current They usually contain more current information about a specific topic than information about a specific topic than textbookstextbooks

Reviews & Systematic Reviews & Systematic ReviewsReviews

How is a Review Made ??!!How is a Review Made ??!!

Where to Find Where to Find Systematic Systematic Reviews??Reviews??

Example:

The Cochrane Database

Reactive:Reactive: Information or advice given by the pharmacist Information or advice given by the pharmacist

in response to questions or enquiries about in response to questions or enquiries about medicinesmedicines

Proactive (active):Proactive (active): The preparation of newsletters, bulletins, The preparation of newsletters, bulletins,

websites, etc. in an attempt to educate or raise websites, etc. in an attempt to educate or raise awareness of key therapeutic issuesawareness of key therapeutic issues

Drug Information ProvisionDrug Information Provision

Consult their peersConsult their peers

Expert opinionsExpert opinions

Carry out a literature searchCarry out a literature search

Pharmaceutical industry representativesPharmaceutical industry representatives

How Do Healthcare workers Mostly How Do Healthcare workers Mostly Manage Their Information Needs ?!!!Manage Their Information Needs ?!!!

The major disadvantage of The major disadvantage of making clinical decisions making clinical decisions based on expert opinions is based on expert opinions is the the susceptibility of the susceptibility of the opinion to biasopinion to bias, as it is , as it is NOTNOT based on systematically based on systematically collected information collected information

Expert opinions !!!!Expert opinions !!!!

1.1. Formulate answerable questions,Formulate answerable questions,

2.2. Identify and acquire the best evidence to Identify and acquire the best evidence to answer the question,answer the question,

3.3. Critically appraise the evidence for its Critically appraise the evidence for its validity, impact and applicabilityvalidity, impact and applicability

Carry out a literature search ???!!!!Carry out a literature search ???!!!!

4.4. Integrate the findings with clinical expert Integrate the findings with clinical expert and patient factors to extract a "clinical and patient factors to extract a "clinical bottom line" or answerbottom line" or answer

5.5. Evaluate the four previous steps for Evaluate the four previous steps for effectiveness and efficiency effectiveness and efficiency

Carry out a literature search ???!!!!Carry out a literature search ???!!!!

Choice of therapy (including indications and Choice of therapy (including indications and contraindications)contraindications)

Adverse effectsAdverse effects

Administration and dosageAdministration and dosage

Product information, availabilityProduct information, availability

Drug interactionsDrug interactions

Most Frequent Categories of Most Frequent Categories of Enquiry Received by PharmacistsEnquiry Received by Pharmacists

Drugs in breastfeedingDrugs in breastfeeding

Complementary medicineComplementary medicine

Identification of tablets and other dosage Identification of tablets and other dosage formsforms


Pharmaceutical (stability, compatibility, Pharmaceutical (stability, compatibility, formulations)formulations)

Pharmacology (including pharmacokinetics)Pharmacology (including pharmacokinetics)


Before using the internet:Before using the internet:

http://www.ed.uiuc.edu/wp/credibility/index.htmlhttp://www.ed.uiuc.edu/wp/credibility/index.html

http://library.albany.edu/usered/webeval/http://library.albany.edu/usered/webeval/

The InternetThe Internet

Welcome to internet for medicine:Welcome to internet for medicine:

http://www.vts.intute.ac.uk/he/tutorial/medichttp://www.vts.intute.ac.uk/he/tutorial/medic

http://www.vts.intute.ac.uk/he/tutorial/healthhttp://www.vts.intute.ac.uk/he/tutorial/health

http://www.vts.intute.ac.uk/acl/tutorial/wellbeinghttp://www.vts.intute.ac.uk/acl/tutorial/wellbeing



1.1. Become familiar with search techniques and Become familiar with search techniques and the range of information availablethe range of information available

2.2. Plan your search strategyPlan your search strategy

3.3. Use sites you know are trustworthy and that Use sites you know are trustworthy and that give details of who produces them and when give details of who produces them and when they were last updatedthey were last updated



4.4. Understand the need to critically evaluate Understand the need to critically evaluate resources you find on the internetresources you find on the internet

5.5. Establish who is responsible for the Establish who is responsible for the resource and what expertise or qualifications resource and what expertise or qualifications they have in fieldthey have in field



6.6. Don't use information from a site that is not Don't use information from a site that is not convincingly authoritative (this could have convincingly authoritative (this could have disastrous consequences)disastrous consequences)

7.7. Beware that the internet can be volatile – Beware that the internet can be volatile – information can change or disappear without information can change or disappear without warningwarning


One of the most popular is provided by the Health on the Net (HON) Foundation, a non-profit organization founded in 1995 whose mission is to guide Web users to sound, reliable information

http://www.hon.ch/home.html

Quality of Information on The Quality of Information on The InternetInternet

Wikipedia !!!

Quality of Information on The Quality of Information on The InternetInternet

Problems with Wikipedia

Many articles are written anonymously,

Many contributors are students still studying the very topics about which they write,

Some Wikipedia authors self-identify as "pre-hospital care workers," and

Anyone can purposefully add misinformation

Problems with Wikipedia

40

82.5

0102030405060708090

Wikipedia MedscapeDrug

Reference

Ability toAnswerDrugInformationQuestions

0

90

0102030405060708090


Reference

Informationon DrugDosing

76

95.5

0102030405060708090

100


Reference

Completenessof Answers

Conclusions:

Wikipedia has a more narrow scope, is less complete, and has more errors of omission than the comparator database

Wikipedia may be a useful point of engagement for consumers, but is not authoritative and should ONLY be a supplemental source of drug information

http://www.medscape.com/viewarticle/584450_1

Selected Selected Internet Internet

SitesSites

Examples:Examples:

Annals of PharmacotherapyAnnals of Pharmacotherapy


Examples:Examples:

International Journal of Pharmacy International Journal of Pharmacy PracticePractice


Examples:Examples:

The PubMed DatabaseThe PubMed Database


Reviews at PubMed

information resources 1

Education