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Agenda  •  Icebreaker  •  Drug  informa1on  references  

– Categories  of  drug  informa1on  literature  •  Advantages  vs.  Disadvantages  •  Examples  

– Some  commonly  used  resources  

•  Poten1al  topics  for  future  webinars  

Icebreaker  •  Presenters  

– Võ  Thị  Hà,  MSPharm.  – Nguyễn  Như  Hồ,  MSPharm.  – Nguyễn  Đức  Như  Khuê,  PharmD/MPH  

•  ASendees  

To  Wiki  or  Not  to  Wiki?   Categories  of  Drug  Informa6on  Literature  

• Primary  literature  

• Secondary  literature  

• Ter1ary  literature  

Primary  Literature  •  Original  “research”  publica1ons.  •  Source  of  informa1on  for  the  development  of  the  secondary  and  ter1ary  literature.  

•  Containing  a  detailed  descrip1on  of  study  design,  methodology,  and  results.  

•  Research  studies,  case  reports,  editorials,  disserta1ons,  leSers  to  the  editor,  and  randomized  control  trials  published  or  presented  for  the  first  1me.  

•  Top  1er  peer  reviewed  journals:  NEJM,  JAMA,  Archives  of  Internal  Medicine,  BMJ,  Pharmacotherapy,  Lancet,  etc…    

Primary  Literature  (cont.)  

•  Advantages:  – Current,  original,  and  "cucng-­‐edge"  informa1on.    – Pa#ent-­‐oriented  &  evidence-­‐based  medicine  that  can  be  directly  u#lized  to  help  care  for  pa#ents.  

– Peer  reviewed,  unbiased  sugges1ons,  and  open  to  cri1ques  and  rebuSals.  

•  Disadvantages:  –  Inaccurate  conclusions  d/t  flaws  in  methodology  –  Improper  interpreta1on  d/t  lack  of  knowledge  about  scien1fic  methods  and  sta1s1cs  

– Time  for  new  informa1on  to  be  widely  accepted  

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Primary  Literature  in  Prac6ce  

•  Learn  to  be  cau1ous  with  new  informa1on.  •  Is  the  ar1cle  from  a  peer-­‐reviewed  journal?    •  Understand  study  popula1on,  methods,  sta1s1cal  and  clinical  relevance    to  your  prac1ce  popula1on  before  extrapola1ng  to  your  pa1ent.  

•  Remember  case  reports  relate  only  to  one  pa1ent,  watch  for  bias,  and  avoid  relying  on  anecdotes.  

Secondary  Literature  •  Indexing  and  abstrac1ng  services.  •  Examples:  

– Medline  Database  covers  many  fields  of  medicine  including:  den1stry,  nursing,  veterinary,  pharmacy  and  hard  sciences.  

•  PubMed  Medline  •  OVID  Medline  

–  Iowa  Drug  Informa6on  Service  indexes  English  (full  text)  ar1cles  relevant  to  drugs  and  treatment  of  disease  from  approximately  200  journals.  

– Micromedex:  an  extensive  pharmacology  database  

Secondary  Literature  (cont.)  •  Advantages:  

– Quick  access  to  the  primary  literature.  – Large  scope  of  and/or  concise  informa1on  on  specific  topics  

– Generally  from  peer  reviewed  and  high  standard  journal  sources.  

•  Disadvantages:  – Lag  1me  – Availability  of  specific  journal  – Large  amount  of  informa1on  –  Search  techniques  – Cost  

Ter6ary  Literature  

•  Textbooks  e.g.  Goodman  &  Gilman’s  Pharmacological  Basis  of  Therapeu1cs  

•  Compendia  (a  vast  array  of  informa1on  about  many  drugs)  e.g.  such  as  Facts  and  Comparisons  

•  Review  ar1cles  in  journals  that  thoroughly  summarize  a  par1cular  topic  can  also  be  considered  ter1ary  literature  (usually  more  up  to  date  than  text)  

Ter6ary  Literature  (cont.)  •  Advantages:  

– Convenient  and  easy  to  use.      – Divided  into  specific  subjects,  e.g.  drug  interac1ons,  drugs  in  pregnancy.  

–  Informa1on  generally  well  accepted  •  Disadvantages:  

– Lag  1me  – Space  limita1on  – Less  thorough  review  – Possible  inappropriate  references  – Flawed  primary  literature  (poorly  done  studies)  

Common  Online  Sources  (in  US)  •  FDA  approved  drug  products:  www.accessdata.fda.gov/scripts/cder/drugsarda  

•  Dailymed  @  NLM  (database  of  product  package  inserts)  :  www.dailymed.nlm.nih.gov/dailymed    

•  Drug  informa1on  portal  @  NLM:  www.druginfo.nlm.nih.gov/drugportal    

•  Consumer  page  @  FDA:  www.fda.gov/forconsumers  •  MedlinePlus  @  NIH:  www.nlm.nih.gov/medlineplus  •  FDA  medica1on  guides:  www.fda.gov/drugs/drugsafety/  •  MedWatch:  www.fda.gov/safety/medwatch  •  Medica1on  safety:  www.ismp.org    •  Drug  iden1fica1on:  pillbox.nlm.nih.gov    

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Common  Online  Sources  (in  US)  •  Diseases  &  Condi1ons  @  CDC:  www.cdc.gov/diseasescondi1ons  

•  Travel  medicine:  www.cdc.gov/travel  or  www.iamat.org    •  Na1onal  guideline  clearinghouse:  www.guideline.gov  •  Clinical  trials:  www.clinicaltrials.gov  •  Na1onal  Cancer  Ins1tute:  www.cancer.gov  •  Most  of  cancer  guidelines:  www.nccn.org    •  DM  guideline:  ADA  2013  (less  commonly  used  AACE)  •  HTN:  JNC  8  or  AHA  for  HTN  •  An1thrombo1c  therapy:  CHEST  2012  •  Dyslipidemia:  AHA/ACC  2013  Cholesterol  (aka  “ATP  4”)  

•  Be  proac1ve:  look  for  drug  problems.    No  other  healthcare  provider  has  the  unique  opportunity  to  improve  drug  therapy  that  pharmacists  have.  

•  Dig  deeper:  oxen  1mes  the  ques1on  that  is  originally  asked  is  not  the  ques1on  the  person  was  trying  to  ask.  

•  Be  skillful:  use  a  systema1c,  logical,  organized  approach.  •  Keep  records:  document  your  search  methods  and  answer.  •  There  may  be  more  than  one  correct  answer.      •  An  acceptable  answer  may  be  “I  will  find  out”.  

Drug  Informa1on  Pearls