Doctorline: a private toll-free telephone medical information service. Five years of activity: old problems and new perspectives

Naturalistic Evaluation of Pharmacotherapy Consultations Provided to Hospital Clinicians: A Developing Country's Perspective

Background: Critical appraisal of published literature for hospital clinicians has never been taken as an initiative in developing countries. Objective: This study was aimed at evaluating the nature of pharmacotherapy consultations from the drug information center (DIC) of the Postgraduate Institute of Medical Education and Research, Chandigarh, India. Methods: The DIC received pharmacotherapy consultation requests from January 2016 to December 2017. Various aspects such as clinical queries, patient-related factors, and disease-related information in these requests were recorded and analyzed. Descriptive statistics and χ2 test were used for the analysis of the data and feedback evaluation, respectively. Results: During the study, a total of 179 consultation requests were documented. On 19 (10.61%) encounters, pharmacotherapy consultations occurred for emergency patient care. Of the 179 queries, 31 (17.3%) were answered immediately while 148 (82.68%) were answered within an average time of 1.6 hours. The most common type of query was the pharmacotherapy of disease, followed by dose calculation and dose modification. Communications with DIC staff took place for timely critical appraisal of the medical literature, followed by a judicious selection of higher antimicrobials and other drugs. The time taken for answering a query was found to be a statistically significant determinant of user satisfaction (P < .05). Conclusion: The evidence level-specific drug information service was established and catered to hospital clinicians through critical evaluation of offline and online resources. DIC services have the potential to revolutionize the pharmacy and pharmacology curriculum in developing countries.

Assessment of Queries Received by the Drug Information Center at King Saud Medical City

Background:

The complexity of drug therapies has increased the need to evaluate the drug information scientifically. In this regard, the aim of drug information centers (DICs) is to promote rational use of drugs in a health-care setting. DI pharmacists play a vital role in providing the necessary and reliable information on drugs to promote the concept of rational drug use, eventually leading to a better patient outcome. The objective of the present study was to assess the drug-related queries received by the DIC at the King Saud Medical City (KSMC) from health-care professionals working in a large tertiary care setting.

Methods:

A retrospective analysis was conducted from February 2016 to January 2017. Data were collected using the DI request form, available in both printed and electronic formats for use by the health-care professionals. Descriptive statistics were used to calculate frequencies and percentages. Data analysis was performed using the Statistical Package of the Social Sciences software, version 16.0.

Results:

The current study received a total of 139 queries that were answered by the DIC pharmacists over a period of 1 year. The majority of queries were asked by pharmacists (61.2%), followed by physicians (23.7%) and nurses (10.10%). About half of the queries were related to the dosage and administration of the drugs. Lexicomp® acted as the common resource of information.

Conclusion:

DIC has been instrumental in the dissemination of drug-related information to health-care professionals since its inception in February 2016, resulting in the provision of quality health care to the patients. However, based on yearly queries, there still exists a need to increase the awareness of health-care professionals about the DIC at KSMC, which will urge them to take drug consultation from DIC pharmacists and promote patient safety.

A network system of medical and welfare information service for the patients, their families, hospitals, local governments, and commercial companies in a medical service area

A service information system using the Internet, which connected the various people who are related to medical treatment and nursing welfare, was constructed. An intractable neurological disease patient who lives in the Onga district, Fukuoka, Japan, and the people who are related to the service were chosen as test users in an experimental model. The communicated service information was divided into open-use data (electronic bulletin board, welfare service, medical care service, and link to private company service home page) and closed-use data (the individual patient's hysterics). The open data server was installed in an Internet service provider The open data could be accessed not only by the patient, but also by the family, information center, companies, hospitals, and nursing commodity store related to patient's nursing and medical treatment. Closed data server was installed in an information center (public health center). Only patient and information center staff can access the closed data. Patients should search and collect the service information of various medical and welfare services by themselves. Therefore, services prepared for the patient are difficult to know, and they cannot be sufficiently utilized. With the use of this information system, all usable service information became accessible, and patients could easily use it. The electronic bulletin board system (BBS) was used by patients for knowing each other or each others' family, and was used as a device for exchange of wisdom. Also, the questions for the specialist, such as doctor, dentist, teacher, physical therapist, care manager, welfare office staff member, and public health nurse, and the answers were shown on the BBS. By arranging data file, a reference of various patients in question and answer, which appeared in this BBS, was made as "advisory hints" and was added to the open data. The advisory hints became the new service information for the patients and their family. This BBS discovered the possibility of becoming an important information source for companies, hospital and, administration to know the requirements of patients and their families and the kind of services to be served. Although suppliers provide medical and welfare services for the patient, there is a tendency that the service information is sent by the suppliers at their own convenience. The information system in which various people participated was constructed in order to collect information for the patient, taking a patient-oriented approach. The result of the model test showed that this information system using Internet technology is a good system for both the service supplier and its receiver.

Medicine information help lines: a survey of hospital pharmacy-based services in the UK and their conformity with guidelines

OBJECTIVE

To describe the prevalence and nature of hospital pharmacy-based medicine help lines for consumers in the UK and to compare service provision with published guidelines.

BACKGROUND

Since 1992, telephone help lines for patients have proliferated in hospital pharmacies in the UK. There is no common template for such services with variations in target group, number and type of calls, and arrangements for training and audit. Data on these factors will help guide further development of such services.

METHODS

All medicine help lines operating from hospital pharmacies in the UK were identified through the national Drug Information Pharmacists network. They were sent a piloted questionnaire covering many aspects of help line operation, including funding, method of advertisement, procedures, target group, number and nature of calls, and audit procedures.

RESULTS

Eighty-two help lines were identified in England, Scotland, Wales, and Northern Ireland. Completed responses were received from 69 help lines (84% response rate). The pharmacy drug information center was the help line site in 57% of hospitals; all other help lines were located in the dispensary. In 55% of cases, help lines were open only to patients of the hospital. In the remainder of help lines, calls from the public were answered (although the majority of help lines only advertised to hospital patients). Calls were answered by pharmacists only in 45% of services, and additional staff training had been provided in 43%. Only 48% of services had written procedures or guidelines for operation of the help line. Forty-six percent of the services received fewer than five calls per week, 31% received between five and 10 calls per week, and 22% received 11 or more calls per week. In 59% of the sites, calls took an average of 10 minutes or less to answer; it took 11-15 minutes in 32% of the sites and >15 minutes in 9% of the sites. The most common queries related to adverse effects, dosage and administration, and interactions (including alcohol). Only 33% of help lines had any auditing or monitoring of the service in place.

CONCLUSIONS

The increasing use of the telephone to provide services directly to consumers is reflected in the growth of hospital-based medicine help lines in the UK. The telephone route is likely to become more important as patients' needs for information about their medicines increase. However, the rate of calls is low when compared with the number of patients issued prescriptions; further research is needed to investigate the reasons for this low response. There is currently reason for concern because most help lines lack not only professional training in telephone counseling, but also proper documentation, monitoring, and audit procedures.

The basis for using the Internet to support the information needs of primary care

Synthesizing the state of the art from the published literature, this review assesses the basis for employing the Internet to support the information needs of primary care. The authors survey what has been published about the information needs of clinical practice, including primary care, and discuss currently available information resources potentially relevant to primary care. Potential methods of linking information needs with appropriate information resources are described in the context of previous classifications of clinical information needs. Also described is the role that existing terminology mapping systems, such as the National Library of Medicine's Unified Medical Language System, may play in representing and linking information needs to answers.