Assessment and use of drug information references in Utah pharmacies

Drug information-seeking behaviours of physicians, nurses and pharmacists: A systematic literature review

BACKGROUND

Medication use typically involves physicians prescribing, pharmacists reviewing, and nurses administering medications to patients. Drug information (DI) is often required during the process, with the various health care professionals (HCPs) seeking information differently according to their needs and familiarity with various resources.

OBJECTIVE

This systematic literature review aims to evaluate studies on drug information-seeking behaviour (ISB) of physicians, nurses and pharmacists to ascertain their DI needs, DI sources used, facilitators and barriers to DI-seeking.

METHODS

A systematic search was conducted on PubMed, Embase.com, Scopus, PsycINFO, CINAHL and Cochrane Library to identify eligible primary research articles published between January 2000 and May 2020.

RESULTS

The reviewed studies (N = 48) revealed that HCPs have a wide range of DI needs, with the top needs being similar across the three HCPs. Information sources used most often by all three groups were tertiary, followed by human and primary sources. Factors relating to the source characteristics were the most reported facilitators and barriers to DI-seeking. Some differences in drug ISB were also identified.

CONCLUSION

Our findings can also guide information providers and educators to optimize information provision. It may also facilitate effective communication amongst HCPs when obtaining DI from or providing DI to one another.

Comparison of Tertiary Drug Information Resources With the CDC Guideline for Oxycodone Dosing: Are Patients at Risk?

Background: Inappropriate prescribing of opioids is thought to play a central role in the ongoing opioid health crisis. Tertiary information resources are commonly used by clinicians for obtaining opioid dosing information. To assist health care providers in pain management, the Centers for Disease Control and Prevention (CDC) developed a guideline for prescribing opioids. Objective: To identify discrepancies for dosing information on oxycodone between commonly used tertiary drug information resources and the CDC Guideline. Methods: Searches of the tertiary drug information resources were conducted in the following order: Facts and Comparisons, Lexicomp, Medscape, and Micromedex. The term "oxycodone" was entered in the search box in the tertiary resources' applications. Drug information items retrieved were organized in tabular format. In the Google Chrome version 106.0.5249.119 search box, the term "CDC guideline for opioid dosing" was entered to retrieve current information on the CDC Guideline. Results: Searches produced drug information on oxycodone for available formulations, dosing regimens, recommended dosing, and maximum daily dose (MDD). Searches revealed discrepancies in dosing recommendations for oxycodone among tertiary drug resources and between tertiary drug resources and the CDC Guideline. Conclusions: When considering maximum daily dosing information for oxycodone from the selected tertiary drug information resources, the potential exists for patients to be at risk of addiction, overdose, and perhaps death. Improving the way opioids are prescribed through the CDC Clinical Practice Guideline can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse or overdose from inappropriate dosing information.

Preference and usage pattern of mobile medical apps for drug information purposes among hospital pharmacists in Sarawak, Malaysia

Introduction

Pharmacists are frequent users of mobile medical apps (MMA) for drug information (DI) and clinical decision-making purposes. However, the wide range of available MMA may be of variable credibility and results in heterogeneous recommendations. The need for subscription may also influence choice of apps.

Objective

The objective of this study was to determine the usage pattern of MMA among hospital pharmacists, including their perceptions and factors affecting their choice of apps.

Methods

This cross-sectional study required respondents to fill in an online questionnaire. The questionnaire included sections on respondents' demographic data, MMA usage pattern, perceived usefulness and opinion on subscription fees. Items were adapted from available literature and validated locally. It was made accessible for 6 weeks starting November 2019 for all pharmacists working in the 23 public hospitals in Sarawak to response (universal sampling). Collected data were analysed using descriptive and inferential statistics.

Results

A response rate of 37.2% was achieved (n = 162). Respondents were heavily reliant on MMA, with 78.4% accessing them multiple times daily. The majority also agreed that MMA contain correct and up-to-date information. A median of 5 apps were downloaded, suggesting an ultimate app catering for all DI needs was lacking. The Malaysian Drug Formulary was the most downloaded app (88.3%), whereas Lexicomp® was the most “well-rounded” in terms of functionality. Clinical pharmacists were significantly more likely to purchase MMA, in particular UpToDate® (p < 0.01) due to their need to access clinical updates. Respondents highly recommended institutional access for either UpToDate® or Lexicomp® be made available. Pre-registration pharmacists should be guided on judicious MMA usage, as they downloaded significantly more apps and were more likely to indicate not knowing which DI recommendation to follow (both p < 0.01).

Conclusion

MMA has become an indispensable tool for hospital pharmacists, however there was a tendency to download multiple apps for DI needs. Institutional access can be considered for credible apps identified to ensure accuracy and uniformity of DI recommendations, with purchase decision made after surveying the needs and preferences of end users.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01949-9.

The Role of Drug Information Centers to Improve Medication Safety in Saudi Arabia - A Study from Healthcare Professionals' Perspective

Background and objective

The primary function of the Drug Information Center (DIC) is to provide drug-related information to healthcare professionals. The purpose of this research was to assess the use of drug information centers by health care the professionals to improve medication safety in Saudi Arabia.

Methods

A retrospective study was carried out at King Khalid University Hospital's drug and poison information center (DPIC). During the study period, requests received by drug information specialists were saved in the DPIC questions’ bank. Patients’ demographic, type of drug information request, caller information, number of references used, medications, class of medication, medication error type and subclass were assessed and analyzed using descriptive analysis. Medication error types were captured based on nature of questions.

Results

A total of 243 drug information inquiries were assessed. Most of the inquiries were about adult population (n = 168; 69.1%). Most drug information inquiries were received from pharmacists (n = 117; 48.1%), followed by physicians (n = 94; 38.7%), then nurses (n = 23; 9.5%). Prescribing error were the most type of medication error prevented by drug information specialists (n = 214; 88.1%) followed by dispensing errors (n = 11; 4.5%). Approximately half of the medication errors in this study were near-misses (n = 110; 45.3%), followed by potential near misses (n = 84; 34.6%). Only, (n = 49; 20.2%) were identified as errors.

Conclusion

This study highlights the role of drug information specialists in providing evidence-based information and helps in preventing possible medication errors which will enhance the safety of the services provided to the patients.

Identifying Training Needs and Active Information Opportunities in Primary Care Through the Analysis of Drug Information Requests

INTRODUCTION

Drug information (DI) services should work toward efficiency by identifying knowledge gaps and actively creating resources to address those needs. The aim was to identify training needs and active information opportunities in primary care by analyzing DI requests and to calculate labor cost associated with DI requests addressable with training or active information.

METHODS

DI requests received in 2016 and 2017 by ambulatory care pharmacists were independently classified by 2 authors into: training (i.e., delivery of content meant to be retained as knowledge and used when needed); active information (i.e., resources created preemptively and consulted when needed); or passive information (i.e., not addressable with training or active information). Inter-rater reliability was calculated using Cohen's Kappa. Median time spent by category and across practice settings/professional types was compared using bivariate analysis. Thematic analysis categorized specific training and active DI requests and labor costs were calculated.

RESULTS

Of 2,041 DI requests, 330 (16.2%) were classified as training, 454 (22.2%) active information, and 1257 (61.6%) passive information (kappa = 0.769). Median (IQR) time to resolve requests was 5 (2-10) mins for training, 5 (3-11) active information, and 10 (4-15) passive information. Pharmacists spent 132.1 hrs = $8,956.98 answering questions addressable with training or active information. Areas warranting training or active information included: controlled substances, immunizations, patient assistance programs, policy/regulations, medication preparation/administration, storage/stability, disposal, availability/ordering medications, and patient-related resources.

CONCLUSION

Several opportunities for training and active information were identified. Despite the single-institution nature, the method described can serve as an example for other institutions.

Survey of Drug Information Database Preferences among Staff from Selected British Columbia Health Authorities

BACKGROUND

With the increasing use of electronic point-of-care resources, it is imperative to clearly understand what health professionals consider valuable when selecting a drug information database. A current analysis of the preferences of staff in selected British Columbia health authorities was deemed helpful for determining which electronic drug information database should be purchased.

OBJECTIVES

To determine the factors that BC hospital pharmacists, nurses, and other health professionals value in an electronic drug information database and to better understand the general preferences of staff in choosing between the Lexicomp and Micromedex databases.

METHODS

An electronic survey was created for data collection. The survey was open from August 10 to September 15, 2018, and again from November 11 to December 7, 2018. The survey link was sent by e-mail to staff in the following health authorities: Fraser Health, Providence Health Care, Provincial Health Services Authority, and Vancouver Coastal Health. Qualitative and quantitative methods were used to analyze the survey data.

RESULTS

A total of 247 responses were received, of which 145 (58.7%) were complete. Completed surveys were received from 77 pharmacists, 52 nurses, and 16 other health professionals. Participants ranked dosing information and ease of use as the most important factors that they considered when choosing a drug information database. There were no significant differences between the Lexicomp and Micromedex resources in terms of usability, quality, and preference.

CONCLUSIONS

This survey provided insights into what BC health authority staff perceive as important when utilizing a drug information database. Those considering either renewing or initiating a subscription to an online drug information database can use these results to better understand the preferences of health care professionals. Survey respondents ranked dosing information and ease of use as the 2 most important factors in selecting a drug information database. Pharmacists were more particular about using their preferred database than were other health professionals.

Appropriateness evaluation of Drug Information Center's Facebook page for evidence-based drug information dissemination

OBJECTIVE

To assess the characteristics of an unpaid Facebook page for drug information (DI) and its reachability to users.

METHODS

In this retrospective observational study over a 6-month duration, a Facebook page for the DI Center was created. One drug-related clinical question recently asked in the DI Center by a hospital clinician and its evidence-based answer along with the appropriate references were framed in a scenario and posted on the Facebook page on working days. The Facebook page likes, consumption, reach, engagement, impressions, and total number of followers were obtained from Facebook insights. The monthly averages of these parameters were assessed using the augmented Dickey-Fuller (ADF) test.

RESULTS

The cointegration (ADF) test revealed a statistically significant time-dependent correlation trend between the mean engaged users and mean monthly reach (ADF, -4.904; P = 0.01). Similarly, a statistically significant time-dependent correlation trend was observed with mean engaged users and mean monthly impressions (ADF, -5.456; P = 0.01).

CONCLUSION

The knowledge gap between quality DI and evidence-based medicine practice in a developing country can be bridged with a novel DI Center Facebook page initiative.

Use of References in Responses from Scandinavian Drug Information Centres

Background: The aim of this study was to compare use of references in responses from Scandinavian drug information centres (DICs). Methods: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The six queries concerned adverse effects, pharmacokinetics, pregnancy, complementary medicine, polypharmacy, and breast feeding. References in the responses were categorised into five types of drug information sources: primary (original studies), secondary (reviews), tertiary (drug monographs, handbooks, etc.), DIC database, or personal communication. Results: Two hundred and forty-four references were used in the 42 responses. The mean number of references varied from 3.0 to 10.6 for the six queries. The largest difference between centres with regard to number of references used (range 1⁻17) was found for the query on complementary medicine. In total, 124 references (50.8%) were tertiary, and only 10 of the 42 responses (23.8%) did not have any tertiary references included. Complementary medicine, breast feeding, and pregnancy were query types associated with relatively frequent use of primary references. Use of DIC database was not uncommon, but personal communications were seldom used. Conclusions: Scandinavian DICs differ substantially in number and type of references to identical drug-related queries. Tertiary sources are mainly preferred irrespective of type of query.

Assessment of Drug Information Service in Public and Private Sector Tertiary Care Hospitals in the Eastern Province of Saudi Arabia

Drug information service is a dedicated and specialized service provided by pharmacists to enhance knowledge of medicines use, promote rational prescribing among prescribers, and reduce medication errors. Saudi Arabia has a National Drug and Poison Information Center (NDPIC) responsible for answering drug queries. There is a lack of literature that reports the current scenario of drug information services in the country, especially the Eastern Province. This study reported the current status of drug information services being provided among tertiary care hospitals of the Eastern Province of Saudi Arabia. All hospitals provided drug information services. The qualification of personnel was mostly bachelor’s level (46.2%) and without proper training (54.8%). The most common queries received in a day were related to drug alternatives, dosage, and administration, as well as the availability of drugs. Physicians were the main users of the service. The most common health resources employed for the service was Lexi-Comp (76.9%) and Micromedex (69.2%). The use of Saudi National Formulary was not reported by any hospital, which highlights a potential research gap to address i.e., to investigate the lack of use of SNF by practitioners.