Drug Information Resources 1

2 The Growth of Medical Information Indexed Citations Added to MEDLINE (i.e. PubMed) by Fiscal Year ?? U.S. National Library of Medicine. National Institutes of Health. Reviewed 25 March

3 Assessing What You Already Know For a drug information question, which would you consult? List a pro and a con for each resource. JournalTextbook

Resource Types: Primary Secondary Tertiary 4

5 Primary Resources Scientific journals Provide original studies or reports E.g. Clinical trial, case series, case report Good for foreground questions Scope is narrow Good when topic is new or new data has been published

6 Primary Resources Pros: Most current evidence Provide data on new drugs Can personally assess validity of studies Cons: May not lead one to best decision because of limited scope Data can be poor or controversial Every study has limitations Too complex for patients

7 Secondary Resources Bibliographic databases that provide abstracts or full-text of studies Good for foreground questions

8 Secondary Resources Pros: Can construct searches to find specific information at high granularity Cons: Often require more expertise to use than primary or tertiary resources Retrieved references must be filtered for quality Must track down resources before looking for answers Too complex for patients

9 Tertiary Resources Compilations of knowledge in the field E.g. Textbooks, handbooks, online drug compendia Good for background questions Scope is broad

10 Tertiary Resources Pros: Provide comprehensive information Information reflects views of multiple experts in field Fast, easy to use, and may be good for patients Cons: Usually at least 2 years out of date by publication High dependency on interpretation of authors** **Pharmacists can address this by consulting at least 2 tertiary resources to find corroborating information

11 When trying to answer a clinical question, the best strategy is often to consult resources in the following order: Tertiary, Secondary, Primary Tertiary resources are good when: The answer to a question is basic factual knowledge in the field The question was studied extensively and a conclusion was made Many experts have addressed the question and agree on answer Secondary and primary resources are good when: A question is new and has never been studied There is no consensus among experts; various opinions abound There is conflicting evidence and the question needs further study

12 Resource Table Primary Resources JAPhA JAMA Pharmacotherapy New England Journal of Medicine Annals of Internal Medicine AJHP Secondary Resources PubMed/Ovid MEDLINE Cochrane Database of Systematic Reviews DARE TRIP National Guideline Clearinghouse Tertiary Resources Access Pharmacy UpToDate Drug Facts and Comparisons Epocrates Lexi-Comp Micromedex Clinical Pharmacology

13 Determining the Ultimate Question 44 y.o. male High blood pressure Rx ACE inhibitor Develops dry cough Ultimate Question: Resource Type: Major Concepts (i.e. search terms): Is cough a side effect of ACE inhibitors? Tertiary ACE inhibitors, side effects, cough

List 3 facts about Ambien (Zolpidem Tartrate) OR Insomnia 14

Drug Facts and Comparisons Search for information about Ambien (Zolpidem Tartrate) 15 Facts and Comparisons provides electronic drug data and clinical information to healthcare professionals worldwide

List 3 facts about Proventil (Albuterol Sulfate) OR Asthma 16

17 Epocrates Search for information about Proventil (Albuterol Sulfate) American company for medical info provider

List 3 facts about Zoloft (Sertraline Hydrochloride) OR Depression 18

Lexi-Comp Search for information about Zoloft (Sertraline Hydrochloride) 19 Medical software for smart phone

List 3 facts about Aricept (Donepezil Hydrochloride) OR Dementia 20

21 Micromedex Search for information about Aricept (Donepezil Hydrochloride) Evidence based clinical reference

List 3 facts about Zyrtec (Cetirizine Hydrochloride) OR Allergies 22

Clinical Pharmacology Search for information about Zyrtec (Cetirizine Hydrochloride) 23

Development of drug information services (FDA) In accordance with Section 915 of the Food and Drug Administration Amendments Act of 2007 (FDA), the website of FDA provides postmarked drug safety information to improve transparency and communication to patients and healthcare providers. Several information can be obtained here for example: Adverse drug event reporting approved drug list Safety profile of drug. 24

25 The Big Picture 1.Obtain background info/understand context 2.Determine ultimate question 3.Select and search appropriate resources 4.Evaluate and analyze information found 5.Draw conclusion and formulate response Addressing a Drug Info Need