Resources Update January 2014 Christopher Jones Pharmacist

Refresher on core resources how to access coverage pros and cons How to assess the quality of resources Useful newsletters and newsfeeds Aims

Query answering service within LTHT staffed by pharmacists experienced in searching the literature and turning the information found into practical advice Part of a national network of MI centres - UKMI Available 9-5, Mon-Fri, 9-3 Sat-Sun on or Will provide advice on any medicines-related question, but would expect you to have looked in the core resources first! Leeds Medicines Information Service

Paper copies of BNF published twice a year, only the September edition is obtained by the NHS Paper copies of BNFc published once a year Electronic versions (internet / apps) updated monthly – electronic is more up to date App available for free on android and iPhone. Need your Athens password to download updates Internet version freely available from NHS computers Core Resources – BNF / BNFc

Pros Readily available Up to date (electronic versions more so) Guidance updated in light of MHRA updates / NICE etc Well respected resource Cons Little coverage of unlicensed medicines / indications Space requirements mean not comprehensive - not all ADRs / interactions listed, advice on e.g. dose adjustment in renal impairment limited Core Resources – BNF / BNFc

Information provided by the manufacturers of products Contains SPCs (aimed at HCPs) and PILs (aimed at patients) Only holds information from manufacturers who are members of the ABPI who choose to participate – other manufacturers publish their information elsewhere Core Resources – EMC

Pros Gives a lot of information on the licensed uses of medicines Additional information on pharmacology and the evidence supporting its use Cons Not all products are listed Only gives information on licensed indications Can be cautious, so will tend to say ‘no’ if limited data – e.g. renal impairment / pregnancy Core Resources - EMC

Resource provided by NICE Searches resources from reputable providers only Need to use filters – searching ‘methotrexate’ returns >7,000 results. Can filter by information type (guidelines / pathways / trials etc) or provider (NICE / Cochrane / UKMI etc) Core Resources – NHS Evidence

Pros ‘NICE approved Google’ Fairly comprehensive with a lot of different types of available information Useful first step to search the literature Cons Can be difficult to find the things you want (but practice makes it easier) Core Resources – NHS Evidence

nww.lhp.leedsth.nhs.uk Local repository for guidelines and pathways Used by LTHT and all Leeds CCGs All content approved by relevant groups before publishing Core Resources - Leeds Health Pathways

Pros Reflects local practice, with guidelines to be followed within LTHT Shared resource Robust review processes Cons Older guidelines may not reflect current practices – check review dates Core Resources – Leeds Health Pathways

pharmacy/information-on-medicines/iv-monographs National collaborative intravenous administration guide, with local customisation National monographs written by pharmacists in participating hospitals, local customisation added by Leeds Medicines Information Service Available within LTHT without a password Core Resources - Medusa IV guide

Pros Tailored to local practice Reasonably comprehensive Cons Some monographs more up to date than others Sometimes too much detail in national monographs Paediatric guide in development IV guide, not IM or SC Intermittent access problems (use back-up site) Core Resources - Medusa IV guide

The medicines formulary followed by all NHS organisations in Leeds Lists the medicines supported for use within Leeds, along with links to further information (guidelines, NICE, information updates etc) Managed by the Leeds Medicines Information Service at LTHT Core Resources – Leeds Formulary

Pros Reflects local practice, and links to assessed resources (does your filtering for you) Hosts a newsfeed for information on medicines Acts as a hub for other sources of information – all core resources linked Updated continually Cons Work in progress, so some chapters are not yet complete Some links will only work within LTHT or the NHS Core Resources – Leeds Formulary

Why? If you are working as a specialist within an area, you may find your practice is not covered by ‘standard’ resources The problem used to be finding information. The problem now is finding reliable, useful information Any 15 year old can make a professional-looking website There is a huge amount of dubious information out there – search ‘George Eby’ (‘special’ zinc cures the common cold) or ‘Miracle Mineral Solution’ (drink bleach to cure AIDS) as extreme examples Assessing quality of new resources

Has someone else you trust done an assessment already? If not… Is it an appropriate person/organisation providing the information? Relevant qualifications / experience etc Is the information referenced to sensible resources? Is there a publication date and review date? Is the editorial policy clear? Is the information relevant to your patient group? Does the cohort the resource covers match your patient? If a non-UK product, does their practice match ours, and are the products available in the UK? Assessing quality of new resources

MHRA Drug Safety Update Important safety alerts on medicines – go to and search ‘drug safety update’ to subscribe NICE Medicines Awareness Daily or weekly options for digests of new information on medicines – search ‘NICE Medicines Awareness’ to subscribe NICE ‘Eyes on Evidence’ Monthly update on new NICE products – subscribe from the same page above Useful newsletters and newsfeeds