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Heck J, Stichtenoth DO, Sabau R, Schröder C, Engeli S, Pape T, O'Connell N, Schumacher C, Krause O, Koop F. Clinical-pharmacological drug information center of Hannover Medical School: experiences and analysis from a tertiary care university hospital. Sci Rep 2022; 12:19409. [PMID: 36371467 PMCID: PMC9653451 DOI: 10.1038/s41598-022-24005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Drug information centers (DICs) are institutions dedicated to provide objective, independent, and up-to-date information on drugs and their rational use. To overcome the lack of recent DIC reports from central Europe, we analyzed all queries (n = 594) submitted to the DIC run by the Institute for Clinical Pharmacology of Hannover Medical School between October 2018 and April 2022. Approximately one in three queries (31.1%; 185/594) was submitted by internists. 82.8% (492/594) of the queries were patient-specific, while the remaining 17.2% (102/594) were general queries. Adverse drug reactions (ADRs), indications/contraindications, and pharmacodynamic interactions (PDIs) represented the three most frequently addressed query categories, being involved in 44.8% (266/594), 43.3% (257/594), and 34.3% (204/594) of all queries, respectively (assignment of more than one category per query was possible). As compared to general queries, patient-specific queries were statistically significantly more often related to ADRs, PDIs, and pharmacokinetic interactions (PKIs) (ADRs: 35.3% vs. 46.7%, P = 0.034; PDIs: 14.7% vs. 38.4%, P < 0.001; PKIs: 20.6% vs. 31.5%, P = 0.028). To demonstrate the complexity of queries submitted to the clinical-pharmacological DIC, we present and comment on an illustrative selection of queries.
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Affiliation(s)
- Johannes Heck
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Dirk O Stichtenoth
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Drug Commissioner of Hannover Medical School (Dirk O. Stichtenoth); Head of Pharmacovigilance of Hannover Medical School (Christoph Schröder), Hannover, Germany
| | - Ruxandra Sabau
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Christoph Schröder
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Drug Commissioner of Hannover Medical School (Dirk O. Stichtenoth); Head of Pharmacovigilance of Hannover Medical School (Christoph Schröder), Hannover, Germany
| | - Stefan Engeli
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Institute for Pharmacology, University Medicine Greifswald, Greifswald, Germany
| | - Thorben Pape
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Nina O'Connell
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | | | - Olaf Krause
- Institute for General Practice and Palliative Care, Hannover Medical School, Hannover, Germany
- Center for Medicine of the Elderly, DIAKOVERE Henriettenstift, Hannover, Germany
| | - Felix Koop
- Institute for Clinical Pharmacology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Uljas K, Hämeen-Anttila K, Honkoila E, Laaksonen R. The perceived development needs for medicines information services in university hospital pharmacies: A mixed methods study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 6:100140. [PMID: 35573485 PMCID: PMC9096662 DOI: 10.1016/j.rcsop.2022.100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/10/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022] Open
Abstract
Background Reliable and evidence-based medicines information (MI) is critical for patient care. To guarantee this, in many countries, there are medicines information centers (MICs) which offer medicines information services (MISs). While there are no MICs in Finland, pharmacists in all five university hospital pharmacies provide MISs. A proposal for establishing five MICs has been made by the National Medicines Information Network. Objectives The aim was to explore the current MISs and the perceptions of current and potential MI service providers of the need for the proposed national MICs. Barriers and facilitators for potential transition from the current MISs provided by the university hospital pharmacies to establishing national MICs, were examined. Methods This sequential explanatory mixed methods study was conducted nationally during September 2019-April 2020 as an online survey and semi-structured individual, pair and group theme interviews with hospital representatives. The survey questionnaire was sent to chief pharmacists and MI pharmacists in all five Finnish university hospital pharmacies (n = 5, census). The interviews (n = 13) were carried out with chief pharmacists, MI pharmacists, medication safety officers (pharmacists), chairs of the Medicines Advisory Board (physicians) and clinical pharmacologists (physicians) (participants n = 19). The data was analyzed using descriptive quantitative analysis and qualitative content analysis. Results All invited representatives participated in the study. Offered MISs are quite similar but the human resources vary among the organizations. Answering MI questions was one of the core MISs. Most representatives considered a proposal of establishing five MICs to Finland positively. The expected benefits were related to achieving an official status to enhance MI, establishing the MICs within the university hospitals and close to where the MISs are needed, and fostering multiprofessional collaboration and collaboration between the MICs. Limited financial and human resources were seen the most critical challenges. Conclusion The existing expertise of the pharmacists and the similarities in MISs provided by the university hospital pharmacies seem to provide a good basis and preconditions for expanding MI operations and forming MICs at the national level. By pooling current limited resources, synergies could be achieved and MISs, and potentially MICs developed. The establishment of MICs may enhance utilization of networking and multiprofessional collaboration in producing MISs at the national level.
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Affiliation(s)
- Katja Uljas
- Tampere University Hospital, Hospital Pharmacy, Finland
| | | | - Elina Honkoila
- Helsinki University Hospital, Hospital Pharmacy, Finland
| | - Raisa Laaksonen
- University of Helsinki, Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Finland
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Campbell C, Braund R, Morris C. A mixed methods study on medicines information needs and challenges in New Zealand general practice. BMC FAMILY PRACTICE 2021; 22:150. [PMID: 34246231 PMCID: PMC8272906 DOI: 10.1186/s12875-021-01451-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/05/2021] [Indexed: 11/13/2022]
Abstract
BACKGROUND Medicines are central to healthcare in aging populations with chronic multi-morbidity. Their safe and effective use relies on a large and constantly increasing knowledge base. Despite the current era of unprecedented access to information, there is evidence that unmet information needs remain an issue in clinical practice. Unmet medicines information needs may contribute to sub-optimal use of medicines and patient harm. Little is known about medicines information needs in the primary care setting. The aim of this study was to investigate the nature of medicines information needs in routine general practice and understand the challenges and influences on the information-seeking behaviour of general practitioners. METHODS A mixed methods study involving 18 New Zealand general practitioner participants was undertaken. Quantitative data were collected to characterize the medicines information needs arising during 642 consultations conducted by the participants. Qualitative data regarding participant views on their medicines information needs, resources used, challenges to meeting the needs and potential solutions were collected by semi-structured interview. Integration occurred by comparison of results from each method. RESULTS Of 642 consultations, 11% (n = 73/642) featured at least one medicines information need. The needs spanned 14 different categories with dosing the most frequent (26%) followed by side effects (15%) and drug interactions (14%). Two main themes describing the nature of general practitioners' medicines information needs were identified from the qualitative data: a 'common core' related to medicine dose, side effects and interactions and a 'perplexing periphery'. Challenges in the perplexing periphery were the variation in information needs, complexity, 'known unknowns' and 'unknown unknowns'. Key factors affecting general practitioners' strategies for meeting medicines information needs were trust in a resource, presence of the patient, how the information was presented, scarcity of time, awareness of the existence of a resource, and its accessibility. CONCLUSIONS General practitioners face challenges in meeting wide-ranging medicines information needs in patients with increasingly complex care needs. Recognising the challenges and factors that influence resource use in practice can inform optimisation of medicines information support resources. Resources for general practitioners must take into account the complexity and time constraints of real-world practice. An individually responsive approach involving greater collaboration with pharmacists and specialist medicines information support services may provide a potential solution.
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Affiliation(s)
- Chloë Campbell
- School of Pharmacy, University of Otago, Dunedin, New Zealand.
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
- Pharmaceutical Society of New Zealand, Wellington, New Zealand.
| | - Rhiannon Braund
- School of Pharmacy, University of Otago, Dunedin, New Zealand
- New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand
| | - Caroline Morris
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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Tukukino C, Wallerstedt SM. Drug information centre queries and responses about drug interactions over 10 years-A descriptive analysis. Basic Clin Pharmacol Toxicol 2020; 126:65-74. [PMID: 31310705 PMCID: PMC6972620 DOI: 10.1111/bcpt.13294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/08/2019] [Indexed: 01/19/2023]
Abstract
Many people are treated with ≥1 drug, implying that risks of drug interactions need to be considered. The aim of this study was to describe drug interaction queries from healthcare professionals to a drug information centre in Sweden over 10 years focusing on drugs frequently asked about and the advice provided. Advice was recorded in mutually exclusive groups: Avoid, Adjust dose, Separate intake, Vigilance or No problem. For queries with Avoid, Adjust dose or Separate intake advice, alerts were extracted from an interaction database (Janusmed). Of 4335 queries to the centre in 2008-2017, 589 (14%) concerned interactions. Most were posed by physicians (91%) and concerned a specific patient (83%) before treatment initiation (76%). Sertraline, warfarin and methotrexate were the most frequently asked about, whereas queries about cyclophosphamide and rifampicine occurred most often in relation to the number of exposed patients. Advice provided in 557 (95%) replies comprised Avoid: n = 85 (15%), Adjust dose: n = 57 (10%), Separate intake: n = 17 (3%), Vigilance: n = 235 (42%) or No problem: n = 163 (29%). In all, 113 (71%) of 159 queries with Avoid/Adjust dose/Separate intake advice elicited an action alert on Janusmed, whereas 31 (20%) did not result in any alert at all. Summarized, seven in ten replies from the drug information centre recommended an explicit drug treatment action, regarding either specific prescribing aspects, for instance dose adjustments, or active follow-up including monitoring potential adverse reactions and/or laboratory results. Readily accessible decision support regarding drug interactions often provides relevant action alerts, but cannot be solely relied on.
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Affiliation(s)
- Carina Tukukino
- Department of Clinical PharmacologySahlgrenska University HospitalGothenburgSweden
- Department of Pharmacology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Susanna M. Wallerstedt
- Department of Pharmacology, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- HTA‐centrumSahlgrenska University HospitalGothenburgSweden
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Flôres DDRV, Augusto de Toni Sartori A, Antunes JB, Nunes Pinto A, Pletsch J, da Silva Dal Pizzol T. Drug information center: challenges of the research process to answer enquiries in hospital pharmaceutical practices. Eur J Hosp Pharm 2019; 25:262-266. [PMID: 31157037 DOI: 10.1136/ejhpharm-2017-001417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 11/03/2022] Open
Abstract
Objective To characterise information requests (IRs) from hospitals received by a drug information center (DIC-RS) according to the resolution of the inquiries. Method The sample consisted of all requestors and their respective IRs registered in the DIC-RS database from January 2012 to December 2016. Request without information in the consulted literature (RWI) were categorised according to the institution of origin. IRs from hospitals were classified by the information source, topic and subtopic of the questions, and the number of drugs and the pharmacological or therapeutic group. Results A total of 2,500 IRs were analysed. Of those, 25% did not exhibit conclusive information in the consulted sources. RWI from hospitals represented 51% of all RWI, followed by those from community pharmacies (13%) and health centres (9%). Tertiary literature was the most commonly used source (73%) for IRs from hospitals. The greatest difficulties in finding information were related to off-label drug administration and indication issues (52% of RWI). The most common type of off-label use was related to changes in the original pharmaceutical form of the drug. Furthermore, 61% of RWI were directed at a specific drug, mostly systemic anti-infectives. Conclusion We found that a quarter of the answers did not exhibit conclusive information in the consulted sources. Answers to IRs from the hospital environment exhibited the greatest extent of limited information, and off-label use was responsible for most cases.
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Affiliation(s)
| | | | - Julia Borges Antunes
- Universidade Federal do Rio Grande do Sul, Faculdade de Farmacia, Porto Alegre, RS, Brazil
| | - Alessandra Nunes Pinto
- Universidade Federal do Rio Grande do Sul, Faculdade de Farmacia, Porto Alegre, RS, Brazil
| | - Julia Pletsch
- Universidade Federal do Rio Grande do Sul, Faculdade de Farmacia, Porto Alegre, RS, Brazil
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Schjøtt J, Spigset O. Drug information centres and their provision of decision support: The Scandinavian experience. J Clin Pharm Ther 2019; 44:489-492. [PMID: 30710370 DOI: 10.1111/jcpt.12804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Appraisal of drug information centres (DICs) is mainly by word of mouth communication and surveys of overall user satisfaction. Efforts to study the impact of this type of informatics and decision support systematically are generally lacking within the healthcare system. COMMENT Scandinavian DICs question-answering databases are relevant sources for identifying recurring problems in pharmacotherapy, including drug safety questions, and for re-use of previous answers. Recent studies in this setting have shown that high-quality answers demand easily accessible literature sources, skills in literature search and critical assessment of the retrieved documentation. Furthermore, patient-specific advice in clinical cases presented within a requested time frame is appraised by clinicians. WHAT IS NEW AND CONCLUSIONS Effective decision support by Scandinavian DICs depends on skills among staff and technological resources. Our experience could motivate further studies investigating methods and evaluating the impact of DICs in the healthcare system.
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Affiliation(s)
- Jan Schjøtt
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Olav Spigset
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Regional Medicines Information and Pharmacovigilance Centre (RELIS Midt-Norge), Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
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Schjøtt J, Böttiger Y, Damkier P, Reppe LA, Kampmann JP, Christensen HR, Spigset O. Use of References in Responses from Scandinavian Drug Information Centres. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E66. [PMID: 29966383 PMCID: PMC6165374 DOI: 10.3390/medicines5030066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Jan Schjøtt
- Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, 5021 Bergen, Norway.
- Institute of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, 5021 Bergen, Norway.
| | - Ylva Böttiger
- Clinical Pharmacology, Department of Drug Research, Linköping University, 58183 Linköping, Sweden.
| | - Per Damkier
- Department of Clinical Chemistry & Pharmacology, Odense University Hospital, 5000 Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark.
| | - Linda Amundstuen Reppe
- Pharmacy Division, Faculty of Nursing and Health Sciences, Nord University, 7800 Namsos, Norway.
| | - Jens Peter Kampmann
- Department of Clinical Pharmacology, Bispebjerg University Hospital, 2400 Copenhagen, Denmark.
| | | | - Olav Spigset
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Midt-Norge), Department of Clinical Pharmacology, St. Olav University Hospital, 7006 Trondheim, Norway.
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Reppe LA, Spigset O, Kampmann JP, Damkier P, Christensen HR, Böttiger Y, Schjøtt J. Quality assessment of structure and language elements of written responses given by seven Scandinavian drug information centres. Eur J Clin Pharmacol 2017; 73:623-631. [PMID: 28161750 PMCID: PMC5384946 DOI: 10.1007/s00228-017-2209-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/26/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). METHODS Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts). In addition, linguistic aspects of the responses were evaluated by a plain language expert. RESULTS The quality of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some experts preferred the use of primary sources to the use of secondary and tertiary sources. Both internal and external experts criticised the use of abbreviations, professional terminology and study findings that was left unexplained. The plain language expert emphasised the importance of defining and explaining pharmacological terms to ensure that enquirers understand the response as intended. In addition, more use of active voice and less compressed text structure would be desirable. CONCLUSIONS This evaluation of responses to DIC queries may give some indications on how to improve written responses on drug-related queries with respect to language and text structure. Giving specific advice and precise conclusions and avoiding too compressed language and non-standard abbreviations may aid to reach this goal.
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Affiliation(s)
- Linda Amundstuen Reppe
- Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Midt-Norge), Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway
| | - Olav Spigset
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Midt-Norge), Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway
| | - Jens Peter Kampmann
- Department of Clinical Pharmacology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Per Damkier
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | | | - Ylva Böttiger
- Clinical Pharmacology, Department of Drug Research, Linköping University, Linköping, Sweden
| | - Jan Schjøtt
- Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway
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Amundstuen Reppe L, Spigset O, Schjøtt J. Drug Information Services Today: Current Role and Future Perspectives in Rational Drug Therapy. Clin Ther 2016; 38:414-21. [PMID: 26831829 DOI: 10.1016/j.clinthera.2015.12.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 12/01/2022]
Abstract
Polypharmacy and complex drug treatment regimens are becoming increasingly common, which may lead to adverse drug reactions, drug interactions, medication nonadherence, and increasing costs and thus challenge the rational use of drugs. At the same time, the accessibility of drug information increases, and health care professionals may have limited opportunities and capabilities to search and critically evaluate drug information. Clinicians have reported difficulties in searching the best evidence and translating study findings into clinically meaningful information applicable to specific patients. Consequently, it remains a challenge to ensure the rational use of drugs in the years to come. Drug information centers (DICs) have been established to promote the rational use of drugs. One of the most important tasks of DICs is the question and answer services for health care professionals posing drug-related questions. DICs staffed by pharmacists and clinical pharmacologists hold expertise in searching for drug information and critical evaluation of the literature. The uniqueness in this service lies not only in the identification and interpretation of the scientific literature but also in the adaptation of the findings into specific clinical situations and the discussion of possible solutions with the enquirer. Thus, DICs could provide valuable decision support to the clinic. Taking into account the increasing number of possible drug-related questions that will arise today and in the future, the DICs will remain highly relevant in the years to come. However, the DICs must follow the developments in health information technology to disseminate relevant, unbiased drug information to old and new users of the service. Moreover, the DICs are important tools to counterbalance the drug information published by the pharmaceutical industry.
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Affiliation(s)
- Linda Amundstuen Reppe
- Faculty of Health Sciences, Nord University, Steinkjer, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Regional Medicines Information and Pharmacovigilance Centre, Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway.
| | - Olav Spigset
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Regional Medicines Information and Pharmacovigilance Centre, Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim, Norway
| | - Jan Schjøtt
- Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Regional Medicines Information and Pharmacovigilance Centre, Haukeland University Hospital, Bergen, Norway
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Schjøtt J. Challenges in psychopharmacology: a drug information centre perspective. J Clin Pharm Ther 2016; 41:4-6. [DOI: 10.1111/jcpt.12354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 12/15/2015] [Indexed: 10/22/2022]
Affiliation(s)
- J. Schjøtt
- Section of Clinical Pharmacology; Laboratory of Clinical Biochemistry; Haukeland University Hospital; Bergen Norway
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest); Haukeland University Hospital; Bergen Norway
- Department of Clinical Science; Faculty of Medicine and Dentistry; University of Bergen; Bergen Norway
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Salat D, Llop R, Aguilera C, Danés I, Bosch M, Asensio C, Castañeda F, Esterlich E, Vallano A. Therapeutic enquiries about biological agents as a tool to identify safety aspects and patterns of use. Eur J Hosp Pharm 2015; 23:161-165. [PMID: 31156839 DOI: 10.1136/ejhpharm-2015-000770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/22/2015] [Accepted: 10/12/2015] [Indexed: 12/12/2022] Open
Abstract
Background Biotechnological agents (BA) are increasingly being used in clinical practice. We aimed to determine, whether enquiries about them to a therapeutic consultation service have also become more frequent, and to describe the information requested in these consultations. Methods We retrospectively reviewed 14 104 therapeutic consultations collected in a computerised database between 2000 and 2014. Enquiries about BA (monoclonal antibodies, fusion proteins or cytokine antagonists) were chosen. Information on the type of BA, underlying condition, type of enquiry and affiliation of the enquirer was retrieved and compared with data from consultations about other agents. Results During the study period, 365 enquiries about 30 different BA were received. Only 4% of them were received before 2004, while 48.8% were received after 2010. Rituximab, infliximab, adalimumab and etanercept were most frequently enquired about. Agent selection (n=184) and/or adverse effects (n=174) were the most frequent reasons for making an enquiry. Most enquiries about an agent selection were made about an off-label use (n=164), mainly for systemic autoimmune diseases (n=61). Over half of the enquiries about adverse effects were about their teratogenic potential (n=96). Enquiries about BA more often requested an opinion (87.7% vs 77.7%) were made by physicians (89.9% vs 76.9%), from a hospital (81.6% vs 44.5%) and regarded a specific patient (87.4% vs 74.5%). Conclusions Therapeutic consultations about BA are increasing. Most of them are related to uncertainties of health professionals regarding any new medicine: their off-label use, actual adverse effects or the teratogenic potential of the involved agents.
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Affiliation(s)
- D Salat
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain
| | - R Llop
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Aguilera
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Danés
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Bosch
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Asensio
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain
| | - F Castañeda
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - E Esterlich
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Vallano
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Helldén A, Al-Aieshy F, Bastholm-Rahmner P, Bergman U, Gustafsson LL, Höök H, Sjöviker S, Söderström A, Odar-Cederlöf I. Development of a computerised decisions support system for renal risk drugs targeting primary healthcare. BMJ Open 2015; 5:e006775. [PMID: 26150141 PMCID: PMC4499680 DOI: 10.1136/bmjopen-2014-006775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To assess general practitioners (GPs) experience from the implementation and use of a renal computerised decision support system (CDSS) for drug dosing, developed for primary healthcare, integrated into the patient's electronic health record (EHR), and building on estimation of the patient's creatinine clearance (ClCG). DESIGN Qualitative research design by a questionnaire and a focus group discussion. SETTING AND PARTICIPANTS Eight GPs at two primary healthcare centres (PHCs). INTERVENTIONS The GP at PHC 1, and the project group, developed and tested the technical solution of the CDSS. Proof-of-concept was tested by seven GPs at PHC 2. They also participated in a group discussion and answered a questionnaire. A web window in the EHR gave drug and dosage in relation to ClCG. Each advice was according to three principles: If? Why? Because. OUTCOME MEASURES (1) The GPs' experience of 'easiness to use' and 'perceived usefulness' at PHC 2, based on loggings of use, answers from a questionnaire using a 5-point Likert scale, and answers from a focus group discussion. (2) The number of patients aged 65 years and older with an estimation of ClCG before and after the implementation of the CDSS. RESULTS The GPs found the CDSS fast, simple and easy to use. They appreciated the automatic presentation of the CICG status on opening the medication list, and the ability to actively look up specific drug recommendations in two steps. The CDSS scored high on the Likert scale. All GPs wanted to continue the use of the CDSS and to recommend it to others. The number of patients with an estimated ClCG increased 1.6-fold. CONCLUSIONS Acceptance of the simple graphical interface of this push and pull renal CDSS was high among the primary care physicians evaluating this proof of concept. The graphical model should be useful for further development of renal decision support systems.
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Affiliation(s)
- Anders Helldén
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fadiea Al-Aieshy
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
| | - Pia Bastholm-Rahmner
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Healthcare Development, Public Healthcare Administration, Stockholm County Council, Stockholm, Sweden
| | - Ulf Bergman
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars L Gustafsson
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hans Höök
- Department of Healthcare Development, Public Healthcare Administration, Stockholm County Council, Stockholm, Sweden
| | - Susanne Sjöviker
- Department of Healthcare Development, Public Healthcare Administration, Stockholm County Council, Stockholm, Sweden
| | | | - Ingegerd Odar-Cederlöf
- Department of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
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Reppe LA, Spigset O, Böttiger Y, Christensen HR, Kampmann JP, Damkier P, Lydersen S, Schjøtt J. Factors associated with time consumption when answering drug-related queries to Scandinavian drug information centres: a multi-centre study. Eur J Clin Pharmacol 2014; 70:1395-401. [PMID: 25213372 PMCID: PMC4198806 DOI: 10.1007/s00228-014-1749-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/01/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE There is little research-based documentation on the services provided by drug information centres (DICs). The aim of this multi-centre study was to explore for the first time the factors associated with time consumption when answering drug-related queries at eight different but comparable DICs. METHODS During an 8-week period, staff members at eight Scandinavian DICs recorded the number of minutes during which they responded to queries. Mixed model linear regression analyses were used to explore the factors associated with time consumption when answering queries. RESULTS The mean time consumption per query was 178 min (range 4-2540 min). The mean time consumed per query increased by 28 (95 % confidence interval (CI) 23 to 33, p < 0.001) min higher for queries for which there was a lack of documentation and 139 (95 % CI 74 to 203, p < 0.001) min higher when conflicting information was present in the literature. Staff members with less than 1 year of experience consumed a mean of 91 more minutes (95 % CI 32 to 150, p = 0.003) per query than staff members with more than 2 years of experience. CONCLUSIONS This study demonstrates the large variation in time consumed answering queries posed to Scandinavian DICs. The results highlight the need for highly competent staff members and easy access to drug information sources. Further studies are required to explore the association between time consumption and response quality.
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Strobach D, Gruber AC, Möhler NC, Vetter-Kerkhoff C. Clinical impact of the hospital pharmacy drug information service: how does information on drug–drug interaction enquiries translate into clinical decisions? Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2014-000487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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