Clinical pharmacology: Prospects and development in India

Assessment of the Impact of Clinical Pharmacology Consultations Provided to Hospital Clinicians From the Drug Information Center-An Outcome Research in a Developing Country

BACKGROUND

Drug Information Center (DIC) with on-call evidence-based medicine service can revolutionize health-care practice and also can play a major role in health-care delivery in both developed and developing countries.

OBJECTIVE

To assess the feedback received from hospital clinicians for the newly initiated DIC services in a tertiary care hospital of North India.

METHODS

This is a retrospective cohort study conducted between January 1, 2016, to December 31, 2018. The clinicians approached DIC for specific pharmacotherapeutic questions for managing an index patient. After providing consultation, DIC followed up with them for the action taken and feedback on the consultation. The results of the data analyzed using Fisher Exact test and descriptive statistics.

RESULTS

Of 264 encounters, more than 98% of clinicians found the service satisfactory. There was a statistically significant association between the timely answer provided to treating physicians and their level of satisfaction with the service (P < .05). There was no significant association between academic experiences and the satisfaction or dissatisfaction among the clinical fraternity colleagues. The interpretation ability of on-call pharmacology postgraduate students was a significantly associated factor with clinician's satisfaction level (P < .05). More than 96% of clinicians followed the pharmacotherapy advice recommended by DIC in their patient management.

CONCLUSION

Thorough evaluation of published research needs to be taught to budding pharmacologists, pharmacists in their curriculum for an effective DIC service. DIC service has the potential to minimize the barrier of evidence-based medicine practice in developing as well as developed countries.

Clinical pharmacology training in India: Status and need

Clinical pharmacologists undertake many tasks, and this makes defining a curriculum challenging. This is especially so under the changing circumstances in developing countries, where clinical pharmacology has an expanding role. The clinical pharmacologist may be responsible for conducting ethical clinical trials, supporting the needs of the generic drug industry, providing access to safe, effective and affordable medicines, guiding their rational use, achieving millennium development goals, and supervising medicines management standards for hospital accreditation. Clinical pharmacologists, including those in developing countries, have a great opportunity to contribute to public health and the growth of pharmaceutical industry, but at present, less clinical research is undertaken and fewer clinical trials are done than might be expected. Here we review clinical pharmacology training in India, consider the needs of different professionals contributing to clinical research and medicines utilization, and suggest ways in which current programs can be modified and new programs started. The conclusions are relevant to clinical pharmacology in both the developing and the developed world.