Drug Information and Literature Evaluation 30:725:470

Role of the Pharmacist as a DI Provider

Evelyn R. Hermes-DeSantis, Pharm.D., BCPS
Objectives:
1.
2.
3.
4.

List the functions of a drug information service

Obtain background information for the drug information request
Describe the appropriate handling of a drug information request
Formulate a response to a drug information request

Recommended Reading: Chapter 1, 2, 21

1.

Introduction
Why drug information is important?
Function of a clinical pharmacist
A.

Definitions
Drug information - ___________ regarding _________________
Medication information - conveys the ___________ and ______ of

information on medication therapy and to signify the _____________ that

all pharmacists take in information provision
Drug informatics - emphasizes the use of ____________ as an integral tool

in effectively __________, analyzing, __________, and communicating

information on medication use in patients
Drug information specialist one who has received __________ ___________ in
the area of drug/medication information
B.

History of Drug Information

First clinical service
University of Kentucky

C.

Educational objectives for Drug Information

Required component didactic and experiential
-

Drug Information and Literature Evaluation Course

Longitudinal experiences
Problem-solving technique
Essential concepts of drug information

D.

Applying medical information to ____________ situations

Counter-detailing and appropriate interactions with the _______________
______________
Creating ________ and ________ literature searching strategies
___________ evaluating marketing and promotional materials and
advertisements
___________ evaluating medical literature
Describing the process of ___________ in the United States
Distinguishing ___________ versus ___________ significance
___________ and ___________ appropriate health information for
patient education
Evaluating ___________ _______ ___________ and procedures
Identifying, evaluating, and utilizing ___________ sources of medical
information
Identifying, managing, reporting, and preventing ___________
___________ ___________
Incorporating principles and practices of ___________ ___________
___________ into pharmaceutical care
___________ and ___________ evaluating medical information on the
Internet
Preparing, presenting, and participating in ___________ ___________
Providing ___________ and ___________ responses to drug
information requests
Summarizing basic ___________ and ___________ ___________
methods
Understanding the creation, maintenance, and management of a
medication ___________
Using electronic medical information ___________ and other
technologically enhanced references and resources in an effective and
efficient manner to ___________ ___________ care

Practice sites
Hospital
Academia
Community
Medical informatics
HMO, PBM, MCO
Contract DI
Poison Control

Drug Information and Literature Evaluation Course

Industry

E.

2.

Services provided

The service
A.

Requestors/customer

B.

Documentation/Background
Who is calling?
Where are they calling from?
What are they requesting?
Why are they calling now?
When do they need the information by?

2.

Responding to a questions
Step 1

Identify caller (demographics)

Step 2

Collect background information

Requestors name, location, contact number
Requestors affiliation, frame of reference
Resources already used
Patient specific or academic
Diagnosis, other medications, medical conditions
Urgency

Step 3

Ultimate question, classify the request

Step 4

Develop a search strategy

Start broad then narrow down resources.

Step 5

Evaluate and critique information

Drug Information and Literature Evaluation Course

Step 6

Formulate and provide response

Consider how the information will be used
May not find information, or may be conflicting
Logical argument:
Present competing viewpoints or considerations
State the assessment of the literature or information review and claim
the superior viewpoint
Succinctly refute the major strengths and present weakness of the
inferior viewpoint
Defend the major weakness and promote the strengths of the superior
viewpoint
Reiterate the final assessment in support of the superior viewpoint.

Step 7

Follow-up and document

If it is not documented, it didnt happen

Responses:
1. Formulating a response Ask yourself Do I Know
a. The requestors name, profession, affiliation?
b. Specific patient?
c. Clear understanding of the question/problem?
d. Correct question being asked?
e. Why the question is being asked?
f. Pertinent patient history and background information?
g. Unique circumstances that generated the question?
h. What information is really needed?
i. When in the information is needed and in what format?
j. How the information I provide will actually be used?
k. How the problem or situation has been managed to date?
l. Alternative explanations or management options that have been considered or should be
further explored?

2. Ideal characteristics of a response:

a. Timely
b. Current
c. Accurate
d. Complete
e. Concise
f. Well referenced
g. Clear and logical

Drug Information and Literature Evaluation Course

h.
i.
j.
k.
l.

Objective and balances

Free of bias or flaws
Applicable and appropriate for specific circumstances
Answers important related questions
Addresses management of patients or situations

3. Factors to be considered
a. Patient factors
i.
Demographics
ii.
Primary diagnosis and
medical problem list
iii.
Allergies/intolerances
iv.
End-organ function,
immune function, nutritional
statues
v.
Chief complaint
vi.
History of present
illness
vii.
Past medical history
viii.
Family history
ix.
Social history
x.
Review of body systems
xi.
Medications
xii.
Physical examination
xiii.
Laboratory tests
xiv.
Diagnostic
studies/procedures
b. Medication Factors
i.
Name
ii.
Status and availability
iii.
Physiochemical properties
iv.
Pharmacology and
pharmacodynamics
v.
Pharmacokinetics
vi.
Indications and uses
vii.
Adverse effects
viii.
Allergy/cross reactivity
ix.
Contraindications and
precautions
x.
Special populations

b. Disease factors
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
control
ix.
x.
xi.

xi.

Definition
Epidemiology
Etiology
Pathophysiology
Clinical findings
Diagnosis
Treatment
Prevention and
Risk factors
Complications
Prognosis

Mutagenicity
and carcinogenicity

xii.

Pregnancy and
lactation

xiii.
xiv.

Toxicity
Drug
interactions

xv.

Laboratory test
interactions

xvi.
xvii.

Administration
Dosage and
schedules

xviii.
xix.

Dosage forms
Monitoring
parameters

xx.

Product
preparation

xxi.

Compatibility
and stability

Drug Information and Literature Evaluation Course

c. Pertinent background information, Special circumstances, etc.

i. Setting
ii. Context
iii. Sequence and timeframe of events
iv. Rationale for the question
v. Events prompting the question
vi. Unusual or special circumstances
vii. Acuity and time constraints
viii. Scope of question
ix. Desired detail or depth of response
x. Limitations of available information or resources
xi. Completeness, sufficiency, and quality of information
xii. Applicability and generalizability of the information

3.

Evaluating and critiquing information

Things to think about:
Lag time
Reliability of source
Type of source
Tertiary references

Secondary references
Primary references

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Drug Information Service

Name: ________________________________
Caller Type: _____ Location: ____________
Address:
__________________________
__________________________

Phone/Page: ___________________
Received: _____________________

Classification: __________________________

Product type: __________________

Referred by: ___________________

Question: _______________________________________________________________
________________________________________________________________________
________________________________________________________________________
Background: _____________________________________________________________
________________________________________________________________________
________________________________________________________________________
Call taken by: ____

Date: __/__/_ Time: _____ Ans. Needed by: ________________

Response: _______________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Call Back Attempts
Date
_____
_____
_____
_____

Time
_____
_____
_____
_____

Response: ____________

Initials
_____
_____
_____
_____

Results
______________________________
______________________________
______________________________
______________________________

Time: __________________________

References:
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

Drug Information and Literature Evaluation Course