Chapter I Drugs information provided ppt

Course Title: Drug Informatics
Course ECTS: 3 ECTS
Abera J. (B.Pharm, MSc in Clinical Pharmacy)

2 Course Objectives
After completion of this course, students will be able to:
• Rapidly locate and evaluate drug information sources,
• Systematically manage and communicate drug information,
• Apply drug information knowledge for preparation and management of
formularies, guidelines and bulletins,
• Provide drug information to health care professionals and Pts on the
rational use of drugs,
• Compare and contrast online resources to printed resources, and
• Differentiate between primary, secondary and tertiary literature.

4
1. Introduction to the concept of Drug
Information

5 Introduction to the concept of DI Outline
 Definitions of basic terms
 The evolution of drug information…..Reading Assignment
 Medication information services & skills
 Factors influencing the evolution of the pharmacist’s
role as a medication information provider
 Opportunities in specialty practices

6 Introduction to DI
 Traditionally, drug informatics is the use of computer to
manage drug-data or drug information (DI) by the
means of drug information technology;
 Currently, it is the provision of unbiased, well-referenced,
and critically evaluated information on drug-related
issues to improve health outcomes.

7 Introduction to DI …
 The provision of DI is among the most fundamental
responsibilities of all pharmacists;
 DI may be patient-specific or developed for a given
patient population, such as:
Development of therapeutic guidelines,
Coordination of ADE reporting and monitoring programs,
Publication of newsletters, or updating websites.

8 Introduction to DI …
 The pharmacist can serve as a resource for issues regarding cost,
medication selection/use, medication policy decisions, medical
and DI resource selection and education;
Drug information:
 An information found in a reference or articulated by an
individual that pertains to medications;
 It comprises:
A body of biomedical literature (facts & information);
A set of skills…….that provide pharmacy professionals with the
ability to access, communicate information and acquire
knowledge.

9
The term DI contextualizes by connecting it with other
words;
 Specialist/practitioner/pharmacist/provider: a person
whose job is to respond to DI questions.
 Centre/service/practice: A unit designed for receiving,
collecting, analyzing, and providing unbiased, accurate and up-
to-date information about drugs and their use.
 Functions/Skills: Activities and abilities of individuals to
provide DI services.
Introduction to DI …

10
 Drug Information Center (DIC):
A facility specifically reserve for, and specializing in provision
of DI
 Drug Information Services (DIS):
Activities undertaken by pharmacists in providing
information to optimize drug use, the term also includes but
not limited to, the specialized services offered by a drug
information center.
 Drug Information Specialists:
The individual responsible for operation of the DIC…the one
who store, retrieve, select, evaluate, and disseminate DI

11 DIC Establishment
 DIC will be established at national level in EFDA, at regions
in Regional Health Bureaus and at Hospitals and Health
centers.
 What must be fulfilled to establish DIC?
A. DI trained personnel
B. Adequate size building and furniture
C. Telephone line
D. Internet access
E. Equipped with computer, required software and
F. Necessary reference materials.

12
Pharmacy Informatics:
 Focuses on the use of information, information systems, and
automation technology to ensure safe and effective
medication usage
 e.g., electronic health record (HMIS), computerized
provider order entry (CPOE), e-Prescribing, clinical decision
support systems (CDSS) etc.
 Orders entered via a CPOE system communicated to the
medical staff & appropriate departments over a computer
network
 Eliminates illegible handwriting, decreases medical errors
as well as the delay in order completion, improves Pt care.

14
 The two broad categories of information used in pharmacy
informatics/other clinical informatics domains:
a) Pt-specific information: medical histories, lab. tests results,
radiology interpretations, physical assessments, medication
and other information that is unique to the specific Pt;
b) knowledge-based information: referential information (about
medications, procedures, disease states, etc.), clinical
practice guidelines etc.

15 Why DI from Centers to Practitioners?
 Biomedical literatures are growing rapidly in size and complexity.
 As a report of Study Commission on Pharmacy, 1975
“….. among deficiencies in health care system, one is the
unavailability of adequate information for those who: consume,
prescribe, dispense & administer drugs
-> this deficiency has resulted in inappropriate drug use
and an unacceptable frequency of drug-induced disease”.
 Laid the foundation for clinical pharmacy concept!

16
 Accordingly the responsibilities of individual pharmacists
regarding the provision of DI have changed substantially as
consultants of:
Medication use process, drug interactions or adverse effects
of new or existing medications;
Publications in the area of therapeutic guidelines or other
drug policy initiatives (authored by a pharmacist);
 Currently, the education and training of pharmacists also
developed to meet these important responsibilities.
Why DI from Centers to Practitioners?...

17
A. Medication safety
B. Advances in pharmacy informatics
C. Evidence-based medicine
D. Formulary management
E. Medication policy development

18
A. Medication Safety: Adverse Drug Events (ADE)
 Impact of ADEs on Pt health and economic implications:
 In US, annually an estimated 700,000 emergency room visits
and ~120,000 hospitalizations attributed to ADEs,
 An annual extra cost of 3.5 billion dollar to the health care
system
 40% of these events are considered to be preventable.

19
 ADE….in Africa
 The median prevalence of ADE during hospitalization was;
 7.8% (IQR: 4.2–21.4%) in general Pts
 74.2% (IQR: 54.1–90.7%) among specific Pts.
 From this, 43.5% and 12.4% of ADEs being preventable in general and specific Pts,
respectively.
(Nyame L. et al., Variation of adverse drug events in different settings in Africa: a systematic
review. Eur J Med Res 29, 333 (2024). https://doi.org/10.1186/s40001-024-01934-0)

20
B. Integration of new Health Information Technologies
 All medical records are standardized and electronic
 Pharmacy informatics as an integral tool to management and
integration of medication-related data that spans across systems
and supports the medication-use process
Incorporating automated interventions such as computer-
based clinical decision support systems & computerized
provider order entry.

21
Growth of information technology
 The internet allows individuals to easily access information
 An increasing demand by clinician, as well as the consumer to
access information:
 New medication becomes commercially available
 Withdrawn from the market for safety reasons
 Released data from a new study
 Accuracy of DI on the internet (using sites that are sponsored by a
variety of companies & individuals with diverse interests)??
 Information may be incomplete or inaccurate
--> May result in harmful practice

22
C. Evidence-Based Medicine (EBM)
 Evidence-based Pt-centered health care delivery as a key
feature of high-quality medical care
 To develop & implement various quality assurance tools (e.g.,
therapeutic guidelines, clinical path ways, medication-use
evaluations) in an effort to improve Pt outcomes & decrease
costs across the health care system
---> Give emphasis to need for DI expert

23
D. Sophistication of Medication Therapy (Formulary Mgt)
 As the types and sophistication of medication therapy continues
to evolve,
this will present challenges for Pts, family members, and health
care providers seeking information on these emerging
therapies.
 Provides pharmacist much more opportunity to lend their
expertise:
To assess DI needs, search, analyze and retrieve appropriate
literature, and apply information to Pts.

24
E. Rise in the Self-care Movement (Medication Policy)
 Pts participate in their health care decisions, including the selection &
use of medications
 Pts are increasingly interested in finding information regarding their
medications from
• Direct-to-consumer advertising (DTCA) campaigns through
magazines, television, through e-mail, search engine marketing on
specific websites, and radio reports
 Pharmacists are in an excellent position to interpreting this DTCA to
determine what information is applicable to their medical condition

25 Medication Information Services (DIS)
 A drug information center or specialist may be involved in one or all of
these functions:
 Supporting clinical services with DI;
 Answering questions regarding medications;
 Coordinating pharmacy & therapeutics committee activity
 Coordinating formulary management initiatives;
 Publishing or editing information on appropriate medication use
through newsletters, journals, Web sites
 Developing and educating health care professionals on
medication use policies

26
 Analyzing the clinical & economic impact of drug policy decisions
 Providing education for health professionals, students, and consumers
 Developing criteria/guidelines for medication use
 Managing medication use evaluation
 Managing investigational medication use
e.g., institutional review board activities, information for practitioners
 Coordinating of ADE reporting and analysis programs
 Providing poison information
Medication Information Services (DIS)..

27 Medication Information Skills
A pharmacist should keep… when confronted with a drug information
question:
 Access available information and gather situational data needed
to characterize question or issue
 Assess the level of urgency & extent of the needs for information
 Formulate appropriate question(s)
 Use a systematic approach to find needed information
 Evaluate information critically for validity and applicability
 Develop, organize, and summarize response for question
 Communicate clearly when speaking or writing, at an appropriate
level of understanding
 Anticipate other information needs and follow-up

28 Ethical Provision of Drug Information
 Information provided should not be conflicting between the
needs of audience and legal or public health consideration;
 Information provided should not violate relationship between
the Prescriber/Dispenser and the Pt;
 The center shall not give information on chemical entities
whose therapeutic merits are not yet provide and not
released to the market for public consumption;
 Shall provide DI for medico-legal cases;
 The center shall provide independent information and
without having in advertising a particular product;
 The center shall provide reliable, accurate, up-to-date
information in sustainable manner.

29 Opportunities of MI Specialist
 A MI specialist: whose primary responsibility is the provision of
unbiased and well referenced drug information to improve Pt
outcomes & decrease health care costs
 The role of the specialist has changed from an individual who
specifically answers questions:
to one who focuses on the development of medication
policies and provides information on complex medication
information questions

30
Area of Leadership & Career Opportunities
 Health system pharmacies (e.g., hospital pharmacy)
 A contract drug information center
 Pharmacy informatics in a health system
 Managed care organizations (e.g., health maintenance
organizations)
 Scientific writing & medical communications
 Poison control
 Pharmaceutical industry, and academia.
Opportunities of MI Specialist…

31
Institutional Health-system Drug Information Services
 Managing the formulary system, medication safety programs,
medication usage evaluation, and medication policy
development and management
 Improve Pt outcomes & decrease health care costs through the
provision of unbiased information
that supports rational, cost-effective, Pt- and disease-specific
medication therapy.

32
Contracted Drug Information Center (fee-for-service)
 Providing answers to MI requests
 Preparing new drug evaluation monographs or class reviews
 Developing medication-use evaluation criteria
 Preparing pharmacoeconomic evaluations
 Developing guidelines for a particular disease
 Writing a pharmacotherapy publication e.g., Website, etc
 Providing continuing education programming
* The cost may be decided based on the number and types of services
chosen by the contracting party

33
Pharmacy informatics in a health system
 An individual who has advanced DI skills with a keen understanding of
computer and information technology
Support patient care activities by improving the efficiency of workflow
 Increasing access to Pt-specific information and the medical literature
through technology to remote site
 Increasing opportunities for applying computer technology, using
clinical decision support system (SDSS), to enhance many aspects of
the medication use process

34
Managed care organizations:
 Health maintenance organizations, pharmacy benefit management
organizations, state and national government agencies (e.g., Medicaid,
Medicare, medical insurance programs in the US)
interested in the cost-efficient use of medications
 Support the cost-effective selection and use of medications managed
pharmacy organizations
to establish evidence-based practice guidelines for selected
disease states or classes of drugs

35
Scientific Writing and Medical Communication
 More than 77% of medical education & communication companies employ
at least one licensed specialist
 Having good writing skills, to have scientific expertise and literature
evaluation skills
 MI specialists: write, edit, or develop such as:
 Pt education materials, journal articles, regulatory documents, poster
presentations, grant proposals, drug evaluation monographs etc.
-->by gathering, interpreting, and presenting information for either medical
professionals or public

36
Academia
 MI specialist: provide leadership in the pharmacy curriculum,
including both instructive & competency-based experiential
training
 Serves as a collaborator with other faculty on cases and activity
designed to reinforce DI skills for students
Poison Information Centers
 Practicing in an accredited poison information center or an
emergency room
 To provide information on the management of any poison situation

37
Pharmaceutical Industry:
 Providing written information on the drug product produced
by the manufacturer
 Serve as reviewers for journal articles, evidence-based
guidelines, and published drug monographs
 May interact with sales and marketing, participate with
regulatory affairs issues, and handle product complaints
 Review ADE identified in clinical studies and communicate this
to appropriate research and development team.

38
Summary
 All pharmacists must be effective DI providers regardless of their
practice site;
 It is one of most fundamental responsibilities of a practitioner;
 Developing the skills of an effective DI provider is the foundation for
the pharmacist to be a life-long learner and problem solver;
 Literature is a valuable component of both of these processes and
will allow individual pharmacist to familiarize to needs of a continually
changing healthcare system.

Chapter I Drugs information provided ppt

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