Assessing the quality of pharmacist answers to telephone drug information questions

A quality assurance (QA) program is described in which frontline pharmacists were asked test drug information questions via anonymous telephone calls. The program was instituted at a university hospital that began providing decentralized pharmaceutical services in 1985. Questions were developed on the basis of a pilot study conducted to determine the types and complexity of drug information questions received by frontline pharmacists at the hospital. Data on departmental clinical productivity were used to determine the number of questions that would be posed during each shift in the various service areas. The questions were posed during a 10-day period; the pharmacists were aware of the program, but the callers did not identify their affiliation with it. In response to 105 questions asked, 86 were judged to have been answered correctly, 13 answers were deemed incomplete, and 6 were judged incorrect. Pharmacists were more likely to respond incorrectly to complex questions and questions posed during the night shift. As a result of the audit, staff members with advanced clinical knowledge were asked to help less experienced pharmacists, the position of assistant director for drug information and staff development was created, and educational programs were instituted. The QA audit has been repeated twice. Posing test drug information questions via anonymous telephone calls is effective in assessing the quality of drug information provided by pharmacists in patient-care areas.     

Creation and usefulness of the "drug information card" for support of dispensing

We placed a "drug information card" on each medication shelf to assist dispensing by pharmacists, education of students, and risk management of pharmaceutical practices at the Department of Pharmacy, University of Tokyo Hospital. To provide appropriate information items on the drug information cards, we conducted questionnaire survey of 41 pharmacists on the utility of the cards and reviewed questions received from medical staff in the drug information section in our hospital. Based on the results of these investigations, "usage and dosage," "interactions," "contraindications," "product name," and "effects" were printed as basic information items on the drug information cards. Furthermore, information on pharmacokinetics was added. To make maintenance easier, we classified drug information items into "renew often" and "not so often." A good response on the use of the drug information cards was received for dispensing support from 38 pharmacists (92.7%), 14 trainees (100%), and 16 students (94.1%) in the questionnaire investigation. The drug information cards make it possible to obtain precise information rapidly in pharmacies.     

How to use medical and drug information: view of integrated information handling

It has become very easy to import drugs from overseas due to the spread of the Internet, and this has made the construction of a country-wide system that ensures safety a complicated matter. Although drug information and side-effect information databases are widely used, what is the situation concerning non-medicinal health foods that find their way into Japan from overseas? If the harmful effects of unknown substances can be prevented, it will be very beneficial. I would like to discuss these problems from the point of view of handling medical information.     

General medical practitioners' perceived use of drug information sources with special reference to drug information centres

This study reports the current perceived use of available sources of drug information for general medical practitioners. The sample frame, of 463 GPs practising in Derbyshire, England, on January 1, 1990, provided a 74 per cent response rate to a pre-piloted questionnaire. Two printed sources, the Monthly Index of Medical Specialities and the British National Formulary (BNF) plus one personal service, fellow colleagues, were by far the most frequently used. The estimated average minimum number of days per year on which personal information services were consulted was 28.51 days compared with 63.83 days for non-personal, printed sources. Thus, if GPs are to be guided by independent sources then the BNF must be considered a prime vehicle. Drug information centres (DICs) were ranked last with 56 per cent of GPs having consulted such a source within the previous year. Use of DICs could not be predicted from GPs' characteristics or demographic data. Interviews with 101 of 106 randomly selected GPs generally confirmed questionnaire findings. However, only 41 per cent perceived themselves as users of DICs. Collation of queries from two local centres showed 25 per cent were known to be users. From interviews, discrepancies were seen to arise from accessing DICs outside the sample frame boundary plus confusion of DICs with poisons centres and hospital pharmacy departments. Thus, for use of DICs, questionnaire techniques may be unreliable unless source definition is considered. If using DICs, GPs very significantly had lower concurrent use of community pharmacists, GP colleagues and hospital consultants for general drug information     

药师在药物不良反应处理和登记中的原则

<正> 医院药师在药物不良反应(ADR)监测工作中,应该全程参与,正确、合理地协助医护人员完成ADR的处理和登记,近几年,我院在这方面的尝试工作一直没有间断。我们体会到,药师在此过程中必须要把握好各关键问题的解决原则,才能顺利的完成与医患双方的沟通和协调。这里,我们总结了一些常见问题的解决原则。 1 总原则 1.1 果断停用可疑药物出于安全的考虑,一旦患者发生ADR,不论症状多么轻微,都应     

Impact of a pharmacist education program on nonformulary drug use

The effect of an educational program for pharmacists that included instructions for handling nonformulary drug requests and determining suitable formulary alternatives for frequently prescribed nonformulary drug requests was measured. Results indicate a significant increase in the number of appropriate nonformulary drug dispensings when the postintervention phase was compared with the preintervention phase. Other values, including the financial impact per nonformulary drug request, did not differ significantly between the two phases. Since all nonformulary drug requests require pharmacist time, a more cost-effective nonformulary drug policy might focus the pharmacist's efforts on nonformulary drug products that are more costly than their formulary alternatives.     

The utility of a medical admissions pharmacist in a hospital in Australia

Background Medication-related hospital admissions in Australia have previously been estimated to account for approximately 3% of all hospital admissions, with hospital entry points being a point of vulnerability. The timely medication review and reconciliation by a pharmacist at the early stage of an admission for patients admitted to the Acute Medical Unit (AMU) would be beneficial. Setting The Emergency Department (ED) and AMU in a 300 bed tertiary teaching hospital, in South Australia. Objective To investigate the impact of a Medical Admissions (MA) pharmacist on the proportion of AMU patients who receive a complete and accurate medication history by a pharmacist prior to admission and within 4 h of presentation. Method This prospective observational study with a non-concurrent parallel study design examined a standard clinical pharmacist service within the AMU and ED to a Medical Admissions (MA) Pharmacist, in addition to the standard AMU and ED pharmacist service. Continuous variables were analysed using a two sample t test, whilst categorical data were analysed using Fisher’s exact test. Risk ratios were also calculated for categorical data, with p < 0.05 taken as statistically significant. Main outcome measures Rates of completion of a complete medication history prior to admission and proportion of patients seen within 4 h of presentation by a pharmacist. Results The intervention resulted in more patients receiving a complete medication history prior to admission (2.7% in the control group vs 18.5%, p < 0.01) and being seen by the pharmacist within 4 h of presentation (1.6% in the control group vs 7.5%, p < 0.01). Conclusion Implementation of an extended hours clinical pharmacy service in the form of a medical admissions pharmacist based in the ED significantly increased the number of complete medication histories and clinical reviews completed for patients being admitted to an AMU. These were also completed earlier in the patients’ admission. There was also a small trend toward increasing the proportion of patients discharged by 11 am in the intervention group.