# E-DRUG: Drug information services **URL:** \ **Category:** e-drug\ **Created:** [November 23, 1999, 7:28pm UTC](https://talk.edrugplus.org/t/e-drug-drug-information-services/6732 "1999-11-23T19:28:27Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Dr\_Samuel\_Vusi\_Magag](https://avatars.discourse-cdn.com/v4/letter/d/ac91a4/32.png) [@Dr\_Samuel\_Vusi\_Magag](https://talk.edrugplus.org/u/Dr_Samuel_Vusi_Magag)\ **Post date:** [November 23, 1999, 7:28pm UTC](https://talk.edrugplus.org/t/e-drug-drug-information-services/6732/1 "1999-11-23T19:28:27Z")
E-drug: Drug information services --------------------------------------------- Dear E-Druggers I am doing a research on drug information services in hospitals. Can anyone help me with information on "why is drug information important to prescribers and dispensers in hospitals", and "does the provision of drug information improve rational drug use". Has anyone done a research on the impact of drug information services on rational drug use. I will be very grateful of any assistance. M. Magagula Quality Control Pharmacist Swaziland [This question is extremely important but unfortunately not often asked, as it is generally assumed that providing drug information automatically translates into improved prescribing. You could take a look in the INRUD drug bibliography and find the references I listed below. You could also look at the web site of the International Conference on Improving Use of Medicines (ICIUM) and see whether recent research has been done ([http://www.who.int/dap-icium/index.html](http://www.who.int/dap-icium/index.html)) Hilbrand Haak] 1. Angunawela II, Tomson GB. Physicians perceptions of their own prescribing. Proc Wandy Soc Med 1987; 3:92-94. Notes : At institutions at different levels of health care in Sri Lanka, 26 physicians were interviewed about their prescribing. The prescribers in the peripheral unit were totally dependent on and positive to drug information from drug companies, whereas the others mentioned colleagues and seminars as important sources of drug information. A majority expressed a need for a Drug Information Bulletin. Only 2/26 of the physicians had heard of the essential drug list of WHO. Their own perception of number of drugs needed to treat 95% of their patients were on an average 35 different drugs. They estimated that each patient was given a mean of 3-5 drugs. 24/26 of them stated that they used placebos, most frequently vitamins. More than 50% referred patients to Ayurvedic practitioners. MORE DRUG INFORMATION SHOULD BE MADE AVAILABLE FOR PHYSICIANS. AS A RESULT OF THE RESEARCH A `DRUG INFORMATION BULLETIN' IS BEING DISTRIBUTED NATIONALLY 4 TIMES A YEAR TO ALL PRESCRIBERS. (HAI-#-00005). 2. Christensen DB, Wertheimer AI. Sources of information and influence on new drug prescribing among physicians in an HMO. Soc Sci Med 1979; 13:313-322. Notes : HMO physicians interviewed and their prescribing patterns monitored to assess sources of drug information and patterns of communication affecting prescribing decisions. Doctors used mostly literature for general drug information, but the most influential source in encouraging first prescribing of a new drug was colleagues. 3. Herxheimer A, Lionel NDW. Minimum information needed by prescribers. BMJ 1978; 2:1129-1132. Notes : This paper develops the proposals on the arrangement of drug information made in the WHO report, "The selection of essential drugs". (DAP #46). 4. Mitchell MF. Popular medical concepts in Jamaica and their concepts on drug use. West J Med 1983; 139:841-847. Notes : Popular medical concepts, developed in relation to traditional herbal medicines, are now being applied to over-the-counter and prescribed drugs in Jamaica. Consequently, consumers run the risk of drug misuse and neglect of serious medical conditions especially in the case of chronic diseases. Inadequate physician-patient communication is seen as an important contributing factor to poor adherence to prescribed drug regimens and misuse of prescribed drugs. Methods for improving physician-patient communication and for providing needed drug information to supplement the popular medical concepts are suggested. (DAP/ANTHRO). 5. Rucker TD. Pursuing rational drug therapy: a macro view from the United States. Journal of Social and Administrative Pharmacy 1988; 5:78-86. Notes : Examines: definition and methods of measuring rational drug therapy; prevalence and significance of irrational drug therapy; factors contributing to inappropriate drug use; and macro strategies to optimize drug benefits and minimize patient risk. Suggests a key role for pharmacists, including the development of a National Drug Education Foundation to disseminate drug information to practitioners, evaluate formularies and coordinate information for patients. (DAP #431). 6. Watkins WM, Maitai CK. A drug utilization survey of dosage forms dispensed at Kenyatta Hospital Nairobi. East Afr Med J 1981; 58:284-287. Notes : In a previous study,the relationship between the different pharmacological classes of drugs dispensed to out-patients at Kenyattan Hospital Nairobi (KNH) has been investigated. The purpose of the present study was to investigate the extent to which different dosage forms are utilised at KNH, and in particular to examine the feasibility of pre-packaging, which is only presently done to a very limited extent. ADVANTAGES ASSOCIATED WITH PRE-PACKAGING: OPPORTUNITY TO USE IMPROVED PACKAGING MATERIALS AND LABELLING METHODS, AND THE OPPORTUNUTY TO USE THE ADDITIONAL TIME GENERATED, FOR DRUG INFORMATION COUNSELLING, ESPECIALLY WITH PATIENTS, WHICH HAS BEEN SHOWN TO IMPROVE PATIENT COMPLIANCE WITH THE PRESCRIBERS DIRECTIONS. (HAI-#-00107). 7. Zelnio RM, Gagnon JP. The effects of price information on physician prescribing patterns - a literature review. Drug Intell Clin Pharm 1979; 13(3):156-159. Notes : Literature review was used in an attempt to predict the impact that drug cost information might have on physicians' prescribing decisions and reimbursement costs. Conclusion: physicians will not incorporate price information in to the prescribing decision to the extent necessary for the achievement of cost savings. Authors propose alternative: use pharmacists to provide drug information. 8. Lilja J. Theoretical social pharmacy - the drug sector from a social science perspective. Kuopio: University of Kuopio, 1988. Notes : Aims to develop models which include cultural and organizational factors to increase understanding of how drug systems behave. The first chapters familiarize the reader with social science methods and models. The succeeding ones describe different parts of the drug system, including research, production, market structure, distribution, consumption, prescribing and drug information. 9. Angunawela II, Diwan VK, Tomson GB. Experimental evaluation of the effects of drug information on antibiotic prescribing: a study in outpatient care in an area of Sri lanka. Int J Epidemiol 1991; 20:558-564. Notes : The intervention level of epidemiology is useful for studying effects in health systems research. Due to practical and ethical reasons, it is often difficult to apply experimental methods such as classical randomized clinical trials in the field. However with alternative approaches such as 'randomization by group' some of these problems can be overcome. Drug information has since long been considered as an instrument to influence physicians, however evaluation of its effects is a new field of research. In the present study the impact of drug information on prescribing behaviour was evaluated in an outpatient setting in Sri Lanka. The study included 15 state health institutions (45 prescribers) with a common drug formulary. Groups of prescribers were randomized into two interventions; newsletters and newsletters reinforced by a group seminar, and one control group. The target topic was 'rational prescribing of antibiotics'. Some 18,766 randomly selected outpatient drug prescriptions were studied. Antibiotics (and sulphonamides) were prescribed to 33.2% of the patients. An overall trend towards a decrease in proportion of patients prescribed antibiotics in the two intervention groups was seen, although the difference was not significant (p greater than 0.05) compared to the control group. This is similar to the effect of written information on prescribing in other studies. A mean difference of -7.4% in written, -7.3% in written + seminar and -0.4% in the control group was shown. The general antibiotic prescribing pattern did not change in any of the three groups. Penicillin was the most commonly prescribed antibiotic and tetracycline was only rarely prescribed to children. This experiment indicates the feasibility of drug information intervention studies in developing countries.(ABSTRACT TRUNCATED AT 250 WORDS) 0 (Antibiotics). 0 (Penicillins). 10. Tomson GB. Drug utilization studies and people. A Swedish perspective. [Review]. Ann Ist Super Sanita 1991; 27:239-245. Notes : Innovative ways of collaboration between actors involved are needed to increase the quality of drug therapy. Sweden is fortunate to have access to reliable and detailed statistics on drug sales and prescribing patterns. The various data bases are being described. A common classification system (ATC) and a unit of measurement (DDD) enable comparisons at various levels. Major differences between countries, counties, and health centres are presented. Little is known about the reasons for these differences. In order to leave its infancy, drug utilization studies need that clinical pharmacology establishes linkages with primary health care where a majority of the prescribing takes place. Systems should also be developed activating the prescribers involving them in a revolving cycle of self audit. To study drug use in its context a multidisciplinary approach is needed. The descriptive phase should be complemented by targeted intervention and methods should be developed for drug information. Future drug utilization studies need more of a patient-prescriber perspective (PPP). [References: 29]. -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.