Systemic approaches in answering drug information queries (DIC)

Systemic approaches in answering drug information queries (DIC) & Preparation of written and verbal response.

1. SYSTEMIC APPROACHES IN ANSWERING DRUG INFORMATION QUERIES Mr.s.lahar PHARMACY PRACTICE 1 ST YEAR REG.NO:623209530010 SEMINAR-1 1 A.U. COLLEGE OF PHARMACEUTICAL SCIENCE VISAKHAPATNAM CLINICAL PHARMACY PRACTICE-1 AUCoPS

2. CONTENTS : INTRODUCTION TO DRUG INFORMATION SERVICES HISTORY SYSTEMIC APPROACH TO ANSWER DRUG INFORMATION REQUEST PREPARATION OF WRITTEN RESPONSE PREPARATION OF VERBAL RESPONSE CONCLUSION 2 AUCoPS

3. INTRODUCTION DRUG INFORMATION : 3 Drug information means providing clinically relevant information on any use relating to individual patients or general information on how best to use drugs for populations. Pharmacists have a unique range of knowledge and skills which are required for drug information practice. These include knowledge of pharmaceutics , pharmacology , pharmacokinetics and pharmacotherapy. All of these are required to optimise the use of drugs in the treatment and prevention of disease. Pharmacists provide the information across the spectrum of clinical practice. Providing concise information to patients during counselling is an important aspect of pharmaceutical care. Pharmacists also provide drug information to other health professionals in the course of their clinical activities. AUCoPS

4. ANSWERING DRUG INFORMATION QUESTIONS : Drug information enquiries in clinical practice often reflect circumstances which are unusual in some way, and beyond the scope of average patients and situations. Prescribers will be familiar with established drugs but may ask about new drugs, new or unusual adverse effects, or how to manage therapy in a patient with interacting drugs or complications such as renal or liver disease. It is often necessary to seek further details from the enquirer in order to provide a meaningful response. However, systematic questioning for unnecessary detail will not be appreciated. Adopting a stepwise approach may reduce literature search time, avoid overlooking significant information and help the enquirer understand the search strategy. 4 AUCoPS

5. HISTORY : This five step systematic approach to responding to drug information queries was introduced by Watanabe et al. In 1975. - Watanabe’s method instructed student pharmacists on how to manage drug information requests. - Over the past 30 years modification to this approach have been introduced however the basic concepts of Watanabe et al. have remained the golden standard for answering drug information queries 5 AUCoPS

6. SYSTEMIC APPROACHS (1975 ) 6 AUCoPS

7. SYSTEMIC APPROACH TO ANSWER DRUG INFORMATION REQUESTS: TABLE MODIFIED SYSTEMIC APPROACH(1987) STEP 1 Secure demographics of requestor STEP 2 Obtain background information STEP 3 Determine and categorize ultimate questions STEP 4 Develop strategy and conduct research STEP 5 Perform evaluation , Analysis and synthesis STEP 6 Formulate and provide STEP 7 Conduct follow-up and documentation 7 AUCoPS

8. 1. ACCEPT THE INITIAL QUESTION AND SECURE DEMOGRAPHS OF REQUESTOR : The initial question shows the requestors knowledge regarding the subject matters but it is important to more directly determine the requestors position , education , and anticipated knowledge. Identify the enquirer and obtain sufficient contact details. For regular clients, these details should be recorded in a database to facilitate future enquiries. 8 AUCoPS

9. 2. OBTAIN BACKGROUND INFORMATION : The requestors name. The requestors location and contact method. The requestors affiliation(institution or practice) if a health care professional. The requestors frame of reference( title,profession or occupation and rank) The resources the requestor already consulted. The urgency of the reques t. 9 AUCoPS

10. BACKGROUND INFORMATION. WHY ? Background information aids in clarifying the questions and is a critical step in the process. The question may not be stated concisely or the requestor may not know how to ask the question. To formulate an acceptable response both the caller and researcher must have a clear understanding of ultimate question. 10 AUCoPS

11. 3. ULTIMATE QUESTIONS/CATEGORIZATION OF QUESTIONS : Refocusing the requestors questions is useful . Once the ultimate question has been acknowledged the question is categorized. The categorization is useful for the initial development of the search strategy and for the determination of resources and staff training to be maintained. Allows for efficient use of resource. An all inclusive resource with data to answer every drug information question does not exist. Examples of question classification: Adverse drug reactions/contraindications Availability Dose Drug interaction 11 AUCoPS

12. Ultimate questions : Receiver_____________ Respond by ____________ Classification: - Availability(strength , manufacturer) -Pharmaceutics(compounding , formulation) - Identification -Pharmacokinetics(ADME) -General product information -Adverse effects -Procedure -Poisoning/Toxicology -Cost -Others:____________ -Compatibility -Administration - Drug interactions 12 AUCoPS

13. 4. DEVELOP STRATEGY AND CONDUCT RESEARCH: Categorization of the ultimate question prompts the resource selection process. Consider all the available information resources and prioritise them based on the probability of locating the required information. In many cases, beginning the search with tertiary sources (textbooks) and then progressing to secondary literature will provide an adequate answer, and there will be no need to attempt a literature search. 13 AUCoPS

14. 5. DATA EVALUATION , ANALYSIS AND SYNTHESIS : Skills for literature evaluation and clinical application of statistical analysis are applied. -Application of these skills at this step is one of the opportunities to differentiate the professional from the technician through using the modified systemic approach. 14 AUCoPS

15. 6. FORMULATION AND PROVISION OF RESPONSE : 15 STEP 1 : Present the competiting viewpoints or considerations STEP 2 : State the assessment of the literature or information reviewed and claime the superior viewpoint STEP 3 : Briefly refute the major strengths and present weakness of the inferior viewpoint STEP 4 : Defend the major weaknesses and promote the strength of superior viewpoint STEP 5 : Reiterate the final assessment in support of the superior viewpoint AUCoPS

16. 7. FOLLOW-UP , FOLLOW-THROUGH AND DOCUMENTATION: - Follow-up is the process of verifying the appropriateness , correctness and completeness of a response following the communication. -Follow-through is the process of readdressing a request based on the availability of new data or a change in the situation or circumstances that were decisive factors in the synthesis of a response. -The ultimate questions , the materials searched , the response and follow-up should be documented. -Documentation essential for reducing liability and potentially promoting the development of a continual service. 16 AUCoPS

17. 17 PREPARATION OF WRITTEN AND VERBAL RESPONSE AUCoPS

18. PREPARATION OF WRITTEN RESPONSES: Preparation of written response: GOAL: Is to prepare a document that is clear , concise , complete and correct GENERAL RULES: Organize the information before starting to write. Use proper spelling and grammar. Preferably avoid passive voice throughout. Avoid writing in the first person and second person wherever possible. Prepare a document In presentable manner. Keep things as simple and direct as possible. Consider whether graphs tables or figures would make the document simpler. Avoid using abbreviations and acronyms. 18 AUCoPS

19. Cont … If the document is long use subheadings. Present it in correct order as required. Write in your own words. At first make sure that all of the information is down on paper. Once that occurs go back to revise and perhaps reorganize the document. SPECIFIC DOCUMENT SECTIONS: It should contain Introduction Body Conclusion 19 AUCoPS

20. Cont … INTRODUCTION: - Should inform what the reminder of the document is to cover. BODY: Should contain all the details of the document. Do not include unnecessary information . Do not stray from the subject. Sub divide the document further in a logical order and as appropriate when necessary. Always focus end point. CONCLUSION: Should be placed at the end of the document. Readers need something to bring their thoughts together at the end . 20 AUCoPS

21. PREPARATION OF VERBAL RESPONSE : Verbal communications are most frequently used in practice setting. Need to use good verbal communication skills. Deliver the information at an ideal place Deliver the content confidently Must be prepared for additional questions. Show evidence when appropriate /necessary. Listen carefully when clarification is sought. Clarify all doubts confidently. Use appropriate language with good grammar. Use correct pronunciation of all terms of the document . 21 AUCoPS

22. CONCLUSION: Using the systemic approach to answer drug information questions is essential for providing efficient pharmaceutical care. Like other pharmacy functions it is an acquired skill which improves with proper training and experience. -Improves quality and consideration of all relevant factors for each question. -Provide standardized process for all researches to use-increases uniformity in responses. -Clear communication between researchers and requestors . 22 AUCoPS

23. REFERENCE: TEXT BOOK OF CLINICAL PHARMACY PRACTICE 2 ND EDITION – G.PARTHASARATHI KARIN NYFORT-HASEN , MILAP C NAHATA. TEXT BOOK OF CLINICAL PHARMACY- PEE VEE. 23 AUCoPS

24. 24 THANK YOU AUCoPS