Comprehensive clinical drug information service: first year's experience.

Davies, David G.; Ashton, C. H.; Rao, Juhi; Rawlins, M. D.; Routledge, Philip A.; Savage, Rodrigo; Thompson, Joshua W.; Zar, M A

doi:10.1136/bmj.1.6053.89

Cited by 31 publications

(18 citation statements)

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“…Drug hypersensitivity reactions (DHRs) are the adverse effects of pharmaceutical formulations (including active drugs and excipients) that clinically resemble allergy (Box ). DHRs belong to type B adverse drug reactions, which are defined by the World Health Organization as the dose‐independent, unpredictable, noxious, and unintended response to a drug taken at a dose normally used in humans . A‐type reactions, including overdoses and pharmacological reactions, are dose dependent and predictable.…”

Section: Methodsmentioning

confidence: 99%

InternationalConsensus on drug allergy

Demoly

Adkinson

Brockow

et al. 2014

Allergy

837

964

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When drug reactions resembling allergy occur, they are called drug hypersensitivity reactions (DHRs) before showing the evidence of either drug-specific antibodies or T cells. DHRs may be allergic or nonallergic in nature, with drug allergies being immunologically mediated DHRs. These reactions are typically unpredictable. They can be life-threatening, may require or prolong hospitalization, and may necessitate changes in subsequent therapy. Both underdiagnosis (due to under-reporting) and overdiagnosis (due to an overuse of the term 'allergy') are common. A definitive diagnosis of such reactions is required in order to institute adequate treatment options and proper preventive measures. Misclassification based solely on the DHR history without further testing may affect treatment options, result in adverse consequences, and lead to the use of more-expensive or less-effective drugs, in contrast to patients who had undergone a complete drug allergy workup. Several guidelines and/or consensus documents on general or specific drug class-induced DHRs are available to support the medical decision process. The use of standardized systematic approaches for the diagnosis and management of DHRs carries the potential to improve outcomes and should thus be disseminated and implemented. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), formed by the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma and Immunology (AAAAI), the American College of Allergy, Asthma and Immunology (ACAAI), and the World Allergy Organization (WAO), has decided to issue an International CONsensus (ICON) on drug allergy. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences and deficiencies of evidence, thus providing a comprehensive reference document for the diagnosis and management of DHRs.Allergy 69 (2014) 420-437

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Section: Methodsmentioning

confidence: 99%

InternationalConsensus on drug allergy

Demoly

Adkinson

Brockow

et al. 2014

Allergy

837

964

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“…However in Africa only South Africa and Zimbabwe were pioneers in establishing drug information centers. However, nowadays many countries in Africa including Egypt, Ethiopia, Ghana, Eritrea, Kenya, and Uganda had established DICs [9–15]. But studies assessing these DICs whether they are performing best under the developing country (in Sub-Saharan Africa) scenario or not are rare except few like Uganda [16], Zimbabwe [17], Ethiopia [18], and Sudan [19].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Use and Status of New Drug Information Centers in a Developing Country, Ethiopia: The Case of Public University Hospital Drug Information Centers

Ashenef

Reshid

Yilma

et al. 2018

BioMed Research International

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Introduction Drug information center (DIC), in most cases, is part and parcel of pharmacy service established as a unit that deals with offering recent, balanced, truthful facts about drugs to the public, patients, and health care professionals. Objective To assess the query receiving and response trends by the drug information centers (DICs) found in main university affiliated teaching health care institutes in Ethiopia. Settings The drug information centers located in Mekelle, Gondar, Jimma, Tikur Anbessa Specialized University Hospitals, and St. Peter Public Hospital, Ethiopia. Methods It employed analytical, descriptive (cross-sectional), and retrospective methods. The study was performed from June to August, 2015. All the available documented data were gathered with the help of checklist and questionnaire (self-administered). Results A total of 439 queries submitted to the DICs during their active service period were included in this study of which 407 were found to be suitable for this assessment. The highest inquiries had come from public hospitals (60 %) from health care workers (95.1 %), out of which pharmacists were the highest (63.57 %) submitters, followed by health care students (12.7 %). The major purposes of query submission were to improve treatment outcome of patients (33.9 %) and then to update the knowledge (25.1 %) although 39.3 % of the queries did not document it. The most common requests concern drug interaction (19.7 %) followed by therapeutic use (17.8 %) and the major pharmacological group is about antimicrobials (23.3 %) followed by antihypertensives (11.4 %). Web sites (31.4 %) were the most highly used references followed by Micromedex (19.0 %). Conclusion The assessment of the DICs had shown that it is feasible to establish and develop DIC services in a developing country setting, Ethiopia. The study found that most of the common queries deal with drug interaction, therapeutic use, and general product information (most commonly about antimicrobials).

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“…However, the assessment of judgemental/non-judgemental is quite subjective, and others have used the term consultative for questions that requires clinical advice on a special case. Consultative questions usually entail discussion with the inquirer on possible benefits and hazards of one or more courses of action in a clinical case 10. The justification for using judgemental classification versus consultative and other classifications is not clear-cut, and this makes comparisons between different studies difficult.…”

Section: Discussionmentioning

confidence: 99%

A question–answer pair (QAP) database integrated with websites to answer complex questions submitted to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS): a descriptive study

et al. 2012

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ObjectiveTo assess a question–answer pair (QAP) database integrated with websites developed for drug information centres to answer complex questions effectively.DesignDescriptive study with comparison of two subsequent 6-year periods (1995–2000 and 2001–2006).SettingThe Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS).ParticipantsA randomised sample of QAPs from the RELIS database.Primary outcome measureAnswer time in days compared with Mann–Whitney U test.Secondary outcome measureNumber of drugs involved (one, two, three or more), complexity (judgemental and/or patient-related or not) and literature search (none, simple or advanced) compared with χ2 tests.Results842 QAPs (312 from 1995 to 2000 and 530 from 2001 to 2006) were compared. The fraction of judgemental and patient-related questions increased (66%–75% and 54%–72%, respectively, p<0.01). Number of drugs and literature search (>50% advanced) was similar in the two periods, but the fraction of answers referring to the RELIS database increased (13%–31%, p<0.01). Median answer time was reduced from 2 days to 1 (p<0.01), although the fraction of complex questions increased from the first to the second period. Furthermore, the mean number of questions per employee per year increased from 66 to 89 from the first to the second period.ConclusionsThe authors conclude that RELIS has a potential to efficiently answer complex questions. The model is of relevance for organisation of drug information centres.

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Comprehensive clinical drug information service: first year's experience.

Cited by 31 publications

References 0 publications

InternationalConsensus on drug allergy

InternationalConsensus on drug allergy

Assessment of the Use and Status of New Drug Information Centers in a Developing Country, Ethiopia: The Case of Public University Hospital Drug Information Centers

A question–answer pair (QAP) database integrated with websites to answer complex questions submitted to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS): a descriptive study

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