Download Resources Update September 2013

Resources Update
September 2013
Dave Abbott
Medicines Information Pharmacist
Aims
• Refresher on core resources
• how to access
• coverage
• pros and cons
• Update on more specialist resources
• How to assess the quality of resources
• Useful newsletters and newsfeeds
Core Resources – BNF / BNFc
•
•
•
•
www.bnf.org
Paper copies published twice a year
Electronic versions (internet / apps) updated monthly –
electronic is more up to date
App available for free on android and iPhone. Need your
Athens password to download updates
Internet version freely available from NHS computers
Core Resources – BNF / BNFc
Pros
Cons
• Readily available
•
• Up to date (electronic
versions more so)
•
• Guidance updated in light
of MHRA updates / NICE
etc
• Well respected resource
Little coverage of
unlicensed medicines /
indications
Space requirements
mean not comprehensive
- not all ADRs /
interactions listed, advice
on e.g. dose adjustment
in renal impairment
limited
Core Resources – EMC
www.medicines.org.uk
• Information provided by the manufacturers of products
• Contains SPCs (aimed at HCPs) and PILs (aimed at
patients)
• Only holds information from manufacturers who are
members of the ABPI who choose to participate – other
manufacturers publish their information elsewhere
Core Resources - EMC
Pros
Cons
• Gives a lot of
• Not all products are
information on the
listed
licensed uses of
• Only gives information
medicines
on licensed indications
• Additional information
• Can be cautious, so will
on pharmacology and
tend to say ‘no’ if limited
the evidence supporting
data – e.g. renal
its use
impairment / pregnancy
Core Resources – NHS Evidence
www.evidence.nhs.uk
• Resource provided by NICE
• Searches resources from reputable providers only
• Need to use filters – searching ‘methotrexate’ returns
>7,000 results. Can filter by information type (guidelines
/ pathways / trials etc) or provider (NICE / Cochrane /
UKMI etc)
Core Resources – NHS Evidence
Pros
• ‘NICE approved
Google’
• Fairly comprehensive
with a lot of different
types of available
information
• Useful first step to
search the literature
Cons
• Can be difficult to find
the things you want
(but practice makes it
easier)
Core Resources - Leeds Health Pathways
nww.lhp.leedsth.nhs.uk
• Local repository for guidelines and pathways
• Used by LTHT and all Leeds CCGs
• All content approved by relevant groups before
publishing
Core Resources – Leeds Health Pathways
Pros
Cons
• Reflects local practice,
• Older guidelines may
with guidelines to be
not reflect current
followed within LTHT
practices – check
review dates
• Shared resource
• Robust review
processes
Core Resources - Medusa IV guide
http://lthweb/sites/medicines-management-andpharmacy/information-on-medicines/iv-monographs
• National collaborative intravenous administration guide,
with local customisation
• National monographs written by pharmacists in
participating hospitals, local customisation added by
Leeds Medicines Information Service
• Available within LTHT without a password
Core Resources - Medusa IV guide
Pros
• Tailored to local
practice
• Reasonably
comprehensive
Cons
• Some monographs
more up to date than
others
• Sometimes too much
detail in national
monographs
• Paediatric guide in
development
• IV guide, not IM or SC
• Intermittent access
problems (use back-up
site)
Core Resources – Leeds Formulary
www.leedsformulary.nhs.uk
• The medicines formulary followed by all NHS
organisations in Leeds
• Lists the medicines supported for use within Leeds,
along with links to further information (guidelines, NICE,
information updates etc)
• Managed by the Leeds Medicines Information Service at
LTHT
Core Resources – Leeds Formulary
Pros
Cons
• Reflects local practice,
• Work in progress, so
and links to assessed
some chapters are not
resources (does your
yet complete
filtering for you)
• Some links will only work
• Hosts a newsfeed for
within LTHT or the NHS
information on medicines
• Acts as a hub for other
sources of information –
all core resources linked
• Updated continually
Specialist Resources Update
For quality assured resources, see:
• Pharmacy Quicklinks - http://pharminfo01/mi_intranet/index.asp
• UKMI free to access resources http://www.ukmi.nhs.uk/filestore/ukmiacg/ResourceswithFreeAccess_Jul13_f
inal.doc
Changes and updates:
Pregnancy and Lactation:
• Schaeffer is now quite old so after Toxbase, Briggs is the preferred resource
for pregnancy queries. The web version may not work with your version of
Internet Explorer – use Firefox if this is a problem (on MI computers)
• UKMI Trent and West Midlands now jointly run the lactation advisory service
– DILAS. Their information is now at www.midlandsmedicines.nhs.uk
Specialist Resources Update
Antimicrobials:
• We now have access to the Sanford and John Hopkins guides. Contact MI
for access
Drug compatibility / stability:
• Stabilis (www.stabilis.org) free to access – second line resource after
Medusa, Trissell etc. French site, so take care – some symbols don’t mean
what you think they might
Other people’s formularies:
• There has been a push to make information more available, so some other
specialist hospitals are publishing their formularies online, including
http://www.moorfields.nhs.uk/Publicationsandresources/Medicines and
http://www.guysandstthomas.nhs.uk/resources/publications/formulary/paedia
tric-formulary-9th-edition.pdf
Specialist Resources Update
General resources:
• Clinical Knowledge Summaries (CKS – previously Prodigy) are back and
being actively maintained. Primary care angle – available via
www.evidence.nhs.uk
• Up To Date – www.uptodate.com – is back. Log in using your Athens
details. Will ask you to register again, but feel free to ignore this. Has a
useful ‘What’s New’ section
Literature searches:
• All of Medline is now indexed in Embase – searching Embase using
thesaurus will cover Medline content as well.
Resources which are no more:
• Meyler’s Side Effects Of Drugs – no additional benefit over Martindale/AHFS
Assessing quality of new resources
Why?
• If you are working as a specialist within an area, you
may find your practice is not covered by ‘standard’
resources
• The problem used to be finding information. The
problem now is finding reliable, useful information
• Any 15 year old can make a professional-looking
website
• There is a huge amount of dubious information out
there – search ‘George Eby’ (‘special’ zinc cures the
common cold) or ‘Miracle Mineral Solution’ (drink
bleach to cure AIDS) as extreme examples
Assessing quality of new resources
Has someone else you trust done an assessment already?
If not…
• Is it an appropriate person/organisation providing the
information? Relevant qualifications / experience etc
• Is the information referenced to sensible resources? Is
there a publication date and review date? Is the
editorial policy clear?
• Is the information relevant to your patient group? Does
the cohort the resource covers match your patient? If a
non-UK product, does their practice match ours, and
are the products available in the UK?
•
We have a more comprehensive assessment tool in MI
if required
Useful newsletters and newsfeeds
MHRA Drug Safety Update
Important safety alerts on medicines – go to
www.mhra.gov.uk and search ‘drug safety update’ to
subscribe
NICE Medicines Awareness
Daily or weekly options for digests of new information
on medicines – search ‘NICE Medicines Awareness’ to
subscribe
NICE ‘Eyes on Evidence’
Monthly update on new NICE products – subscribe from
the same page above