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Drug information literature evaluation 1 PPT

The provision of pharmaceutical care requires
integration of sound therapeutic principles and evidence-based data to render patient-centered care

Pharmacist must have the knowledge and skills to:
Retrieve
Evaluate
Communicate

In order to keep abreast of new and emerging developments and improvements in patient care and patient-oriented outcomes you must possess:
Drug Information
Biostatistics
and Literature evaluation skills

Define Evidence-based medicine from quotes
“The integreation of best research evidence with clinical expertise and patient values”
“The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients

Define Evidence Base Medicine
Explicit, judicious, and conscientious use of current best evidence from medical care research to make decisions about the medical care of individuals

Evidence-Based Medicine Five Fundamental Steps
Step 1: Formulating a well-built question
Step 2: Identifying articles and other evidence-based resources that answer the question
Step 3: Critically appraisiing the evidence to assess its validity
Step 4: Applying the evidence
Step 5: Re-evaluation the application of evidence and areas for improvement

What is PICO for Step 1 for Evidence-Based Medicine
P – The patient’s disorder or disease
I – The intervention or finding under review
C – A comparison intervention (if applicable)
O – The Outcome

Step 2 resources generally fall into three categories
General information (background) information
Filtered resources
Unfiltered resources

What should you check for during step 3?
Validity
Clinical Importance
Applicability

Explain Step 4
– Compare the patient with those in the study
– Consider the patient’s baseline risk for the outcome of interest and other risks associated with therapy
– Consider the patient’s values, beliefs, concerns and readiness for the intervention

In Step 5, once the therapy is administered, evaluate the following:
– Did I formulate a focused question?
– Did I use the most appropriate resource?
– Did the evidence work in my patient
– Is there new information/data in the literature
– How can I improve and/or update my clinical decisions?
– Reassess the strategy

Three key components of Pharmacy EBM
– Comprehensive searches of the scientific literature
– Critical appraisal of the evidence
– Apply the evidence to individual patients and/or populations

Define Information Mastery Concept
The ability to efficiently search through vast amount, find and critically assess the most pertinent pieces of evidence and apply information to the clinical situation

What skills will you need to keep up to date with the best evidence?
– To FIND the evidence more efficiently
– To APPRAISE the quality of the evidence more effectively
– To USE good quality evidence more systematically

What is drug information?
Provision of information on:
– Drugs/medications/regimens
– Use and place in therapy
– Side effects and management
– Interactions
– Alternatives

Info on first hospital based drug information center
– Begun in 1962 – University of Kentucky
– Developed to be a source of “…selected, comprehensive drug information for physicians and dentist to evaluate…”

Academic DIC
– Pharm.D. and R.Ph training
– General drug information to practitioners and general public
– Affiliated with university/hospital

Industry DIC
– Pharm.D. with residency or experience
– Specific drug information on company products
– Primarily to practitioners only

Acaddemic DI
– University or hospital based service
– Primary focus on suppor tto area practitioners
– Resource for Pharm.D. rotations
– Supports for clinical services
– Pharmacy and Therapeutic committee
– Publication

Industry DI
– Focus on a single product/therapeutic area
– Provides on-label and off-label uses and dosages
– Provides drug monographs and formulary kits
– Audience include clinicians as well as internal customers

Pharmacists use biostatistics to:
– Classify
– Measure
– Analyze
– Interpret
– This is the key to avoiding the use of invalid data form the biomedical literature

Define Data
– The raw material of Statistics is data
– We may define data as figures. Figures result from the process of counting or from taking a measurement

What are some sources of data?
1. Routinely kept records
2. External sources
3. Surveys
4. Experiments

Literature Evaluation – Pharmacists must be able to:
– Analyze
– Interpret information

Steps of Literature Evaluation
Step1: Conduct a Relevance (External Validity) Scan
Step 2: Determine the Intent of the Article
Step 3: Evaluate the Validity of the Research Design
Step 4: Assess Study Methodology and Results (Internal Validity)

Pharmacists must be Information Masters:
– Possessing ability to efficiently search out reliable information
– The ability to critically appraise the information
– Have the ability to apply the information to the situation at hand

The triad of areas needed to achieve information mastery for the EBM model:
Drug information
Biostatistics
Literature Evaluation

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