Medicines Information provision in the UK

David ErskineDirector

London & South East Regional Medicines Information Service

The case for a medicine information service

• As defined by Donald Rumsfield – the former US Secretary of State

• There are things we know we know• There are things we know we don’t know• There are things we don’t know we don’t know

in the War against Error…

Medicine Information is the weapon of mass instruction

The aim of medicine information

• To achieve this we need– Staff with the right knowledge and skills

– Access to the right resources– Efficient methods of sharing work and

knowledge across networks (national and international)

What happens in the UK

• About 220 medicine information (MI) centres based in pharmacy departments of most hospitals.

• Training in MI skills is a core part of the development of every hospital pharmacist

• 13 Regional MI centres – provide leadership in quality assurance, education and support, and support commissioning pharmacists working in primary care, led by National Executive

Promoting the things we know we know

• Single national website of information about medicines–the National electronic library for

medicines (www.nelm.nhs.uk -free access)

Support with the things we know we do not know

• Across the UK – about 0.25 million enquiries are answered every year by MI services

Support with the things we know we do not know

• Across the UK – about 0.25 million enquiries are answered every year by MI services

• Nationally implemented quality assurance programme for enquiry answering

Support with the things we know we do not know

• Across the UK – about 0.25 million enquiries are answered every year by MI services

• Nationally implemented quality assurance programme for enquiry answering

• Most centres use same enquiry answering database – MI Databank

Support with the things we know we do not know

• Across the UK – about 0.25 million enquiries are answered every year by MI services

• Nationally implemented quality assurance programme for enquiry answering

• Most centres use same enquiry answering database – MI Databank

• Mailbase – to support pharmacists with enquiries they cannot answer

Reducing the risk of not knowing what we do not know

• National training material for MI pharmacists – workbook and computer-assisted learning package (MiCAL) covering:– Relevant information sources and their

limitations– Literature searching skills

– Dealing with specific types of enquiries– Critical appraisal skills

– Ethics

Reducing the risk of not knowing what we do not know

• National training material for MI pharmacists –workbook and computer-assisted learning package (MiCAL) covering:– Relevant information sources and their limitations– Literature searching skills– Dealing with specific types of enquiries– Critical appraisal skills– Ethics

• MI pharmacists then educate other pharmacists in these skills

Reducing the risk of not knowing what we do not know

• National training material for MI pharmacists –workbook and computer-assisted learning package (MiCAL) covering:– Relevant information sources and their limitations– Literature searching skills– Dealing with specific types of enquiries– Critical appraisal skills– Ethics

• MI pharmacists then educate other hospital pharmacists in these skills

• Use of IT to deliver tailored knowledge through email push and RSS feeds

Lessons we have learned

• Need to promote our service on basis of our combination of knowledge, skills and access to clinical expertise

• Need to be prepared to support health economic work –prescribers need to be take both evidence and cost effectiveness into account

• Need to adjust to reflect changing national resources (NICE, NHS CHOICES, NHS EVIDENCE– so now we focus more on horizon scanning,

Medicines Q&As and individual patient reviews than on individual drug reviews

• Published work is very closely scrutinised– need stringent QA programme in place

• Need robust financial case for IT developments – costs escalate!

Any questions?