This document provides an overview of drug information centers. It discusses the objectives, classification, requirements, resources, functions, and need for drug information centers. It also lists some drug information centers in India and the roles of drug information specialists. Computerized services and resources used by drug information centers are also outlined.

1. Drug information center in a retail
drug store
•Presented By : Trupti Patel
•Guided By:
Dr.Yamini D shah
Head,Department of
Pharmaceutics and
PharmTechnology

2. Content
 Introduction
 Objective
 Classification of DIC
 Requirements of DIC
 Resources
 Drug information sites
 Function of DIC
 Need of Drug Information
 World senario
 Indian senario

3. Content conti…
 List of DIC in india
 Drug information specialist
 Computerized services
 Systematic aaproch for answering the drug information
 Documentation and quality Assessment

4. Introduction
 Drug Information is the written and verbal information about drugs and
drug therapy in response to a request from other healthcare providing
organization, patients,committees and public community.
 Drug information center provides In depth , unbiased source of crucial
drug information to meet need of the practicing physicians , Pharmacists
and other healthcare professionals.

5. Objectives
 To provide an organized database of specialized information
needs of practitioners.
 To provide accurate and unbiased medicines information service
to the pharmacist, physicians and other healthcare professionals
and community.
 To promote patient care through rational use of medicines
 Improve patient adherence
 To educate pharmcay students to serve as effective providers of
medicines information.

6. Classification of the drug information
center
 1. Hospital based DIC
 DIC in hospital performed major activities include receiving and
answering the in-house call by the requestor, involved in formulary
decision.
 They providing in service education, participating in drug use
evaluation, publishing newsletter, reporting ADR, assist in
investigational drug activity and pharmacy and therapeutic committee.

7. 2. Industry based DIC
 In industry, DIC have access about all detailed knowledge accumulated
from the time of drug which was first developed, information about
published literature, the knowledge of unpublished documentation, record
of usage in unusual circumstances, and very important access to the
relevant experts.
 All user can communicate the company through phone call at any peak
hours; telephone recording machine is cleared every hour and the medical
information staff can be contracted for any further information if required.

8. 3.Community based DIC
 Main Aim of Community based DIC is to change the patient behaviour
through drug therapy, improving patient therapy at ultimately lead to
quality healthcare.
 Provide more information about health of patients in response to their
need.
 patient are allow to create their own content and share information about
health on the internet by using mobile technologies.

9. Requirements of Drug Information
center
 space and organization: Different parameters are considered while
determining the requirements of space and organization.
 These factor include availability of space. , Budget , type of activities
offered , staff , resources.
 Setup and equipment:
 The centre should equipped with computer terminals, printed
materials (current periodicals, bound journal volumes, reference
texts) and has access to Medline, the internet and various other online
drug and Medical references.
 Centre should have direct access to computerized online data
searching CD Room database and access to the world wide web (www)
should be available.

11. Requirements of DIC continue…
 Staff, student and time:
 DIC require one full time director, one full time resident and six pharmacy
students. The state pharmacy council provides the secretarial support.
 This centre also serves as training site for undergraduate and postgraduate
student of pharmacy.
 Service activities:
 The staff answer the questions related to drug matters, particularly to those
related to safety of drug.
 The doctor, pharmacist and patients could visit the centre in person to get
information. The literature searches are provided free of charge to all
hospital faculty, clinicians and pharmacy staff for patient specific issues and
for research as well as teaching activities.

12. Resources
 1.Primary resource
 Information is presented by
author without any evaluation
by second party.
 Provide must current
information about drugs.
 Example include article
published in journal
Information is presented by
authors without any evaluation
by second party, newsletter ,
periodicals .

13.  2. Secondary resources
 The original source has been evaluated by second party other than the
publisher.
 Modified and rearranged form .
 Example – review articles ,abstarct ,indexes and combination of
abstarct and full text reprint .

14.  3.Tertiary source
 Information obtained from primary and secondary source and
arranged in a manner to represent a tertiary litrature.
 Example include textbook , refrence book , formulary mannuals
,drug bulletins , Representative from pharmacopoeias .

15. Other sources:
The Drug information center also receive information from
 the public & hospital about adverse effect of any drug
 Local drug list
 National formularies
 Hospital formularies
 Internet
 Phone calls to manufactures
 Government and non-government organizations
 From other DIC’s

16. Drug information sites
 U.S. Food & Drug Administration http://www.fda.gov/
 National Guideline Clearinghouse http://guidelines.gov
 MerckMedicushttp://www.merckmedicus.com/pp/us/hcp/hcp_home.jsp
 BestBetshttp://www.bestbets.org/home/bets-introduction.php
 PrescribingSupportCentrehttp://www.nice.org.uk/mpc/
 World Health Organization Library site:
http://www.who.int/hlt/virtuallibrary/english/ subject.htm
 Australian Prescriber: http://www.australianprescriber.com
 British medical journal :http://www.bmj.com/
 The Free Medical Journal Site: http://www.freemedicaljournals.com 101
 MEDLINE: http://nlm.nih.gov

17. Drug information sites continue …
 Cochrane collaboration: www.cochrane.org
 Bio mail: http://biomail.sourceforge.net/biomail
 SATELIFE: Free information services to health professionals: http://www.healthnet.org
 Harrison’s Internal Medicine: http:// www.harrisoneonline.com

18. Function of DIC
 The primary function of a drug information centre is to respond to enquiries on
therapeutic drug use. Most centre provides service to health professionals and some
also offer a service to the public.
 In some cases, toxicology information is also provided.
 The various functions of drug information centre are follows:
 1. Drug evaluation
 Evaluation of therapeutic drugs is an important function of DIC.
 The centre must have access to the principal medical and pharmaceutical journals.
 The staff should be able to critically assessing the medical literature and information
from media sources and industry.
 The staff should be capable to critically assessing the medical literature and
information from industry and media sources.

19.  2.Therapeutic advice
 Many centres provided patient related drug information action as
their primary activity and this requires an understanding of disease
states and therapy.it also require appropriate resources for rapid
support when response time is an important factor in delivering
optimum therapy.
 Some factors are includes therapeutic advice which are
efficacy,optimum dosage ,mode of administration , effect of other
disease state and strategies to promote adherence in chronic
conditions.
 3.Pharmaceutical advice
 Generally, most other enquiries will be related to pharmaceutical
preparations and it include issues of availability, formulation, cost,
storage and stability.

20.  4.Education and training
 Educational activities are important to support the quality use of
drugs and provide information to health professionals and public. A
drug information centre can also support national and regional
authorities responsible for drug use programmes.
 Healthcare practitioners need to understand the scope and functions
of drug information centre in order to utilise the services they offer.
Training graduate and undergraduate student is an important aspect
of overall clinical training.
 5.Dissemination of information
 DIC can distribute information in the form of drug monographs,
bulletins and websites.

21.  6.Reserch
 DIC should be involved in research activities which including drug
utilisation studies and pharmacovigilance.
 DIC also involved in the development and review of hospital drug use
policies. specialist centres should also provide the quality and commonly
used information resources.
 7.pharmacovigillance
 DIC play role in programs which monitor adverse drug reactions. Some
centre may serve as adverse drug reaction monitoring site for hospitals or
regions.
 Regional centre should be a member of WHO program for international
drug monitoring.

22. NEED OF DRUG INFORMATION:
 In the past , need of drug information was limited due to lesser range
of availability of drug
 But now , newer drugs and multiple combination of the drugs being
introduced. There are more than 20,000 biomedical journals available and
more than 6,000 journals published every day. It is very difficult task for
health care professional to keep themselves up-to-date with available
drug information.
 Most of the developing countries like India suffer from lack of adequate
drug information due to various factors like limited accessibility of
current literature, poor documentation, poor funding etc. In india lack of
accurate drug information service poses problem and in general doctors
get their information from medical representative who obviously are
partially biased towards their product.

23. Need of drug Information continue…
 India, low-income levels populations, the multiple health care
systems and lack of information about the risks and benefits of
drug therapy make good clinical pharmacy practice all the more
relevant and important. Due to increasing population and limited
number of doctors, their practices are loaded and creates too much
of stress. As a result, the good quality clinical management
suffers. There is potential among the clinical pharmacist to fill this
gap.

24. World senario
 In 1962, the first drug information centre was opened at the
University of Kentucky Medical centre which aim to provide a
selective and comprehensive source of drug information for
dentists, staff physicians and also, to meet the needs of nursing
staff there by which allow them to compare and evaluate various
drugs.
 In 1973, the first formal survey identified 54 drug information
centre in USA.
 According to report published Since 1995,120 full-fledged
pharmacist operated drug information centres in the United
States, which accept a broad scope of requests from health care
professionals.

25. Indian senario
 In India the DIC was first established in Tamilnadu JSS
Octas Amund Maharashtra state pharmacy council,
Thriuvanthapura Medical college Kerala and Karnataka
state pharmacy council.
 The WHO India country office, in collaboration with
Karnataka pharmacy council is supporting the
establishment of 5 drug information center.
 The centre has been established in
Rajasthan (Jaipur),
Goa (Panaji),
Haryana (sisra),
Assam (Dibrugarh) and
Chhattisgarh (Raipur).

26. Indian senario continue…..
 The Karnataka state pharmacy council established its DIC in
August 1997 to disseminate unbiased drug information to
healthcare professionals. In India this was the first
independent in DIC started. The centre is registered with
IRDIS , an international Register of drug information
service.
 In Gujrat , K.B institute of pharmaceutical education and
research Drug Information center was set up in 2011.

27. List of drug information center in india
 Indipendent Drug Information center
 1.CDMU Documentation Centre, Calcutta
 2.Drug Information Centre, Maharashtra State Pharmacy Council, Maharashtra
 3.Andhra Pradesh State Pharmacy Council, Andhra Pradesh.
 4.Karnataka State Pharmacy Council (KSPC), Bangalore, Karnataka
 5. JSS, Ooty
 6.Pharma Information Centre, Tamilnadu, Chennai
 7.Drug Information Centre, Girijananda Chowdhury Institute of Pharmaceutical
Science (GIPS), Guwahati, Assam
 8.Drug Information Center, Laureate Institute of Pharmacy, Jwala ji, Kangra,
Himanchal Pradesh.
 9. Gujrat state pharmcay council Drug information center, Ahmedabad , Gujarat
 10. K.B institute of pharmaceutical education and research Drug information
center , Gandhinagar , Gujarat.

28. Hospital attached Drug information
center
 1.Christian Medical College Hospital Vellore, Tamil Nadu
 2.Drug Information Centre, (KSPC), Victoria Hospital, Bangalore, Karnataka
 3.Drug Information Centre, (KSPC), Bowring & Lady Curzon Hospital, Banglor, Karnataka
 4.Department of Pharmacy Practice, Chidambaram, Tamil Nadu
 5.Department of Pharmacy Practice, National institute of Pharmaceutical Education and Research
(NIPER), Chandigarh
 6.Jawaharlal Nehru Medical College Hospital (JNMC), Belgaum, Karnataka
 7. JSS, Mysore, Karnataka
 8. JSS, Ooty, Tamil Nadu
 9.N..R.S.. Medical College & Hospital, Calcutta, West Bengal
 10.Kempagowda Institute of Medical Sciences (KIMS), Bangalore, Karnataka
 11.Kasturba Medical College (KMC), Manipal, Karnataka

29. Hospital attached drug information
center conti…..
 12. Poison Information Centre, All India Institute of Medical Sciences (AIIMS), Delhi
 13.Poison Information Centre, National Institute of Occupational Health, Ahmedabad,
Gujarat
 14.Department of Toxicology (Incl. Poison Information & Laboratory Services) Amrita
Institute of Medical Sciences & Research, Cochin, Kerala
 15. Toxicology & IMCU Unit, Government General Hospital, Chennai
 16.Sri Ramachandra Hospital, Porur, Chennai
 17.Sri Ramakrishna Mission Hospital, Coimbatore, TamilNadu
 18. Trivandrum Medical College, Trivandrum, Kerala

30. Drug information specialists
 Pharmacist are trained to provide general information about medications
to clients.
 Drug information specialist are those who receive specialize training
focusing on drug information research , evidence based evaluations ,
policy design , disbursement methodologies and formulary management.
 Drug information specialist often communicate with patients and
medical professionals about soon -to be developed medication, new
research, drug trail findings and potential side effects of drugs that are
currently for sale.
 Drug information specialists may work for development of
pharmaceutical industries , in hospital ,or in drug information center.
Some travel may be required in order to attend committee hearings,
conferences and other drug information events. Most pharmacist
including those who specialize in drug information work full time.

31. Computerized services
 Computer are very helpful to give drug information to clinical pharmacist. It is helpful to the
chemist and Pharmacist for drug design and to formulate new drug molecule.
 These information system are useful in developed as well as developing countries , as these are
established to store recorded information and provide free exchange of information among
scientists in various countries.
 The major International information systems & services are INIS, AGRIS, INSPEC, BIOSIS,
MEDLARS, MEDLINE etc.
 Computer- based products & services
 AVLINE (Audio-Visual Online)
 CANCERLIT (Cancer Literature)
 CATLINE (Catalogue Online)
 CHEMLINE (Chemical Dictionary Online)
 TOXLINE (Toxicology information Online)
 SDILINE (Selective Dissemination of Information Online)

32. Computerized services continue…
 MEDLINE is introduced in 1971, it is a litrature database of life science and biomedical
information.It includes medicine, nursing, pharmacy, dentistry, veterinary medicine &
health care. It can be searchable via PubMed & NLM‟s National Centre for
Biotechnology Information’s Entrez system.
 MEDLINE uses Medical Subject Headings (MeSH) for information retrieval. Engines
designed to search MEDLINE (such as PubMed &Entrez) generally use a Boolean
expression combining MeSH terms, words in abstract and title of the article, author
names, date of publication, etc.
 PubMed is a free database comprises more than 22 million citations for biomedical
literature from MEDLINE, life science journals, & other online books. Citations may
include links to full- text content from PubMed Central & publisher websites. Available
via the NCBI Entrez retrieval system. MedlinePlus is a free web service produced
maintained by NLM. Provides consumer health information for patients, families, &
health care providers. Brings together information from the US. NLM, the National
Institutes of Health (NIH), other US. govt. agencies & health related. organizations .

33. Systematic approach for answering the
drug information queries
1. Secure requestor demographics.
It’s important to know your audience, as your response technique
may differ depending on whether the question comes from a health
care professional or a patient. For example, you’d use the word
“renal” with a pharmacist and “kidney” with a patient. It’s always
best to inquire how the requestor would like the information
delivered (e.g., phone or fax), as this will help ensure adequate
follow-up.

34. 2. Obtain background information.
 This is historically the most difficult step because you
must act as a detective. Determine whether it’s a general
or patient-specific question, and then identify resources
the requestor has already consulted to help facilitate the
process. For patient-specific questions, it’s important to
inquire about pregnancy, weight, and renal function.

35. 3. Determine and categorize the question.
 If a pharmacist requests information about whether a
patient who’s breastfeeding can take amoxicillin, this
would be classified as a lactation question. Various
categories may include pregnancy, drug interaction,
pharmacy law, or pill identification.

36. 4. Develop a strategy and conduct a search.
 First, begin with tertiary literature, which is a compilation of
primary literature. This may include text books like Drugs in
Pregnancy and Lactation or drug information databases like
Clinical Pharmacology or Lexicomp. Next, consult your
secondary literature resources, which is the path to primary
literature. Secondary resources include PubMed and EMBASE,
which will enable you to locate primary literature or original
research. It’s important to use reputable resources when
researching. When using websites, be sure to consult ones ending
in .gov or .org.

37. 5. Perform evaluation, analysis, and synthesis.
 Objectively critique all of the information you retrieve
from your comprehensive literature search. Also,
consider the background information of your question.
Consult with pharmacists and other health care
professionals with expertise in your specific drug
information question.

38. 6. Formulate and provide a response.
 Inform the requestor when one course of action is more
desirable. Present competing viewpoints and
considerations. Also, describe your evaluation of the
research. Written responses should always be concise
and fully referenced.

39. 7. Conduct follow-up and documentation.
 Following up is important for ensuring the information was
received. Always document your drug information questions so
you can refer back to them. You’ll likely see the same question in
the future, and this well help serve as a reference point.
 When I managed a drug information centre, I’ll always review
these 7 steps with students on my rotation. These tips will enable
you to become confident in answering drug information questions
and prepare you for your pharmacy career.

40. Documentation and quality Assessment
 Methods of documenting pharmacist interventions , including the
provision of drug information , have been described in litrature.
Now a days DICs are using electronic documentation systems ,
which is help to increase the depth and quality of documentation ,
provide increased efficiency and cost saving.
 In addition, an electronic system can promote a standardized and
systematic approach and provides a readily retrievable archive that
can be used to rapidly search previously answered questions.
Documentation of DI services should include elements which is
identified through the systematic approach.

41. Documentation and quality Assessment
conti….
 The ASHP Guidelines on Documenting Pharmaceutical Care in Patient
Medical Records states that “the professional actions of pharmacists
that are intended to ensure safe and effective use of drugs and that may
affect patient outcomes should be documented in the patient medical
record. therefore, if the DI request is patient-specific, it is appropriate,
but not always necessary, to document the request and response in the
patient’s medical record.
 Documentation is critical to appropriate patient care, highlights the
value of pharmacist services, demonstrates accountability, provides a
basis for quality assessment and performance improvement, and details
an appropriate systematic approach in case a medico-legal dispute
arises from a DI request.

42. Future of Drug information center
 In the future the DICs is change according to user’s needs. Support system
integrated in prescriber’s software will cover some of the patient specific
information needed (e.g. alert if 2 interacting drug are combined).
 However, such systems will never replace the need for DICs because there
are an no. of possible drug related questions.
 In addition, no other drug information sources take patient specific data,
such as comorbidities, severity of the disease, Organ function, age, use of
other drugs and so, on.
 One to one communication between the enquirer and the DIC staff member
in each specific question can ensure that the response is adapted to the
specific clinical case.

43.  In Norway, the DICs have started question and answer service for consumer. The
Norwegian government support action to improve empowerment and health literacy
among consumers.
 Collaboration between DICs and an academic detailing program have also been
initiated.
 Academic detailing involves personal visit by a trained specialist to healthcare
professional to introduce best possible in drug therapy.
 The increasing use of bedside tablet computer and smartphone and development of apps
for health care professionals mean that DICs must be the part of professionals mean that
DICs must be the part of a rapid developments mean that DICs must be the part of rapid
developments taking place health information technology. The possibility of 2-way
communication between enquirers and DICs through chat function and telephone
service must be promoted.

44. Challenges
Although the establishment of DICs offers benefits in terms of addressing the
awareness gaps of health-care professionals and improved patient care, many
challenges have to be encountered while setting up these centres.
 The abundant factors that affect the efficient running of a DIC in developing
countries are understaffing, outdated drug information sources, lack of recognition,
ill-defined quality assurance programs, inappropriate facilities for working, and
lack of clinical and managerial skills .
 In resource-limited developing countries, the major hurdle in establishing a DIC
comes in the form of the constraint of funds. Establishing and running DIC
services successfully requires a good supply of recurring and non-recurring
budgets .
 DICs in hospital settings are affiliated to clinical pharmacology/pharmacy
departments, the expenses are usually borne out of the departmental budget.
 Drug information center also provided other valuable services which includes ADR
monitoring , poison information and training of post graduate student concerned
and allied to justify requirement of budget.

45. Challenges conti…
 Providing quality drug-related information requires the employment
of trained and experienced individuals in the DIC. However, there is
a dearth of such individuals within academic hospitals.
 To promote rational usage of drugs, the WHO recommends
independent DIC, as a core component of national programs because
one of the reasons for the failure of DICs is that their director has
other responsibilities.
 DIC are located in pharmcay Colleges in many Latin American
countries and they are directed by the HOD of the college . This
could lead to the wrong approach. DICs should remain near to
physicians, pharmacists, nurses, and other health-care professionals.
They can deal better with the promotion of rational drug use.

46. Challenges conti…
 Quality assurance on the services provided by DIC should be monitor and
compare with good standard resource regularly .
 Frequently monitoring key processes such as number of queries answered
per year, questions answered within 24 hours, user’s satisfaction,
publication of bulletin, participation in drugs committees, updating status of
drug information sources, and continuing education by drug information
specialists are challenges for drug information practitioners.
 The National Prescribing Service, which is an independent, government-
funded organization in Australia, provides toll-free telephone service for
primary care practitioners and consumers to promote the quality of
medicines for patient care and consumer education. A psychotropic drug
advisory service is also available. It was then, the DICs broadened their
scope with more sophisticated activities in other countries which
contributes to one of the major challenges in India .

47. Challenges conti…
 By the end of 1973, the first formal survey identified 54 DICs in
the USA. According to a report published in 1995, there are about
120 full-fledged pharmacists operated DICs, where the scope of
DIC services is expanding, which serves as one of the main
challenges to India.
 Maintaining ethical issues is one of the major challenges in
running DIC. While responding to a query, the drug information
practitioner should take several ethical issues into consideration.
Some of the ethical issues need to be taken into account are while
answering queries: Professional ethics must be maintained,
patient privacy must be protected, the relationship between
patient and physician should not be breached .

48. Challenges conti…
 To assess the functioning of DIC, it is essential to perform the quality assurance
program periodically. Quality assurance in DIC decides what services are to be
provided, measuring how well the services were provided, and if the services
were not found to be optimal or acceptable, undertaking some correctional
activities to ensure future services to acceptable. In developing countries like
India, there are only a few DICs and are limited by a lack of trained staff, funds,
and tied access to current literature. This signifies that there is a need for
periodic evaluation on the mode of functioning and quality of services that are
being provided by DIC.
 To optimize the drug therapy outcomes and to get zero-defect in medication
error, drug information centre acts as a fine-tuning channel. Therefore,
cooperation and competence among all the pharmacists and health-care
professionals are essential for running a successful DIC. Pharmacists undergoing
drug information services should possess a strong commitment and dedication to
the service offered by leadership.

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