The document provides information about Drug Information Centres (DIC). It defines a DIC as a service that provides advice and refers queries about drugs to appropriate resources. DICs aim to promote evidence-based practice and improve patient care. They classify DICs as hospital-based, industry-based, or community-based. Clinical pharmacists working in DICs provide written or verbal drug information to healthcare professionals and patients. They respond to queries about various drug attributes like indications, dosages, interactions and side effects. When answering drug information questions, pharmacists gather background details, clarify the question, search multiple sources for relevant data, interpret the findings and formulate an appropriate response to address the query.

1. DRUG INFORMATION CENTRE

2. 1). What is meant by Drug Information Centre?
Ans- ‘The Drug Information Centre (DIC)’ is a service offered through pharmacy department which provides advice and act
as a referral service by directing the best available resource to respond to query or concern’.
First DIC was developed in University of Kentucky in 1962.
In United states 80% of hospital have DIC.
In India first DIC is developed by Kasturba medical college.
The main function of DIC is to provide written or verbal information or advice about any drug or its therapy to healthcare
providers, organizations, committees, patients and to public in response to their request.

3. Objectives-
Promote evidence-based practice.
Meet patient need while providing pharmaceutical care.
Improve the patient adherence/compliance.
To provide an organized database.
To increase community knowledge and awareness about drug and drug usage.
Classification of DIC –
Hospital based DIC.
Industry based DIC.
Community based DIC.

4. Staff-
PHARMACY TEAM-
Pharmacist.
Pharmacy technicians and students.
MEDICAL TEAM-
Toxicologists.
Clinical pharmacologist.
SUPPORTING TEAM-
People trained in library science with computer knowledge.
Sources of Information-
 Primary source- original information, thesis, scientific
journals, abstract, patents, case reports, articles,
correspondence.
 Secondary source- bibliographies, reviews, indexing
services.
 Tertiary source- textbook, pharmacopeia, encyclopaedia,
AHFS Drug Information, clinical pharmacology online,
drug facts and comparisons, DI handbook, Martindale’s the
complete drug reference, Micromedex health care series,
Mosby drug consult, red book.
 Other source- local drug list, national formularies, phone
call to mfg., hospital formularies, Internet- PubMed,
practo, 1MG.

5. Functions-
 Generic and brands.
 Availability of medications.
 Indication of medication.
 Dosage and adjustments.
 Disease information.
 Side effects.
 Contraindications.
 Drug interactions.
 IV incompatibility.
 Pregnancy/ lactation.
 Therapeutic choices.
 Toxicology.
 New medications.
 Off label medication uses.
 Laboratory value interpretation.

6. 2. What is responsibility of Clinical Pharmacist working in DIC?
ANS-
 The main function of Clinical Pharmacist working in DIC is to provide written or verbal information or advice about any drug or its
therapy to healthcare providers, organizations, committees, patients and to public in response to their request.
 Provide information about- Generic and brands, Availability of medications, Indication of medication, Dosage and adjustments,
Disease information, Side effects, Contraindications, Drug interactions, IV incompatibility, Pregnancy/ lactation, Off label medication
uses, Laboratory value interpretation, etc.
 Provide information in understandable and familiar language because not everyone can understand medical terms.

7. 3). Write short note on answering Drug Information question?
ANS-
Some patients have doubts and some of them they don’t even whether we should learn more about what we are going to follow for our health,
but it’s DIC responsibility to guide everyone about their health to increase their awareness towards health and health care system.
Pharmacist should have healthcare team with them and literature information and when any question is asked then first classify the question,
find it’s background and information related to it, search literature and when you get official data related to it then answer the question.
Not every time patient will have question due to lack of knowledge towards to it but it’s DIC responsibility to provide as much as needed and
possible information about drug and body health.

8. Drug query-
Established to provide unbiased information to healthcare workers and patients. The facilities or personnel are dedicated to and specializing in
providing written or oral information about drugs and pharmacotherapy in response to a request from other health care professionals,
organizations, committees, or patients.
Before answering the drug-related question, the personnel should collect all the data related to the patient to give proper knowledge to the patient
or patient’s family.
Steps involved in answering drug-related questions are:
Requester's details.
Background information
Refine and Categorise the Question
Develop a strategy and conduct a search
Interpret data
Formulate and provide a response
Follow up & document the outcome

9. Requester’s details:
A general question which should be asked to the requester before he formulates their response
Before answering the drug related question, the personnel should collect all the data related to the patient so that he can give proper
knowledge to the patient or patient’s family. A General question which should be asked to the requester before he formulates his/her
response questions which are included are:
Personal details (Name, Age, Contact information etc.)
Background of his family and his history
Drug and disease-related information.
What are the medication and precautions he is taking now?
How does they want the information in which form? (Written, mailed, etc.)
What is he going to do with the information?

10. There are factors which should be considered are:
Patient-related factors:
Demographics (e.g., name, age, height, weight, gender, etc.)
Diagnosis/Problem list
Allergies
Organ function
Chief complaint
History of present illness
Past medical history
Family history
Social history
Review of systems
Medications
Physical findings
Laboratory results

11. Disease Factors to Consider
Epidemiology
Etiology
Pathophysiology
Clinical findings
Diagnosis
Treatment
Prevention and control
Risk factors
Complications
Prognosis
Medication Factors to Consider:
Name of medication
Availability
Physiochemical properties
Pharmacology (pharmacodynamics & Pharmacokinetics)
Pharmacogenetics
Indications (both labelled and off-label)
Uses
Adverse effects
Contraindications
Effects of age, organ system function, disease, pregnancy, etc.
Effect on fertility, pregnancy, lactation
Drug interactions
Available formulations and Administration route

12.  Dosage and schedule
 Monitoring
 Compatibility and stability
Specific factor should be considered for specific type of question
It can be related to ADR (adverse drug reaction), Allergies, Dosing,
Administration of drug (especially infants and children), Drug food or
drug-drug interaction, etc.
2). Background information:
Further details can be sought from the enquirer but this should focus
on the question at hand and not attempt to cover all the clinical
details.
This is a difficult step and clinical pharmacy experience is needed to
maximise the outcome of this initial exchange of information.
It may be necessary to obtain additional information such as age,
other medical conditions, renal and liver function, other relevant
drugs (including traditional medicines), history of allergic reactions
and stage of pregnancy.
3). Refine and categorise the question:
Having accepted the enquiry, it may be necessary to understand some
aspects of the question before seeking an answer.

13. For pharmacists, this applies particularly to medical terminology and aspects of disease and pathology.
This information may help to refine the question and to estimate the time required to achieve an acceptable response.
This is important because all searches must be conducted within the constraints of available resources and the required deadline.
It is rarely possible to create a perfect answer, and beyond a reasonable point, there is a diminishing return in terms of increased quality or
confidence in the response.
For clinical purposes, a concise and rapid response will be preferred to one which is protracted and delayed.
Of course, the reverse is true for research projects.
Almost all drug information requests can be categorised by their nature and this will dictate the most efficient and rewarding strategy. Selecting the
resources most likely to contain the required information can save time and also increase the accuracy of the response. Search patterns can be used
as a guide to the best approach for different types of questions.
This is particularly helpful in training new drug information pharmacists.
Experienced staff are less likely to apply a formal search pattern but will automatically follow an established process for specific types of
questions.

14. 4). Develop a strategy and conduct a search:
Foster a technique and lead a hunt: Consider all the accessible data assets and focus on them dependent on the likelihood of finding the
necessary data.
Much of the time, starting the inquiry with tertiary sources and afterward advancing to optional writing will give a sufficient reply, and
there will be no compelling reason to endeavour a writing search.

16. Notwithstanding electronic and printed assets, it very well might be feasible to look for an assessment from a more experienced partner or
trained professional.
It might likewise be important to apply first standards; for instance, the energy of a medication in renal impedance might not have been
concentrated yet can be anticipated dependent on it science and the idea of the renal substitution treatment.
5). Interpret data:
The information retrieved must be critically evaluated within the context of the enquiry.
It is important to consider consistency of information between various references and whether clinical research is relevant to your population
or a specific patient.
Where possible, the full text of published reports should be consulted as it is often the details, such as how the patients were selected for a
trial, how the drug was given, and limitations of the study (noted in the discussion), which will help with interpretation for specific enquiries.
Absolute answers are rare in drug information, and as a drug information pharmacist you may be the last resort for a person seeking an
answer.

17. Often there is limited data and conflicting research or opinions and this lack of certainty must be summarised and included in a
response. However, clinical decisions still have to be made and you may be required to advise on patient care in an environment with
limited evidence.
6). Formulate and provide a response:
Answers should be derived only after critically analysing the available information obtained from a comprehensive search.
It is also important to provide a formulated response to the enquirer on time.
All responses should be documented with the minimum detail necessary to justify the response.
Even rapid verbal responses with their question should be included in the resources.
The question should be restated to confirm that it has been correctly interpreted.
Clinicians prefer direct and concise replies but this does not mean that all the necessary detail should not be recorded and referenced
within the drug information service.

18. Often, additional (sometimes predictable) questions are raised when providing a response, so extra detail is handy if this occurs.
If a written response is provided, state the answer first and then justify it with the details.
Do not write a paper which arrives at a well-reasoned conclusion at the end.
All written responses should be based on a template which includes the contact details of your service as well as the question (as
you have interpreted it).
If responding by telephone, document the main points you need to state before making the call and for urgent responses, a
detailed record can get completed later but it is easy to be side-tracked during telephone conversations and you must remember
to convey all of your essential points during the discussion.
Restate the question at the beginning of the conversation as this allows the enquirer to focus on the subject and to confirm that
you have correctly interpreted it.

19. 7). Follow-up and document the outcome:
Try to determine the consequences of your advice and any patient outcomes.
This may only be possible in a hospital or clinic but it is critical to developing skills in drug information.
Advice provided should be recorded in at least one mode of documentation (log book, paper worksheet, computer programme).
While drug information pharmacists have access to many skills and information resources, they often lack feedback and the
opportunity to learn from clinical experience.
Practising clinical pharmacists have the advantage that they receive continuous education based on the response of their patients to
interventions.
Drug information services which are located within patient care areas are more likely to receive this important type of feedback
through clients and colleagues.
Feedback can also be sought by email, written requests or by the telephone.
Where possible, include outcomes as a part of the enquiry record.
If enquiry records are indexed, this information can be retrieved to help with future responses.