Drug information system: Primary, secondary, tertiary

1. Gopal Pokhrel
M.Pharm

2. Drug information system
 Huge number of drugs have been coming in the past years
and a pharmacist have to provide drug related
information to medical, nursing staffs and patients which
leads to the need of drug information centre in the
hospital.
 The centre might contain electronic record system
 It is the process of providing drug related information.

3. Common sources of drug
information
 Medical journal
 Drug bulletins
 Drug information sheet

4. Who is responsible?
 The hospital pharmacist is responsible to provide
relevant information about drugs.
 He/she does it through drug information centre.
 The drug information centre publishes a drug
information bulletin for transmission of information
to members of the health care team.

5. Sources of drug information
 Primary sources
 Secondary sources
 Tertiary source

6. Primary sources
 It is the source that includes information by the
author(s) without any evaluation.
 These are the original pieces of information which
have not been interpreted, condensed or commented
upon by any other person.
 E.g.: thesis

7. It consists of:
 Patents that contain original information regarding
the discovery of a drug
 Scientific journals e.g. British medical journal
 Conference
 Thesis/research paper

8. Advantages of primary sources
 Information from primary literature is current and
original.
 Many articles undergo review by the various persons
before an article is accepted to publish, thereby
incorporating unbiased views and suggestions to
improve the quality of the report.

9. Disadvantages of primary sources
 With any research report, flaws in study methodology
may lead to inaccurate conclusions.
 Since the information presented in primary literature
is so new, it may take time before wide acceptance.

10. Secondary sources
 It is the one where the original source of information
has been selected, modified, rearranged, interpreted
or condensed.
 They are usually abstracts that summarize the
information of primary sources.
 It consists of
Formularies
Pharmacopeia
Abstract

11. Advantages of secondary literature
 Provides quick access to the primary literature.
 Provides a broad scope on specific topic.
 The journal sources are reviewed and of a high
standard.

12. Disadvantages
 The time period between publication and conversion
into secondary sources can vary depending upon
database.
 The number of journals encompassed depend on the
scope and relevancy of the database.

13. Tertiary source
 Tertiary sources consist of primary and secondary
source information which has been collected and
distilled.
 It does not answer the problems concerned but act as a
pointer or guide to where it may be found.
 It includes:
Dictionaries
Encyclopaedia

14. Advantages of tertiary sources
 Tertiary references are convenient to use.
 Usually the information contained in tertiary literature
is well accepted in medical sciences.

15. Disadvantages
 Space limitation within a text may prevent extensive
discussion of a drug or topic.
 Insertion of any updates and new information on the
topic is time consuming.

16. How to use literature
 Once pharmacist received the question, he/she has to
follow a series of orderly steps in order to arrive at the
answer.
1. First the background information is obtained: it refers
to whether the information being sought is of a
general nature or it relates to a specific patient.
2. A systematic research of literature is made: The usual
order of search is tertiary, secondary then primary.
3. A response is given.

17. Drug information bulletin
 This bulletin publishes the latest development in
medical sciences, new drugs introduced, new
indications for drugs, adverse drug reactions etc.
 It is the responsibility of the drug information centre,
run by pharmacist, to publish the bulletin.
 A regular publication of the bulletin will update the
knowledge of the drugs on patient care.
 Doctors and pharmacists are the primary audience for
most drug bulletins.
 Some bulletins, however, are read by a broader range
of health professionals, including nurses and
community health workers, and a few reach the
general public.

18. Drug information center (DIC)
 Drug information centers are service providers, which
provide drug information relating to therapies,
pharmacoeconomics, education and research
programs.
 According to WHO, “DIC is an independent center
that is accessible to any health professional regarding
all queries about drug.”
 It is usually a unit located within the hospital which
may include a pharmaceutical library.

19. Resources and facilities of DIC
 Staffing: people trained in library science and
pharmacy, medicine or pharmacology is needed.
Additional training in drug information and computer
based information system is desirable.
 Reference materials: DIC should have the latest
publications and ideally publish a newsletter or other
bulletins. It must contain books, journals,
manufacturer’s literature and other drug information
sources.
 Technological facilities such as computers with
internet, phones, faxes etc. are required.

20. Drug information centers in
Nepal
 Some of the representative examples in Kathmandu that
are initially identified as potential sites for drug
information centers are:
 1. Department of Drug Administration (DDA), ministry
of health
 2. Drug Information Unit (DIU), Tribhuwan University
Teaching Hospital (TUTH).
 3. Resource Centre for Primary Health Care (RECPHEC),
a local non-governmental organization
 4. Nepal Chemists and Druggists Association (NCDA), a
professional association for retailers and wholesalers.

21. Drug information network of Nepal
(DINoN)
 DINoN is an initiative to develop and disseminate
information about the proper use of drugs, possible adverse
reactions, contraindications, toxicity, drug standards and
efficacy, precautions and proper storage and handlings of
drugs to health care professionals and patients.
 DINoN was established on 23rd September 1996 with
multisector participation including government, academic
and non-government institutions to provide unbiased
information on drugs.

22. Founder members of DINoN
 DDA, Ministry of Health and Population
 TUTH, DIC
 Nepal Chemists and Druggist Association (NCDA)
 Resource Center for Primary health care (RECPHEC)
 Nepal Health Research Council (NHRC).

23. Drug information approaches
 For the proper functioning of DICs, while giving
information to the inquirer, the drug informer should
understand the intention of inquirer, his/her
background, nature of the question and should ask all
the needed questions to get the ultimate question.

24. Step by step description of Drug
information approach:
 Step 1: ask demographics of the requestors:
It is important to know whether the inquirer is medical
or non-medical personnel/ educated or non-educated
personnel. So you should ask name, location, phone,
email, etc.
 Step 2: obtain background information:
The following questions can be asked to determine what
additional information should be provided.
 Is he/she taking medicines? For what purpose?
 Where does he/she heard about the drug?

25.  Step 3: determine the ultimate question:
All the information should be put together to form the
ultimate question/s.
 Step 4: develop strategy and conduct research:
It should be done this way: tertiary to secondary to
primary literature.
 Step 5: evaluate, analyze and synthesize a good reply.

26.  Step 6: formulate and give a response:
The response can be formulated in a logical way that may
include introduction, body and conclusion parts.
 Step 7: follow-up and documentation:
It is always a nice step to check whether the inquirer get
the required reply or not. Documenting all the steps is
another important task of the process.