Resources UpdateJanuary 2014Christopher Jones

Pharmacist

• Refresher on core resources• how to access • coverage • pros and cons

• How to assess the quality of resources• Useful newsletters and newsfeeds

Aims

• Query answering service within LTHT staffed by pharmacists experienced in searching the literature and turning the information found into practical advice

• Part of a national network of MI centres - UKMI• Available 9-5, Mon-Fri, 9-3 Sat-Sun on 65377 or

medicines.information@leedsth.nhs.uk• Will provide advice on any medicines-related question,

but would expect you to have looked in the core resources first!

Leeds Medicines Information Service

www.bnf.org • Paper copies of BNF published twice a year, only the

September edition is obtained by the NHS• Paper copies of BNFc published once a year• Electronic versions (internet / apps) updated monthly –

electronic is more up to date• App available for free on android and iPhone. Need your

Athens password to download updates• Internet version freely available from NHS computers

Core Resources – BNF / BNFc

Pros• Readily available• Up to date (electronic

versions more so)• Guidance updated in light

of MHRA updates / NICE etc

• Well respected resource

Cons• Little coverage of

unlicensed medicines / indications

• Space requirements mean not comprehensive - not all ADRs / interactions listed, advice on e.g. dose adjustment in renal impairment limited

Core Resources – BNF / BNFc

www.medicines.org.uk• Information provided by the manufacturers of products• Contains SPCs (aimed at HCPs) and PILs (aimed at

patients)• Only holds information from manufacturers who are

members of the ABPI who choose to participate – other manufacturers publish their information elsewhere

Core Resources – EMC

Pros• Gives a lot of

information on the licensed uses of medicines

• Additional information on pharmacology and the evidence supporting its use

Cons• Not all products are

listed• Only gives information

on licensed indications• Can be cautious, so will

tend to say ‘no’ if limited data – e.g. renal impairment / pregnancy

Core Resources - EMC

www.evidence.nhs.uk • Resource provided by NICE• Searches resources from reputable providers only• Need to use filters – searching ‘methotrexate’ returns

>7,000 results. Can filter by information type (guidelines / pathways / trials etc) or provider (NICE / Cochrane / UKMI etc)

Core Resources – NHS Evidence

Pros• ‘NICE approved

Google’• Fairly comprehensive

with a lot of different types of available information

• Useful first step to search the literature

Cons• Can be difficult to find

the things you want (but practice makes it easier)

Core Resources – NHS Evidence

nww.lhp.leedsth.nhs.uk• Local repository for guidelines and pathways• Used by LTHT and all Leeds CCGs• All content approved by relevant groups before

publishing

Core Resources - Leeds Health Pathways

Pros• Reflects local practice,

with guidelines to be followed within LTHT

• Shared resource• Robust review

processes

Cons• Older guidelines may

not reflect current practices – check review dates

Core Resources – Leeds Health Pathways

http://lthweb/sites/medicines-management-and-pharmacy/information-on-medicines/iv-monographs• National collaborative intravenous administration guide,

with local customisation• National monographs written by pharmacists in

participating hospitals, local customisation added by Leeds Medicines Information Service

• Available within LTHT without a password

Core Resources - Medusa IV guide

Pros• Tailored to local

practice• Reasonably

comprehensive

Cons• Some monographs

more up to date than others

• Sometimes too much detail in national monographs

• Paediatric guide in development

• IV guide, not IM or SC• Intermittent access

problems (use back-up site)

Core Resources - Medusa IV guide

www.leedsformulary.nhs.uk• The medicines formulary followed by all NHS

organisations in Leeds• Lists the medicines supported for use within Leeds,

along with links to further information (guidelines, NICE, information updates etc)

• Managed by the Leeds Medicines Information Service at LTHT

Core Resources – Leeds Formulary

Pros• Reflects local practice,

and links to assessed resources (does your filtering for you)

• Hosts a newsfeed for information on medicines

• Acts as a hub for other sources of information – all core resources linked

• Updated continuallyCons

• Work in progress, so some chapters are not yet complete

• Some links will only work within LTHT or the NHS

Core Resources – Leeds Formulary

Why?• If you are working as a specialist within an area, you

may find your practice is not covered by ‘standard’ resources

• The problem used to be finding information. The problem now is finding reliable, useful information

• Any 15 year old can make a professional-looking website

• There is a huge amount of dubious information out there – search ‘George Eby’ (‘special’ zinc cures the common cold) or ‘Miracle Mineral Solution’ (drink bleach to cure AIDS) as extreme examples

Assessing quality of new resources

Has someone else you trust done an assessment already? If not…• Is it an appropriate person/organisation providing the

information? Relevant qualifications / experience etc• Is the information referenced to sensible resources?

Is there a publication date and review date? Is the editorial policy clear?

• Is the information relevant to your patient group? Does the cohort the resource covers match your patient? If a non-UK product, does their practice match ours, and are the products available in the UK?

Assessing quality of new resources

MHRA Drug Safety Update

Important safety alerts on medicines – go to www.mhra.gov.uk and search ‘drug safety update’ to subscribe

NICE Medicines Awareness

Daily or weekly options for digests of new information on medicines – search ‘NICE Medicines Awareness’ to subscribe

NICE ‘Eyes on Evidence’

Monthly update on new NICE products – subscribe from the same page above

Useful newsletters and newsfeeds