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Background : Inconsistencies in information on safety of medicine use during pregnancy and lactation can result in sub-optimal treatment for pregnant and lactating women, risks to the fetus or child and unnecessary weaning off breastfeeding. The objective of this study was to analyze information discrepancies regarding medicine use during pregnancy and lactation between on-line sources for patients and health care professionals (HCPs) in four European languages. Research design and methods : The medicines analyzed were ibuprofen, ondansetron, olanzapine, fingolimod, methylphenidate and adalimumab. Recommendations were classified into different data source categories, for patients and for HCPs, and compared between the data source categories for each medicine and language. Results : For patients, 11/24 (46%) and 4/24 (17%) comparisons of the pregnancy and lactation recommendations, respectively, were consistent between all sources. The corresponding figures for HCP-sources were 13/24 (54%) and 5/24 (21%). Regulatory sources had generally more restrictive recommendations. Teratology Information Services (TIS) centers' recommendations for medicine use during pregnancy and lactation were consistent in 25/27 (93%) and 15/22 (68%) of cases respectively. Conclusion : Discrepancies between online information sources regarding medicine use during pregnancy and lactation are common, especially for lactation. TIS centers recommendations were more aligned. Additional work is needed to harmonize information within and between countries to avoid conflicting messages.

Objectives: This study aimed to investigate physicians' and pharmacists' perceptions of the importance of pharmacists' role in healthcare in Egypt, and actual delivery of these roles in practice. Identifying any differences and inconsistencies between these will inform future strategies that maximize pharmacists' professional contribution to hospital practice., Methods: A self-administered questionnaire using a 5-point Likert scale was distributed to a convenience sample of physicians (500) and pharmacists (500) practicing in selected private or public hospitals in Egypt. The main sections of the questionnaire comprised statements that pertained to physicians'/pharmacists' views on the importance of pharmacists' roles and their actual delivery in practice., Key Findings: In this study, physicians showed low scores for both the importance of and the delivery of advanced patient-facing clinical pharmacy roles such as suggesting prescription medications, and designing treatment plans. In comparison, pharmacists were more positive on both of these aspects of their roles. High mean scores were reported by the physicians for pharmacist's traditional roles such as patient counselling, assessing compliance, preventing medication errors and treating minor illnesses. Both physicians and pharmacists reported poor pharmacists practice as drug information resources despite their high perception of the importance of that role., Conclusion: This study suggested that in hospitals in Egypt, there are significant differences between physicians' and pharmacists' perception and practice, and pharmacists' clinical skills are underutilized in health care., (© 2020 Royal Pharmaceutical Society.)

Background: Twenty-six years after the arrival of "killer bees" in Arizona, the entire state with the exception of high elevations in the north is populated with this bee variety and 11 people have died at the scene of massive bee attacks., Methods: Because of the aggressive behavior of these bees we studied bee stings reported to the Arizona Poison and Drug Information Center. The center received 399 calls regarding 312 victims of bee stings from January 2017 to June 2019. Calls originated from private residences and emergency centers., Results: Stings occurred at victims' home residences in 272 (84.7%) of cases and 24 (7.5%) in public areas; 251 people suffered 1 sting; 42 individuals, 2-10 stings, 4 had 11-49 stings, and 13 individuals had >50 stings (so-called massive stinging). Three individuals were admitted to intensive care units (ICU) and one 35-year-old man died of anaphylaxis after 1 sting; moderate clinical effects occurred in 32 individuals including 6 admitted to the hospital but not in the intensive care unit. Anaphylaxis occurred in 30 (9.6%) of individuals, 16 receiving 1 sting. Toxic effects, tachycardia, elevated creatinine, or rhabdomyolysis occurred in 13 (4.2%) individuals., Conclusions: In the past, individuals stung more than 50 times were beekeepers working with European honeybees, whereas, in the current era, single as well as massive stings are the result of feral "killer bees." This change in epidemiology requires a new approach to sting victims: those with massive stinging should be evaluated and observed for anaphylaxis and serial laboratory values obtained for days to detect the toxic effects of envenomation., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: This article describes the evaluation of the experiences and needs of users of the Drug Information Resources (DIR) website. The DIR website attracts traffic and use from around the world, with the highest number of users in Canada and the United States., Methods: An online questionnaire was developed through use of a literature review and Google Analytics data. Face validity testing and test-retest reliability were completed prior to releasing the questionnaire., Results: Although the Google Analytics data showed that the site is used internationally, most respondents were Canadian students. They used the site for academic and clinical purposes and reported it was easy to use, was well organized, and included required resources, and they would recommend it to others., Conclusion: The DIR website was found to be a valuable resource for educational and clinical use. Future studies will aim to obtain input from international users., (Copyright: © 2020, Authors.)

Background and Purpose: Hospital pharmacists routinely receive and answer drug information questions via telephone while performing order verification. This report describes the development, implementation, and evaluation of a mock learning experience for student performance of these tasks in a health-systems pharmacy laboratory course., Educational Activity and Setting: An active learning skills-based exercise involving students receiving and answering a standardized drug information question via telephone during an order verification activity, referred to as a cold-call exercise, was developed and implemented. Data collected included student grades on a baseline assessment, the cold call exercise, order verification exercises, and student perceptions from a voluntary post-exercise survey. Student performance on the cold-call exercise was further evaluated via individual sections of the cold-call rubric. Data were summarized using descriptive statistics. Thematic analysis of student opinion and an estimate of faculty time were also executed., Findings: Student grades on the cold call and order verification exercises were 86.14% and 88.8%, respectively. Students often failed to ask category-specific questions because they did not categorize the ultimate question appropriately. Students found the activity organized and applicable. Time dedicated to creation was extensive, but execution and grading were reasonable., Summary: Students performed well on the drug information exercise as well as the order verification component. Students and faculty enjoyed the experience, and students found the exercise relevant and challenging. This exercise could be implemented into any pharmacy curriculum in order to prepare students using authentic learning experiences., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Purpose: To provide a current directory of drug information centers (DICs) in the United States and present information about their characteristics, activities and services, and networking activities., Methods: In February 2018, an electronic 23-question survey was delivered to 118 contacts on a distribution list compiled from previous directories of DICs, responses to listserv messages, and an Internet search. DICs, defined as formal centers dedicated to providing drug information services, including but not limited to responding to drug information requests, were asked questions about their characteristics, activities and services, drug information requests, and networking activities., Results: The response rate was 79% (93 of 118 DICs). Of the 93 respondents, 82 (88%) met the definition of a DIC and were included in the directory. Of the 82 included DICs, 37 (45%) belonged to a university or college, while 36 (44%) belonged to a medical center or hospital. Seventy percent of the DICs (n = 57) had been in existence for more than 20 years. Of the 81 respondents reporting activities performed at the DICs, precepting pharmacy students (n = 79, 98%) and training pharmacy residents and/or fellows (n = 68, 84%) were most commonly reported. Nearly 90% reported that answering drug information questions was central to the DIC operations. Most DICs (n = 52, 65%) indicated receiving an average of 50 requests or less on a monthly basis. DICs reported a variety of electronic means of communicating with the DIC community, although 16 (21%) of the 77 respondents reported no need to do so., Conclusion: The survey identified 82 DICs that collectively provide a variety of services to their clienteles. The DIC directory published herein should facilitate networking among DICs., (© American Society of Health-System Pharmacists 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Lipid lowering therapy using statins prevents the risk of cardiovascular events. However, since the year 2000, there have been some reports that statins increased the risk of developing diabetes (SIRDD). It is socially demanded that pharmacists must apply pharmacotherapy to patients by utilizing drug information like the above, such as selecting appropriate drugs and providing correct drug information. Accordingly, pharmacists must correct drug information, and they should analyze and evaluate such information. Therefore, we conducted a questionnaire survey for pharmacists in community pharmacies with an aim to verify relevance between methods of obtaining drug information and the utilization of the information of "SIRDD" as a subject. We sent a questionnaire by letter to 1522 pharmacists in Fukushima and Mie prefecture, and received the results of the questionnaire from them using "Google forms" that is software to make web questionnaire and letters. We obtained responses from 356 (23.4%) pharmacists out of 1522. The number of responses from the pharmacists that "know" the information of "SIRDD" was 135 (37.9%). We found that these pharmacists obtained the information by websites of pharmaceutical companies, m3, Inc. (Portal site for medical professionals), and Pharmaceuticals and Medical Devices Agency (PMDA), as the sources of information. Our results suggested that pharmacists responded that they "know" "SIRDD" utilized websites as a quick information tool. The difference in network environments will relate to the difference of providable medical quality. So, it is very important to maintain appropriate network environment in cooperation with medical institutions, professional associations and the government.

Objective: The aim of this study was to examine long-term trends in the receipt of medicines information (MI) among adult medicine users from 1999 to 2014., Design: Repeated cross-sectional postal survey from the years 1999, 2002, 2005 and 2008-2014., Setting: Each study year, a new nationally representative sample of 5000 Finns aged 15-64 years was drawn from the Population Register Centre of Finland., Participants: The range of annual respondents varied from 2545 to 3371 and response rates from 53% to 67%. Of the total responses (n=29 465), 64% were from medicine users (n=18 862, ranging by year from 58% to 68%)., Outcome Measures: Receipt of information on medicines in use within 12 months prior to the survey from a given list of consumer MI sources available in Finland., Results: Physicians, community pharmacists and package leaflets were the most common MI sources throughout the study period. Receipt of MI increased most from the Internet (from 1% in 1999 to 16% in 2014), while decreased most from physicians (62% to 47%) and package leaflets (44% to 34%), and remained stable from community pharmacists (46% to 45%) and nurses (14% to 14%). In 1999, of the medicine users 4% did not report receipt of MI from any of the sources listed in the survey, while this proportion had remarkably increased to 28% in 2014., Conclusions: Healthcare professionals and package leaflets had still a dominating importance in 2014 despite the growing number of MI sources over time, but still a minority of adult medicine users reported receiving MI via the Internet in 2014. Worrying is that the proportion of adult medicine users who did not receive MI from any of the sources became seven fold during the study period., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

What Is Known and Objective: Appraisal of drug information centres (DICs) is mainly by word of mouth communication and surveys of overall user satisfaction. Efforts to study the impact of this type of informatics and decision support systematically are generally lacking within the healthcare system., Comment: Scandinavian DICs question-answering databases are relevant sources for identifying recurring problems in pharmacotherapy, including drug safety questions, and for re-use of previous answers. Recent studies in this setting have shown that high-quality answers demand easily accessible literature sources, skills in literature search and critical assessment of the retrieved documentation. Furthermore, patient-specific advice in clinical cases presented within a requested time frame is appraised by clinicians., What Is New and Conclusions: Effective decision support by Scandinavian DICs depends on skills among staff and technological resources. Our experience could motivate further studies investigating methods and evaluating the impact of DICs in the healthcare system., (© 2019 John Wiley & Sons Ltd.)

Harmful drug-drug interactions (DDI) frequently include psychiatric drugs. Drug interaction database programs are viewed as a primary tool to alert physicians of potential DDI, but may provide different results as there is no standard to define DDI. This study compared the category of potential DDI provided by 6 commercial drug interaction database programs (3 subscription, 3 open access) for 100 drug interaction pairs. The pairs involved 94 different drugs; 67 included a psychiatric and non-psychiatric drug, and 33 included two psychiatric drugs. The category assigned to the potential DDI by the 6 programs was compared using percent agreement and Fleiss' kappa interrater reliability measure. The overall percent agreement for the category of potential DDI for the 100 drug interaction pairs was 66%. The Fleiss kappa overall interrater agreement was fair. The kappa agreement was substantial for interaction pairs with any severe category rating, and fair for interaction pairs with any major category rating. The category of potential DDI for drug interaction pairs including psychiatric drugs often differs among drug interaction database programs. Modern technology allows easy access to several interaction database programs. When assistance from a drug interaction database program is needed, the physician should check more than one program., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: The internet is widely and increasingly used to search for health information. Previous studies have focused mainly on health information on the internet and not specifically on medicines information (MI)., Objectives: The aim of this study was to explore the internet as a source of MI compared to other sources of MI; to identify those who use the internet as a source of MI; and to describe patterns of use of the internet as a source of MI., Methods: A cross-sectional design employed a web-based questionnaire posted by patients' and other organizations as well as pharmacies on their websites during six weeks in the beginning of 2014. Logistic regression analysis was used to assess associations of background variables to the use of different MI sources., Results: The most frequently used MI sources among respondents (n = 2489) were package leaflets (90%), pharmacists (83%), physicians (72%), and the internet (68%). According to a multivariate analysis, internet use for MI was associated with female gender, age <65 years, higher education, daily use of the internet, and continuous use of vitamins or herbals. MI was most commonly searched from a Finnish health portal (56%) and websites of pharmacies (41%). Of the respondents, nearly half (43%) used search engines to find information from the internet. The names of the medicinal product, symptom or disease were the most commonly used search terms., Conclusions: Well-educated, young women tend to search MI on the internet. Health care professionals should discuss reliable MI websites and tools that can help patients evaluate the reliability of information., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Analyzing the disease-related web searches of Internet users provides insight into the interests of the general population as well as the healthcare industry, which can be used to shape health care policies., Methods: We analyzed the searches related to neurological diseases and drugs used in neurology using the most popular search engines in the US, Google and Bing/Yahoo., Results: We found that the most frequently searched diseases were common diseases such as dementia or Attention Deficit/Hyperactivity Disorder (ADHD), as well as medium frequency diseases with high social impact such as Parkinson's disease, MS and ALS. The most frequently searched CNS drugs were generic drugs used for pain, followed by sleep disorders, dementia, ADHD, stroke and Parkinson's disease. Regarding the interests of the healthcare industry, ADHD, Alzheimer's disease, MS, ALS, meningitis, and hypersomnia received the higher advertising bids for neurological diseases, while painkillers and drugs for neuropathic pain, drugs for dementia or insomnia, and triptans had the highest advertising bidding prices., Conclusions: Web searches reflect the interest of people and the healthcare industry, and are based either on the frequency or social impact of the disease.

Background: Community pharmacists are in a key position to provide information on drugs and thus promote the rational use of drugs., Objectives: The present study was designed to determine the needs and resources of drug information in community pharmacies., Methods: A prospective institution based cross-sectional study was carried out and data were collected on 48 community pharmacists in Gondar, Northwest Ethiopia, using interviewer administered structured questionnaire., Results: Almost all pharmacists ( N = 47, 97.9%) often receive drug related queries and these were mainly from consumers ( N = 41, 85.4%). While most questions relate to drug price ( N = 29, 60.4%) and dosage ( N = 21, 43.8%), the information resources mainly referred to were drug package inserts and national standard treatment guidelines. However, limited availability of information resources as well as limited ability to retrieve relevant information influenced the practice of pharmacists. Female pharmacists claimed better use of different information resources than males ( P < 0.05)., Conclusions: Community pharmacists in Gondar, Northwest Ethiopia, are often accessed for drug related information. But there are limitations in using up to date and most reliable resources. Therefore, intervention aimed at improving pharmacists' access to and evaluation of drug information is urgently needed.

Purpose: To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines., Methods: A retrospective review and descriptive analysis of drug information consultations was conducted., Results: A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations., Conclusion: Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions., (© The Author(s) 2015.)

What Is Known and Objective: Questions about psychotropic drugs are frequently submitted to drug information centres (DICs). Twenty years' experience from Norwegian DICs was used to identify particular challenges in responding to those questions., Comment: Questions about psychopharmacological therapy are usually patient-related and are often difficult to answer. Frequent questions about psychotropic drugs come from experienced senior physicians in disciplines like psychiatry, geriatrics, general practice and neurology. The physicians often ask about specific drug use in pregnancy or breastfeeding, drug combinations and interactions, drug switching and formulations, and drug-withdrawal reactions., What Is New and Conclusion: There is a lack of relevant information in drug monographs and guidelines to inform answers to the questions posed for the care of individual patients. There is a clear need for these topics to be highlighted in the pre- and postgraduate teaching of physicians. The issues highlighted are likely to be of international relevance based on our experience of the use of international sources of drug information., (© 2016 John Wiley & Sons Ltd.)

Objective: To determine medical residents' day-to-day use of drug information resources since their choices of these resources, when faced with common questions, are unknown., Methods: An online survey including simulated drug information questions was administered to 146 medical residents in the Department of General Internal Medicine during July 2012. Residents were given a wide range of choices in drug information resources to answer these questions and were instructed to select what they would choose in actual practice. A score was assigned to each resource corresponding to a "best," "intermediate," or "not good" choice., Results: Seventy-three respondents completed the survey and results were analyzed for statistical significance. Fifty-seven percent of respondents reported receiving no formal training regarding drug information. Statistical analyses revealed there were no significant differences in performance based on postgraduate year (P = .43) or extent of prior training (P = .45). Individual question responses revealed a generally infrequent selection of "best" choices. Less than 10% of the respondents chose the "best" answer for drug information questions related to drug interactions, herbal supplements, adverse events, and medication identification., Conclusion: Further training in drug information resource selection is warranted in the medical residency program to increase the frequency of use of higher quality resources., (© The Author(s) 2014.)

Rationale, Aims and Objectives: UK Medicines Information (UKMI) is pharmacist-led service funded by the National Health Service providing evidence-based advice about medicines to health care professionals. Service evaluations have repeatedly shown high user satisfaction but few studies have assessed how this advice influences the care patients receive. Furthermore, no study has assessed how prescribers actually use this information in shaping their decision making. The aim was to explore how UKMI advice influences prescriber decision making and patient care., Methods: Doctors and dentists (referred to as prescribers) working in primary care in England and Wales who received reactive medicines advice from a medicines information centre were contacted by telephone to determine how they used the advice provided. Forty semi-structured interviews were analysed and coded using constant comparative content analysis., Results: Five key themes were identified that affected prescriber decision making, these were: prescriber action, patient outcome, medicines information advice, risk management and time factors. Prescribers acted directly on the advice provided enabling them to provide the right care for their patients. Advice had a positive effect on how they viewed a medication problem and empowered them to make decisions that appeared to confer greater confidence in managing patient problems. A favourable patient outcome was described by over half of the prescribers, for example, the advice enabled them to provide patient reassurance, avoid a potential allergic reaction, stabilize the patient's condition or stop treatment., Conclusions: Medicines information advice empowered prescribers in helping them to make decisions about medicines that shaped patient care., (© 2015 John Wiley & Sons, Ltd.)

Purpose: There is little research-based documentation on the services provided by drug information centres (DICs). The aim of this multi-centre study was to explore for the first time the factors associated with time consumption when answering drug-related queries at eight different but comparable DICs., Methods: During an 8-week period, staff members at eight Scandinavian DICs recorded the number of minutes during which they responded to queries. Mixed model linear regression analyses were used to explore the factors associated with time consumption when answering queries., Results: The mean time consumption per query was 178 min (range 4-2540 min). The mean time consumed per query increased by 28 (95 % confidence interval (CI) 23 to 33, p < 0.001) min higher for queries for which there was a lack of documentation and 139 (95 % CI 74 to 203, p < 0.001) min higher when conflicting information was present in the literature. Staff members with less than 1 year of experience consumed a mean of 91 more minutes (95 % CI 32 to 150, p = 0.003) per query than staff members with more than 2 years of experience., Conclusions: This study demonstrates the large variation in time consumed answering queries posed to Scandinavian DICs. The results highlight the need for highly competent staff members and easy access to drug information sources. Further studies are required to explore the association between time consumption and response quality.

Objectives: To characterize pregnancy and lactation-related medication inquiries to a drug information center to identify classes of medications of most concern to providers. A secondary objective was to identify any trends in provider inquiries over the study period., Design: A retrospective descriptive study of pregnancy and lactation-related inquiries to the University of North Carolina Health Care System Drug Information Center database between January 2001 and December 2010., Setting: University of North Carolina Health Care System Drug Information Center., Intervention: Provider inquiries and responses were extracted and characterized by indication for treatment and reason for inquiry. Comparison of the first and second 5-year periods was performed to delineate trends. Descriptive statistics, Fisher's Exact and χ2 tests were used for analysis., Main Outcome Measures: Inquiry origin, time, and subject., Results: 433 inquiries were retrieved over the study period from physicians (50%), pharmacists (21%), and nurses (18%). Inquiries were most often made during the antepartum period (34%), followed by the postpartum (28%) and preconception (22%) periods. The most frequent indications for inquiry were psychiatry (15%) and infectious diseases (14%), which remained constant throughout the study period. Safety was the most common reason for inquiry (52%). The responses provided to callers were limited due to lack of information availability 37% of the time., Conclusion: Psychiatry and infectious disease-related indications are the most frequent subjects of provider inquiry regarding medication use in pregnancy. Rates of inquiry remained constant throughout the past decade in most therapeutic areas. These findings are consistent with previous observations in other developed countries and suggest high-yield areas for pharmacist education.

Objective: To quantify and characterize the use of the Internet to search for information about medicines., Methods: A random sample of subjects was interviewed in the city of Bordeaux (France) in November 2012 regarding their use of the Internet to find information on medicines., Results: Among 103 interviewed subjects (median age: 38 years; 53.4% of men), 48 (46.6%) reported using the Internet to find information about medicines (58.3% of women). Two-thirds (66.7%) declared visiting consumer forums. However, nearly 60% reported to first consult a health professional. Three subjects had already bought medicines on the web and half (52.0%) of those who never made a purchase on the Internet would not trust the quality of the medicine., Conclusion: Even if purchasing medicines on the web remains rare, this media is frequently used to find information on medicines and most often on websites of questionable quality., (© 2014 Société Française de Pharmacologie et de Thérapeutique.)

Background: Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health., Objectives: The objectives of this study were to (1) identify warnings in the literature about dry mouth associated with the most frequently prescribed pharmaceutical products in Canada; and (2) consider how this information might be obtained by physicians, pharmacists and patients., Methods: Monographs on the 72 most frequently prescribed medications during 2010 were retrieved from the Compendium of Pharmaceuticals and Specialties (CPS, a standard drug information reference for physicians and pharmacists), the National Library of Medicine's 'DailyMed' database, directly from the manufacturers, and from a systematic search of biomedical journals., Results: The CPS provided monographs for 43% of the medications, and requests to manufacturers produced the remaining monographs. Mentions of dry mouth were identified in 61% of the products (43% amongst CPS monographs; an additional 43% amongst manufacturers' monographs; 7% in the DailyMed database and 7% from biomedical journals); five medications had contradictory reports in different monographs., Conclusion: Nearly two-thirds (61%) of the most commonly prescribed medications can cause dry mouth, yet warnings about this adverse effect and its potentially serious consequences are not readily available to physicians, pharmacists, dentists or patients.

Aim: To study effects of pharmaceutical products on the results of clinical and laboratory diagnostics., Materials and Methods: The list of vitally important pharmaceuticals, clinico-pharmacological articles of the National registry of medicinal products, formulary articles from the Federal guidelines on the use of pharmaceutical products. Formulary system, instructions for use of individual pharmaceutical products. Systemic and information-based approaches, logical and comparative analysis were used throughout the study., Results: Results of analysis enabled the authors to draw up separate lists of pharmaceuticals based on their influence on parameters of clinical laboratory diagnostics, such as the list of pharmaceuticals exerting marked effect on diagnostic characteristics (blood properties, primary and coagulative hemostasis, serum enzymes), the list of pharmaceuticals exerting marked effect on systematized laboratory characteristics; the list of pharmaceuticals exerting no effect on clinical and laboratory diagnostics; the list of pharmaceuticals whose effect on diagnostic characteristics awaits clarification., Conclusion: The results of the study can be used for the development of recommendations on pharmaceutical counseling and rational choice of pharmaceutical products being prescribed to concrete patients.

Introduction: This study evaluated whether pharmacogenomic information contained in the Food and Drug Administration (FDA)-approved package inserts of sixty-five drugs was present in five drug information resources., Methods: The study searched for biomarkers from the FDA package inserts in 5 drug information sources: American Hospital Formulary Service Drug Information (AHFS), Facts & Comparisons 4.0 (Facts), ePocrates Online Free (ePocrates Free), Lexicomp Online (Lexicomp), and Micromedex 2.0. Each resource had the opportunity to present biomarker information for 65 drugs, a total of 325 opportunities. A binary system was used to indicate presence or absence of the biomarker information. A sub-analysis was performed on the 13 most frequently prescribed drugs in the United States., Results: Package insert biomarker information was available, on average, for 81.5% of the 65 FDA-listed drugs in 2011. Percent availability for the individual resources was: Lexicomp, 95.3%; Micromedex 2.0, 92.3%; Facts, 76.9%; AHFS, 75.3%; and ePocrates Free, 67.7%. The sub-analysis of the 13 top drugs showed Lexicomp and Micromedex 2.0 had the most mentions, 92.3%; ePocrates Free had the least, 53.8%., Conclusion: The strongest resource for pharmacogenomic information was Lexicomp. The gap between Lexicomp and ePocrates Free is concerning. Clinicians would miss pharmacogenomic information 6.6 times more often in ePocrates Free than in Lexicomp., Implications: Health sciences librarians should be aware of the variation in biomarker availability when recommending drug resources for licensing and use. Librarians can also use this study to encourage publishers to include pharmacogenomics information from the package insert as a minimum standard.

Background: Telephone counselling services are increasingly utilised by consumers to obtain contemporary and confidential information about perinatal drug and toxin exposure. The use of such services in regard to psychotropic agents is unknown., Aim: To determine the frequency and types of calls to a New South Wales (NSW)-based telephone counselling service regarding perinatal psychotropic agent exposure between 2000 and 2011., Methods: Retrospective analyses of MotherSafe call data between two epochs: I (2000-2005, n = 46,277) and II (2006-2011, n = 118,587), total 164,864 calls., Results: 25,698 (15.6%) calls were made about psychotropic agents: 16,218 (9.8%) about antidepressants, 3,145 calls (1.9%) about mood stabilisers/antiepileptic agents, 2,878 (1.7%) about benzodiazepines and 3,457 (2.1%) about antipsychotic drugs. Calls regarding psychotropic agents doubled in epoch II (18,231 vs 7,467, epoch I) but decreased as a proportion of total calls (I: 16.1% vs II: 15.4%, P < 0.001). Selective serotonin inhibitors (SSRIs) were the most common drugs of concern (>44% of total psychotropic calls). The proportion of calls regarding particular agents changed significantly between epochs, for example paroxetine (epoch I: 14.8% vs epoch II: 6.7% of all antidepressant calls, P < 0.001) and quetiapine (epoch 1: 10.6% vs epoch II: 34.7% of all antipsychotic calls (P < 0.001). Calls from rural areas of NSW increased from 22.6 to 24.7% (P < 0.001)., Conclusion: Consumer demand for information about the use of psychotropic agents for women of child-bearing age has increased considerably over the last decade, particularly in rural areas of Australia. This indicates a need to review current existing services, particularly for rural consumers., (© 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

Aims: We sought to obtain insights into the efficacy of two websites, www.QTdrugs.org and www.BrugadaDrugs.org, that have the intention to prevent fatal arrhythmias due to unsafe drug use in Long QT syndrome and Brugada syndrome., Methods and Results: Prospective web-use statistical analysis combined with online surveys were employed. Our main outcome measure was the percentage of Long QT syndrome patients and Brugada syndrome patients reporting refraining or discontinuation of possible unsafe drugs. QTdrugs.org has received >3 100 000 visitors from 180 countries. Most visitors originated from the Americas (87%), as compared with Europe (7%), Asia (3%), Oceania (2%), and Africa (1%). The QTdrugs.org survey yielded 340 respondents: 34% were patients and 50% medical professionals. Of the patients, 79% reported that they refrained from, and 61% reported discontinuing drugs due to the website. The website was very much appreciated by 65% of the respondents and 30% found it rather helpful. The BrugadaDrugs.org received >48 000 visitors from 154 countries. Most visitors originated from Europe (46%) and the Americas (39%), but less from Asia (10%), Oceania (4%), and Africa (<1%). The BrugadaDrugs.org survey yielded 178 respondents: 68% were patients and 21% medical professionals. Of the patients, 72% reported refraining from, and 48% discontinuing drugs due to the website. The website was very much appreciated by 72% of the respondents and 25% found it rather helpful., Conclusion: These websites are extensively used, they promote drug awareness, and they help patients to avoid possible pro-arrhythmic drugs. Visitors find the websites valuable but should note their limitations.

Objective: To characterize the types of drug and dietary supplement inquiries submitted to the National Center for Drug Free Sport through the Resource Exchange Center (REC)., Design: Cross-sectional study., Setting: United States, from July 2009 through June 2010., Participants: Athletes and athletic personnel associated with the National Collegiate Athletic Association (NCAA)., Intervention: Tabulation and classification of drugs and dietary supplement inquiries., Main Outcome Measure: Characteristics and trends of drug and dietary supplement inquiries., Results: Inquiries for prescription medications for albuterol inhalers, methylphenidate, amphetamines, and prednisone were the most common using a drug lookup function. The most common inquiries for over-the-counter medications included pseudoephedrine, loratadine, cetirizine, and caffeine. Among dietary supplements, inquiries for amino acids/metabolites, vitamins and minerals, and herbal products occurred most frequently. One dietary supplement, N.O.-Xplode (Bio-Engineered Supplements and Nutrition, Inc.), accounted for the majority of individual dietary supplement inquiries. Banned substances accounted for 30% of all inquiries submitted to the REC and 18% of medications searched in a drug lookup database., Conclusion: Almost 25,000 inquiries were submitted to the REC. Pharmacists can use this information to advise, counsel, and refer NCAA athletes regarding the use of banned and permitted substances. Education programs regarding stimulants, dietary supplements, and the risk of using substances such as animal byproducts are needed, and pharmacists can participate in these programs.

Background: Poisons information is accessed around the clock in the British Isles from six centres of which two are in Ireland at Dublin and Belfast accompanied by consultant toxicologist advisory service. The numbers of calls in Ireland are down to about 40 per day due to easy access to online data bases. Access to Toxbase, the clinical toxicology database of the National Poisons Information Service is available to National Health Service (NHS) health professionals and to Emergency Departments and Intensive Care units in the Republic of Ireland. There are 59 Toxbase users in the Republic of Ireland and 99 % of activity originates in Emergency Departments. All United States Poison Control Centres primarily use Poisindex which is a commercial database from Thomson Reuters., Results: Information on paracetamol, diazepam, analgesics and psycho-active compounds are the commonest queries. Data from telephone and computer accesses provide an indicator of future trends in both licit and illicit drug poisons which may direct laboratory analytical service developments. Data from National Drug-Related Deaths Index is the most accurate information on toxicological deaths in Ireland. Laboratory toxicology requirements to support emergency departments are listed., Conclusions: Recommendations are made for a web-based open access Toxbase or equivalent; for a co-location of poisons information and laboratory clinical toxicology; for the establishment of a National Clinical Toxicology Institute for Ireland; for a list of accredited medical advisors in clinical toxicology; for multidisciplinary case conferences in complex toxicology cases for coroners; for the establishment of a national clinical toxicology referral out-patients service in Ireland.

Given the growing trend of the Internet as a source of health information, this study evaluated whether direct-to-consumer prescription drug websites for stigmatized illnesses contained stigma-reducing components: onset controllability, offset controllability, and recategorization. The authors examined the contents of the first-level homepages and the second-level pages in 88 stand-alone websites for 15 different stigmatized conditions. Overall, about a third of the websites did not provide a direct link to detailed disease information on the homepage. On the homepages, three stigma-reducing components were rarely offered either through textual or visual cues. On the second level, in terms of textual cues, onset controllability and recategorization were the most prevalent, while offset controllability was relatively less frequent. There were no visual cues on the second level. Results point out the limited and insufficient stigma-reducing components of direct-to-consumer prescription drug websites.

Objective: To analyze results of the Horus Information System, comparing elements of this system with some international experiences., Methods: Horus is a technological innovation introduced in 2009 in the Pharmaceutical management information system of the Sistema Único de Saúde (Brazilian Unified Health System). In 2011, local managers and health professionals of 1,247 municipalities (16 states) that adhered to Horus answered questionnaires on pharmaceutical assistance in primary care and about the Horus system. This is a descriptive and exploratory study, developed with the use of quantitative and qualitative methods of research. Multivariate tools were used for data collection and interpretative support of the statistical inference and thematic analysis., Results: The main changes identified after the implementation of this system were: improvement on technical and scientific quality control of Pharmaceutical Assistance, improvement on the supply of medications and health care; training of human resources and knowledge management; improvement on the relationship health managers/users; development in the administrative management and greater inter-state management; and improvement on the technological infrastructure. In terms of health information systems, these categories are consistent with programs and obstacles observed in international experiences. The biggest gap identified was the fact that Horus was not included in a national policy of health information systems, which is in a process of consolidation in Brazil. The national database of actions and services within the Pharmaceutical Assistance will enable the collection, analysis and dissemination of information regarding integrated pharmaceutical assistance in the Brazilian context., Conclusions: The Horus System is a technological innovation that enables the management of the Pharmaceutical Assistance. The national base will enable the definition and agreement on national indicators of Pharmaceutical Assistance, aiming to produce evidence of better health conditions to the users and produce indications about the situation of the National Policy on Pharmaceutical Assistance and its trends.

Background: At hospitalisation and discharge the risk of errors in medication information transfer is high., Objective: To study the routes by which medication information is transferred during discharge from Deventer Hospital, and to improve medication information transfer., Setting: Eight hospital wards of the Deventer Hospital., Method: From December 6 to 17th 2010, the following data was recorded across eight hospital wards: the identification number of discharged patients, the date of discharge and the route by which medication information was transferred. The possible route categories recorded were the Pharmacy Service Point, the hospital's public pharmacy, and "other" routes (which had to be specified). Validation of the data was performed by cross-checking the information collected by the hospital's Admission Office, the Pharmacy Service Point and the hospital's public pharmacy, in addition to electronic patient files, interviews with ward staff and, where necessary, interviews with the concerned patients. Main outcome measure Route of medication information transfer at discharge in all discharged patients., Results: A total of 629 patients were included in the study. The routes of transfer were: Pharmacy Service Point 281 patients (44 %), the hospital's public pharmacy 54 patients (9 %), and other routes 44 patients (7 %). Other routes were most recorded at the children's ward, the short stay and cardiology ward. In 250 patients (40 %), there was no transfer of information by the Pharmacy Service Point because they were registered as using no medication or as experiencing no medication changes during hospitalisation., Conclusion: Medication information was transferred for 53 % of the discharged patients, which is close to the maximum achievable result. Further improvement of medication transfer in Deventer Hospital can be made by adjusting the current procedure and by educating the ward staff about the importance and the clinical practice of this procedure.

The growing importance of the Internet as an information and purchasing channel is drawing widespread attention from marketing decision makers. Nevertheless, the relevance of the Internet to the so-called self-medication market in Germany has been paid barely enough attention. Our study aims to contribute insights concerning the penetration of the Internet in this market, as well as to give an overview of the critical determinants of Internet use for non-prescription drug information seeking, such as the accessibility of professional information, trust in health professionals' opinion and the ability to search online, as well as the perceived usefulness and credibility of online non-prescription drug information. Furthermore, we demonstrate that the preferred use of the Internet as a non-prescription drug information source positively influences the choice of unconventional purchase channels for non-prescription drugs and negatively affects the use of stationary pharmacies.

Background: Dietary supplements are a product group of foods, which are meant to supplement the general nutrition with micronutrients and other substances. They are widely used in Germany. We evaluated the frequency of their use and of information requirements concerning dietary supplements in patients who contacted the independent drug information service at TU Dresden., Patients and Methods: All inquiries from 2008 to 2010 were evaluated regarding information requirement about dietary supplements, the kind of products used and characteristics of patients using supplements. Sociodemographic characteristics, kind and number of drugs and dietary supplements as well as underlying diseases were recorded from the inquiring patients., Results: 23.3 % of persons looking for advice used dietary supplements. The most frequently used product groups included vitamins and minerals (52.5 %) as well as plant extracts (14.0 %). Information requirements were especially high for plant extracts and for products containing glucosamine/chondroitin and lutein/zeaxanthin. Users of dietary supplements were exposed to a higher number of different products than non-users., Conclusions: Information requirements were primarily detected for products without clearly proven benefits or for supplements which are advertised to relieve certain diseases or symptoms although the product characteristics do not support such utilization. The frequency of use of dietary supplements among patients which already receive multiple medications substantiates the necessity to include dietary supplements in assessments of drug interactions and to scrutinize indications for supplement use., (© Georg Thieme Verlag KG Stuttgart · New York.)

This study aimed to quantify and compare the prevalence of simple prescribing errors made by clinicians in the first 24 hours of a general medical patient's hospital admission. Four public or private acute care hospitals across Australia and New Zealand each audited 200 patients' drug charts. Patient demographics, pharmacist review and pre-defined prescribing errors were recorded. At least one simple error was present on the medication charts of 672/715 patients, with a linear relationship between the number of medications prescribed and the number of errors (r = 0.571, p < 0.001). The four sites differed significantly in the prevalence of different types of simple prescribing errors. Pharmacists were more likely to review patients aged > or = 75 years (39.9% vs 26.0%; p < 0.001) and those with more than 10 drug prescriptions (39.4% vs 25.7%; p < 0.001). Patients reviewed by a pharmacist were less likely to have inadequate documentation of allergies (13.5% vs 29.4%, p < 0.001). Simple prescribing errors are common, although their nature differs from site to site. Clinical pharmacists target patients with the most complex health situations, and their involvement leads to improved documentation.

Spain presents a high level of systemic antibiotic consumption and subsequently shows important rates of bacterial resistance. Diverse parameters explain the uneven distribution of their consumption such as the epidemiology of infectious processes, population-dependent factors, and factors dependent on the prescribing doctor. The aim of this study was to investigate demographic parameters that may affect antibiotic consumption. We carried out a retrospective longitudinal study from 2001 to 2005 on the basis of antibiotic consumption data provided by the information system of the drugstore Concylia. The consumption indicator used is the number of defined daily doses per 1000 inhabitants per day (DID). The area studied was the region of Castile and Leon, with nine provinces and eleven health districts. Global consumption per health district under study was as follows: Avila (22.37 DID), Zamora (21.83 DID), Salamanca (21.0 DID), Soria (20.67 DID), Palencia (18.97 DID), Leon (17.56 DID), Burgos (16.59 DID), Segovia (16.50 DID), East Valladolid (16.36 DID), The Bierzo (16 DID) and the lowest consumer, West Valladolid (13.46 DID). Different patterns of consumption were found in the study period, according to the variability of infectious diseases and demographic factors such as population age and population density. Significant area-dependent global consumption differences were observed in relation to acute respiratory infections and population-dependent factors. The differences were more marked when studying the geographical distribution of the consumption of the principal active ingredients.

In accordance with Article 25-2 of the Pharmacists Act, pharmacists provide patients with information about the initial symptoms of adverse drug reactions for detecting and preventing those reactions. Thus far, however, there have been no reports quantitatively evaluating the usefulness of such information. We present a theory of information evaluation using posterior probability (PP), positive likelihood ratio (LR(+)) and incidence of nonspecific initial symptoms (NIS)-a measure of general symptoms without anything come to mind. First, we calculated using the data from the clinical trials. For liver damage caused by loxoprofen sodium hydrate, the LR(+) was as high as 27.9 in the presence of rash, but the PP was 0.002067, which means there were only 2 liver damage cases among 1000 rash cases. Calculated in the same way for voriconazole, the LR(+) was 5 and the PP was 0.2 (1 liver damage case among 5 rash cases). This suggests that information about rash as an initial symptom of liver damage is useful for patients taking voriconazole. However, the PP was greatly reduced when it was calculated by considering NIS. Since patients cannot distinguish initial symptom of side effect from mere change in body condition, the calculation considering NIS is realistic. Therefore, it is necessary to study in order to raise the value of the information service of the pharmacist. Our study demonstrates how PP and NIS, our new effective measure, allow a quantitative evaluation of the usefulness of information about initial symptoms.

Aim: To examine physicians' use and views of various sources for general drug information and to determine the kind of drug-related questions they receive., Method: An online survey of general practitioners who were Singapore Medical Association members was conducted. The survey consisted of questions about the physicians' demographics, the drug information source they used most often, their opinions on the information from that source, and the types of drug-related questions they received from patients., Results: Among the 236 physicians who responded to the survey, 58.1% used reference texts most frequently; of these respondents, 80.3% used the Monthly Index of Medical Specialties. Only 4.2% most often go to pharmacists for drug information. Of the 75 (31.8%) respondents who chose online sources, about half used Google while the remainder used specific websites. Most respondents rated drug information from reference texts as somewhat comprehensive (71.5%) and usually reliable (81.8%). The choice of drug information sources was associated with physicians' age, place of practice, access to the Internet, and clinical experience (P < 0.05). The types of drug-related questions that physicians most frequently received were with regards to adverse drug reactions (76.3%), drug costs (36.4%), and drug use during pregnancy or lactation (34.3%)., Conclusion: Most physicians in Singapore search for general drug information using reference texts and consider them to be comprehensive and reliable. Questions pertaining to adverse drug reactions were the drug-related questions physicians most frequently receive. It is important for physicians to have appropriate drug information references and learn methods with which to verify the credibility of drug information obtained from the Internet. Pharmacists can also work to improve their role as providers of drug information.

Objective: Parents are exposed to many different information sources about children's medicines, including recommendations from other people, the media, and their own previous experience. The aim of this paper is to explore the influence of different information sources upon their non-prescription medicine purchases for children aged 0-4 years., Setting: The setting was thirty-nine community pharmacies across four Primary Care Trusts in England., Main Outcome Measure: We explored the type and range of information sources used by parents in purchasing non-prescription medicines. Methods A self-completion survey and a subset of semi-structured telephone interviews were undertaken with parents/carers buying oral medicines for children aged 0-4 years., Results: One hundred and thirty-four surveys and thirty-eight interviews were completed: most participants were 25-44 year-old women. Recommendations from other people, both from health professionals and family members, were most often cited as influencing parents' and carers' choice of medicine. Advertising, and well-known brands of children's medicines, were also influential. The Internet and other media were less often cited as sources. Medicines leaflets and packaging were found to be useful: a significant minority admitted difficulty in understanding all the information therein., Conclusion: This study explored the information sources reported at the point of a specific medicine purchase, thus reflecting actual behaviour rather than general perceptions of useful sources. Parents and carers of pre-school children reported a number of professional and lay influences on their medicine purchase choices. Pharmacists and staff should consider these influences when advising children's medicine purchasers. A combination of spoken advice and written reminder information would meet the preferences of most purchasers.

Background: Online pharmacies are companies that sell pharmaceutical preparations, including prescription-only drugs, on the Internet. Very little is known about this phenomenon because many online pharmacies operate from remote countries, where legal bases and business practices are largely inaccessible to international research., Objective: The aim of the study was to perform an up-to-date and comprehensive review of the scientific literature focusing on the broader picture of online pharmacies by scanning several scientific and institutional databases, with no publication time limits., Methods: We searched 4 electronic databases up to January 2011 and the gray literature on the Internet using the Google search engine and its tool Google Scholar. We also investigated the official websites of institutional agencies (World Health Organization, and US and European centers for disease control and drug regulation authorities). We focused specifically on online pharmacies offering prescription-only drugs. We decided to analyze and report only articles with original data, in order to review all the available data regarding online pharmacies and their usage., Results: We selected 193 relevant articles: 76 articles with original data, and 117 articles without original data (editorials, regulation articles, or the like) including 5 reviews. The articles with original data cover samples of online pharmacies in 47 cases, online drug purchases in 13, consumer characteristics in 15, and case reports on adverse effects of online drugs in 12. The studies show that random samples with no specific limits to prescription requirements found that at least some websites sold drugs without a prescription and that an online questionnaire was a frequent tool to replace prescription. Data about geographical characteristics show that this information can be concealed in many websites. The analysis of drug offer showed that online a consumer can get virtually everything. Regarding quality of drugs, researchers very often found inappropriate packaging and labeling, whereas the chemical composition usually was not as expected in a minority of the studies' samples. Regarding consumers, the majority of studies found that not more than 6% of the samples had bought drugs online., Conclusions: Online pharmacies are an important phenomenon that is continuing to spread, despite partial regulation, due to intrinsic difficulties linked to the impalpable and evanescent nature of the Web and its global dimension. To enhance the benefits and minimize the risks of online pharmacies, a 2-level approach could be adopted. The first level should focus on policy, with laws regulating the phenomenon at an international level. The second level needs to focus on the individual. This approach should aim to increase health literacy, required for making appropriate health choices, recognizing risks and making the most of the multitude of opportunities offered by the world of medicine 2.0.

Introduction: Provision of access to drug information by prescribers and other health care professionals is important in pharmacotherapy. At the time of this study there was very scanty literature in this area from Africa., Objective: To assess use of a pilot drug information centre (DIC) which was set up in a department of Pharmacology and Therapeutics in a university teaching hospital in Uganda., Methods: This was a situational analysis with a prospective study design. The pilot DIC was established and its use over an eleven-month period was assessed. The received queries were evaluated for source of the query, reason for the query and type of query., Results: During the 11 months 297 queries were received, 72.3% of which were from public hospitals. Most were from prescribing doctors (54.2%). Majority were on drug-drug interaction (41.2%), followed by therapy (23.2%). Out of 197 specific drug requests, 65.5% were on antiretroviral., Conclusion: We found that healthcare professionals were enthusiastically using the drug information centre. It is, therefore, necessary and feasible to establish a DIC in Uganda that will enable these professionals to readily access drug information.

Dentists prescribe a limited range of medicines but it is important that they consider the effects of all medicines their patients are taking when providing dental care. In the UK, a national medicines information (UKMi) service funded by the National Health Service is available to advise health professionals on prescribing and to support evidence-based practice. This paper presents the results of a survey of 151 dental health professionals who contacted the UKMi service for advice. Enquiries most commonly involved antibiotics (32%), but dental health professionals also asked for advice on legal issues relating to medicines (10%), and on managing patients receiving bisphosphonates (9%), local anaesthetics (6%) and antiplatelet drugs (5%). One hundred and forty-six (97%) enquirers used the advice provided: for managing current patients, planning the care of future patients, for continuing professional development and teaching others. Two thirds of enquirers used the information provided to check if current or proposed management was appropriate, one half to change therapy and over one quarter to identify, manage or avoid adverse effects or drug interactions.

Objective: To investigate the relationship between numeracy and the accuracy of side effect risk estimation following the presentation of information about a medicine via the Cancer Research UK (CR-UK) patient information website., Methods: 591 website users were presented with information in different formats about the risks of side effects from taking tamoxifen. Participants estimated the risk of each side effect, provided other subjective ratings about the information and completed a numeracy task., Results: Regardless of presentation format, numeracy was correlated with the accuracy of three side effect risk estimates. People with cancer and tamoxifen users showed stronger correlations for all side effect estimates. In addition, numeracy was positively related to the perceived influence of the information on the decision to take the medicine and was negatively related to ratings of satisfaction with the information., Conclusion: People with a lower numeracy level make larger errors in interpreting medicines side effect risk information., Practice Implications: Pharmacists, other health professionals and patient information websites should ensure they provide clear explanations of risk, particularly to people with low numeracy, and assess their understanding of those explanations. Future research into risk communication should take account of numeracy level, to investigate the impact of different formats., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background: People with mental disorders often report unmet medicine information needs and may search for information on medicines from sources including the Internet, telephone services, books and other written materials., Objective: This study aimed to identify and describe the sources of medicines information used by people with and without mental disorders., Methods: A cross sectional postal survey was mailed to a nationally representative sample (n = 5,000) of Finns aged 15-64 years in spring 2005. Completed responses were received from 3,287 people (response rate 66%), of whom 2,348 reported using one or more sources of medicines information during the past 12 months. Of those who reported one or more sources of medicines information, 10% (n = 228) reported being diagnosed with or treated for a mental disorder. The main outcome measures were the sources of medicines information used by people who did and did not report being diagnosed with or treated for a mental disorder., Results: Among respondents with and without a mental disorder, physicians (83 vs. 59%), pharmacists (56 vs. 49%) and patient information leaflets (53 vs. 43%) were the most common sources of medicines information. After adjusting for age, gender, level of education, working status and number of chronic diseases, respondents with mental disorders were more likely to use patient information leaflets (OR 1.47, 95% CI 1.06-1.98) and the Internet (OR 1.64, 95% CI 1.02-2.64) as sources of medicines information than respondents without mental disorders., Conclusions: The results indicate that physicians and pharmacists are the most common sources of medicines information among people both with and without mental disorders. However, patient information leaflets and the Internet were more commonly used by people with mental disorders. There may be an opportunity for clinicians to better exploit these sources of medicines information when developing medicines information services for people with mental disorders.

Objective: To find out what questions the public ask of pharmacists on a hospital medicines information helpline, and to assess the potential for improving individuals' management of medicines through telephone helpline support., Methods: We analysed consecutive phone calls made by members of the public over 6 months to a hospital pharmacy medicines information helpline. Calls were coded for type of medicine, reason for phoning and any error revealed in the call. We also looked at which medicines were associated with harm and/or potential for harm had the caller not enquired about appropriate action to take., Key Findings: Five hundred of the 923 consecutive calls to the helpline were from members of the public (including discharged hospital patients). Antimicrobial agents, analgesics and cardiovascular medicines accounted for approximately half of all calls. The reason for phoning was most often to ask about interactions (22%), directions for use (21%) or advice on adverse effects (15%). In a third of calls it is possible an error had occurred (including patient error and directions missing from a dispensed item). Forty-eight per cent of calls were concerned with harm or judged to have potential for harm had professional information not been available. Four of these cases (0.8%), one of which was patient error and three of which were adverse effects reported by the caller, were categorised as Harm Index category F, defined as requiring intervention and referral., Conclusions: Our medicines information helpline appears to be a valuable resource for discharged patients and public and the advice given may be expected to improve safety with medicines and reduce harm. Our results reveal gaps in patient education about their medicines, some of which could be addressed by dispensing staff or the pharmacist at discharge. The data provide a baseline for measuring improvements in medicines management and will be useful in identifying patients who may benefit from follow-up call support from pharmacists., (© 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.)

Background: The Internet has become a popular source of health information. However, there is little information on what drug information and which Web sites are being searched., Objective: To investigate the sources of online information about prescription drugs by assessing the most common Web sites returned in online drug searches and to assess the comparative popularity of Web pages for particular drugs., Methods: This was a cross-sectional study of search results for the most commonly dispensed drugs in the US (n=278 active ingredients) on 4 popular search engines: Bing, Google (both US and Canada), and Yahoo. We determined the number of times a Web site appeared as the first result. A linked retrospective analysis counted Wikipedia page hits for each of these drugs in 2008 and 2009., Results: About three quarters of the first result on Google USA for both brand and generic names linked to the National Library of Medicine. In contrast, Wikipedia was the first result for approximately 80% of generic name searches on the other 3 sites. On these other sites, over two thirds of brand name searches led to industry-sponsored sites. The Wikipedia pages with the highest number of hits were mainly for opiates, benzodiazepines, antibiotics, and antidepressants., Conclusions: Wikipedia and the National Library of Medicine rank highly in online drug searches. Further, our results suggest that patients most often seek information on drugs with the potential for dependence, for stigmatized conditions, that have received media attention, and for episodic treatments. Quality improvement efforts should focus on these drugs.