In new era, pharmacists become more than just dispensers of drugs

The fundamentals are still the bottom line

In keeping with the Information Age, pharmacists have become dispensers of information in addition to — and, in some cases, in lieu of — dispensers of medication. Pharmacists are often key sources of drug information in their various health care environments, including those who make rounds with medical teams and provide input for drug therapy decisions, pharmacists in central and satellite pharmacies who prevent drug-drug and drug-disease interactions, and pharmacists who staff poison control centers and drug information [DI] centers. Wherever pharmacists are, though, they must possess drug information skills.

"Drug information skills are the most fundamental of all skill sets taught in pharmacy because they ensure that students and residents will leave with the skills necessary to allow lifelong learning," says Nannette Turcasso, PharmD, BCPS, an assistant professor in the department of pharmacy practice at the Medical University of South Carolina (MUSC) College of Pharmacy and coordinator of the MUSC Drug Information Center, both in Charleson.

"Drug information is constantly evolving. DI centers that are affiliated with colleges of pharmacy support an educational mission in terms of teaching the next generation of pharmacists to not only access drug information efficiently but, more importantly, to interpret, assimilate, and apply the information to specific patients in order to improve patient outcomes," Turcasso says. "The purpose of a drug information center is to provide timely, unbiased patient-specific responses to pharmacotherapy questions. Questions commonly focus on issues of dosing administration, management of drug-drug interactions, therapeutic use, pharmacokinetics, nutrition consults, requests for herbal information, and drugs used during pregnancy and lactation.

"The majority of drug information centers are staffed by pharmacists with advanced training in drug information practice, who have expertise in literature retrieval, interpretation, and application to specific patients to improve patient care. These pharmacists also have very good clinical skills."

It is the marriage of literature evaluation and clinical skills that makes those who staff DI centers so valuable to the medical community around them.

"Drug information centers that are primarily hospital-based support P&T committees in formulary decisions," she says. Those centers write drug monographs and class reviews that help P&T committees make decisions regarding the best agents for formulary inclusion.

"They also write newsletters to help keep the hospital professional staff informed of all important changes regarding medication usage, such as drug recalls and withdrawals," she adds.

Where to go for information

Part of drug information training for pharmacists is knowing where to turn when they don’t know the answer to a question. Many health professionals aren’t aware that their local DI center can help. For questions regarding overdoses and poisonings, a poison control center can provide information to help save a life. Medical information departments of pharmaceutical manufacturers have specialists trained to answer drug-specific questions and typically have more information on their drugs than does anyone else.

There are a growing number of sites on the Web that health care professionals and patients can access, although information gained there should be verified by other sources as well. Everyone now has access to Medline via "Internet Grateful Med," an on-line service run by the National Library of Medicine in Bethesda, MD.

"Each year, students are becoming more computer-literate and Internet ready. But it’s not just a matter of finding information on the Internet. It’s the ability to evaluate that information that’s truly important," says Turcasso. "I can’t imagine practicing drug information in the 21st century without the use of the Internet."

Governmental agencies, such as the Food and Drug Administration and the Centers for Disease Control and Prevention, can be very helpful in seeking answers to questions. "And don’t forget your medical library," she adds. "Both the references there and the librarians possess a wealth of information. No matter what the practice setting, pharmacists teach on a daily basis — to physicians, nurses, other pharmacists, and patients.

"Pharmacists could do their colleagues a great service by helping them become [more] familiar and at ease with new information technologies. An inservice to help the professional staff sharpen their searching skills would probably be greatly appreciated. For example, many health professionals aren’t aware of how databases differ and when it would be appropriate to use one database over another," she says.