UNIT 3 (PART 1)

• Information Search Process (ISP) Model - developed by American Researcher Carol Kuhlthau, offers a valuable framework for understanding how individuals approach information seeking, particularly relevant in pharmacy informatics.
• Carol kuhlthau - an American researcher who developed ISP Model
• Information Search Process (ISP) Model:

  1. initiation
  2. selection
  3. exploration
  4. formulation
  5. collection
  6. presentation
• Initiation:

  • This is the starting point where a person recognizes a gap in their knowledge or a need for information related to medications.
  • Feelings of uncertainty and a desire to understand the situation better are common.
  • For instance, a pharmacist might become aware of a knowledge gap regarding a new drug's interaction with a commonly prescribed medication.
• Selection:

  • The user focuses on defining the information need more clearly.
  • A general topic or area of interest is identified, and initial uncertainty might give way to a sense of optimism about finding the necessary information.
  • In our example, the pharmacist refines their search to focus on potential interactions between the new drug and the established medication.
• Exploration:

  • This stage involves actively searching for information.
  • Users may encounter various sources with inconsistent or conflicting information, leading to increased uncertainty, confusion, and even feelings of being overwhelmed ("in the dip").
  • The pharmacist might consult different databases and drug references, encountering varying details about potential interactions.
• Formulation:

  • As the user gathers and evaluates information, a focused perspective starts to develop.
  • Uncertainty diminishes as a clearer understanding emerges.
  • By critically appraising the research and evidence, the pharmacist starts forming a more precise picture of the potential interaction's nature and severity.
• Collection:

  • Once a focused perspective is formed, the user actively gathers relevant information to support it.
  • Confidence increases as the user feels more engaged and invested in the search process.
  • The pharmacist gathers specific details about the interaction mechanism, potential clinical implications, and available management strategies.
• Presentation:

  • This is the completion stage where the user applies the acquired knowledge.
  • The information search is considered successful, and a new understanding is achieved.
  • The pharmacist might document the interaction details in the patient's profile, prepare a medication information sheet for the patient, or discuss the interaction with a physician to determine the safest course of treatment.
• ISP Model Framework - By understanding these six stages, pharmacy informatics professionals can tailor their information-seeking strategies to optimize efficiency and accuracy when researching drug-related topics.
• Electronic resources:

  1. databases
  2. drug information centers
  3. hospital information systems and electronic medical records (EMRs)
  4. clinical decision support systems (CDSS)
  5. mobile apps
• Databases:

  • MEDLINE/PubMed
  • Other bibliographic databases
• MEDLINE/PubMed - This goldmine offers free access to millions of biomedical journal articles, abstracts, and other resources. It's a cornerstone for in-depth research on specific drugs or therapeutic areas.
• Other bibliographic databases: CINAHL, Embase, and International Pharmaceutical Abstracts - provide access to a broader spectrum of literature, often requiring subscriptions. These can be particularly useful for niche topics or international perspectives.
• Drug Information Centers - online portals or phone hotlines staffed by pharmacists offer targeted information on specific drugs, interactions, or adverse effects.
• Hospital Information Systems and Electronic Medical Records (EMRs) - These systems allow quick access to a patient's medication history, allergies, and potential interactions, informing medication decisions at the point of care.
• Clinical Decision Support Systems (CDSS) - Integrated within EMRs, CDSS can automatically prompt pharmacists with potential drug interactions, dosing errors, or allergies during the prescribing process, enhancing safety.
• Mobile Apps - Reference apps provide on-the-go access to drug compendia, interactions checkers, and medication calculators, aiding decision-making in various settings.
• Non-electronic resources:

  1. textbooks
  2. drug comendia
  3. drug formularies
  4. peer-reviewed journals (print)
• Textbooks - While not the most current source, established pharmacology and therapeutics textbooks offer a strong foundational understanding of drugs and their mechanisms.
• Drug Compendia - Hardcopy versions of authoritative resources like the USP (United States Pharmacopeia) or BNF (British National Formulary) provide a comprehensive overview of drugs, including indications, dosage, and side effects.
• Drug Formularies - These printed lists of approved medications within a specific healthcare system offer guidance on preferred drugs, dosing recommendations, and cost considerations.
• Peer-reviewed Journals (Print) - Though less convenient, some libraries or research institutions may have access to print journals, valuable for in-depth studies or historical context.
• The most effective approach often involves a combination of electronic and non-electronic resources.
• Pharmacy informatics - plays a crucial role in evidence-based medicine (EBM) for both mental health and other illnesses.
• Enhancing EBM in Mental Health:

  • Mental health conditions are complex and require a personalized approach to treatment. Pharmacy informatics can significantly contribute to EBM in mental health by providing pharmacists with:

  1. Up-to-date medication information
  2. Drug interaction screening
  3. Dosage optimization tools
  4. Patient monitoring data
• Up-to-date medication information - Access to comprehensive databases like MEDLINE/PubMed ensures pharmacists stay current on the latest research on psychotropic medications, including their efficacy and potential side effects.
• Drug interaction screening - Pharmacy informatics systems can effectively identify potential interactions between psychotropic medications and other drugs a patient might be taking, reducing the risk of adverse reactions.
• Drug interaction screening - Pharmacy informatics systems can effectively identify potential interactions between psychotropic medications and other drugs a patient might be taking, reducing the risk of adverse reactions.
• Dosage optimization tools - These tools can assist pharmacists in determining the most appropriate medication dosage for individual patients, considering factors like age, weight, and renal function.
• Patient monitoring data - Electronic health records (EHRs) can provide valuable data on a patient's response to medication, allowing pharmacists to identify potential issues and recommend adjustments as needed.
• EBM for Other Illnesses:

  1. Disease management protocols
  2. Medication adherence monitoring
  3. Personalized medicine
• Disease management protocols - Clinical decision support systems (CDSS) can integrate evidence-based treatment guidelines into the workflow, prompting pharmacists to consider the latest recommendations when reviewing prescriptions.
• Medication adherence monitoring - Pharmacy informatics systems can track medication refill patterns and identify patients who may be non-adherent to their medications. Pharmacists can then intervene and provide medication adherence counseling.
• Personalized medicine - By analyzing a patient's genetic makeup and other factors, pharmacy informatics can aid in selecting medications with the highest likelihood of efficacy and minimizing the risk of side effects.
• Overall Advantages:

  Incorporating pharmacy informatics into EBM practices fosters better patient care by:

  • Improved medication safety
  • Enhanced medication efficacy
  • Optimized healthcare costs
• Improved medication safety - Reduced risk of medication errors and adverse drug reactions through robust medication information systems and interaction screening.
• Enhanced medication efficacy - Individualized treatment plans based on the latest research and patient-specific factors can lead to better treatment outcomes.
• Optimized healthcare costs - EBM practices can help reduce unnecessary medication use and potential complications, leading to cost savings for healthcare systems.