Medicines Information
Medicines Information (MI) services in UK Wales aim to provide evidence-based information and advice on the safe and efficient use of medicines. This includes details on the services offered, who utilizes them, common queries received, and where to find reliable information sources like eMC. Explore the essential aspects of MI services for healthcare professionals.
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Presentation Transcript
Medicines Information Useful sources Basic enquiry answering September 2016
Session aims Increase awareness of the Medicines Information (MI) services UK Wales Increase awareness of the questions to ask an enquirer Have practical experience using some resources which will be useful throughout pre-reg year
What is Medicines Information? A service that supports the safe, effective and efficient use of medicines by the provision of evidence-based information and advice on their therapeutic use UKMi Local centres Regional centres Specialist centres Virtual national network
Who uses MI services in Wales? Total enquiries taken in 2014 = 5,593 Enquirer Consultant Senior Hospital Dr (SpR/ST) Junior Hospital Dr GP Hospital Pharmacy staff Community Pharmacy staff Hospital Nurse Member of public Percentage 12 5 5 11 28 6 16 5
What do they ask? Total enquiries taken in 2014 = 5,593 Category Administration / dose Adverse effects Availability / supply Choice of therapy Interactions Pregnancy Breastfeeding Identifications Percentage 29 14 7 27 13 7 3 1
Taking in enquiries A nurse contacts you asking Is cinnarizine alright to take during pregnancy? What else do you need to know?
Another enquiry Patient on the Medical Admissions Unit admitted with GI bleed Consultant suggests may be due to citalopram Junior Dr wants more information on this AE What further information do you need?
eMC Access via www.medicines.org.uk/emc SPCs and PILs Only for products registered with the ABPI (members supply ~90% of UK medicines) Free access no login required Useful links, e.g. X-PIL
BNF / BNFc Access via www.medicinescomplete.com/mc Apps also available to download need NHS Athens password Same content and layout as books Monthly updates
Medicines Complete Access via www.medicinescomplete.com/mc Subscription required AHFS Stockley s Drug Interactions Stockley s Herbal Medicines Interactions Handbook of Drug Administration via enteral feeding tubes Trissel s Handbook on Injectable Drugs Herbal Medicines Dietary Supplements
MicroMedex Access via NHS Wales elibrary http://www.wales.nhs.uk/ehl Basic access with NHS Athens password DrugDex / AltMedex Martindale Drug Interaction Checker Trissel IV compatibility Reprotox / TERIS / Shepard s (MI only access)
SPS website Medicines Use & Safety, Procurement, Quality Assurance, Technical Services & UKMi Access via www.sps.nhs.uk Fridge stability database Drugs in lactation database UKMi Q&As Medicines compliance aid database
NICE Evidence Search https://www.evidence.nhs.uk/ Evidence on treatments, medicines and safety Can search the latest key medicines and prescribing information in one place Enter a term into the search bar Use filters to narrow down search results Register for email updates
Yellow Card Scheme Introduced in 1964 after thalidomide tragedy Spontaneous reports of suspected ADRs Acts as an early warning system to identify ADRs and risk factors Over 31,500 confidential reports received in UK in 2014 MHRA can detect duplicate reports www.yellowcardwales.org
Why report ADRs? Important role in patient safety Allows continual safety monitoring of drugs old and new New drugs lack of experience on ADRs exposure in ~1500 people only for short duration unlikely to detect frequency <1/1500 or long latency lack of experience in special patient groups elderly, children, pregnancy, >1 disease / drug Detect rare adverse effects www.yellowcardwales.org
Completing a Yellow Card Online www.yellowcard.mhra.gov.uk simple and fast drop-down menus can register to save time in the future can be saved part way through App for use via tablets or smartphones Paper available in BNF, MIMs, ABPI available from YCC Wales download from MHRA website www.yellowcardwales.org
What to report? Report: all ADRs for new drugs (marked ) even if mild serious ADRs for established drugs when serious even if well recognised Serious ADRs include: fatal disabling or incapacitating medically significant result in or prolong hospitalisation Vaccines / Unlicensed / Herbal medicines Causality does not need to be established life-threatening congenital abnormalities
Examples of ADRs identified by Yellow Card Scheme Domperidone risk of cardiac SEs use now restricted to N&V indication limited duration Voriconazole liver toxicity Strontium ranelate risk of cardiac SEs C/I in those with cardiac problems use restricted to severe osteoporosis, last resort Risk of switching between branded and generic anti-epileptics www.yellowcardwales.org
Our enquiry Should a yellow card be completed regarding our patient with the GI bleed?
Reflective learning In your own time, consider the following points: 1. What have I learnt today? 2. What do I need clarification on? 3. How am I going to go about clarifying that?
Thank you for listening MI Centre Ysbyty Gwynedd, Bangor Glan Clwyd, Rhyl Wrexham Maelor Withybush, Haverfordwest Powys Local Health Board Morriston, Swansea Princess of Wales, Bridgend Royal Glamorgan, Llantrisant WMIC, Cardiff Royal Gwent, Newport Contact number 01248 384141 01745 534097 01978 726346 01437 773418 01874 712655 01792 703117 01656 752501 01443 443530 029 2074 2251 01633 234233
