Access and use of medicines information sources by physicians in public hospitals in Uganda: a cross-sectional survey

Background :Rational and cost-effective prescription of medicines requires up-to-date and readily accessible medicines information. There are several studies on availability and access to medicines information sources, but have been conducted only in high-income countries. Objective:To assess medicines information sources accessed by physicians in public hospitals in Uganda, and physicians' opinion on establishment of a medicines information centre in the country. Methods:A cross-sectional survey including 369 physicians from six district, six regional and two university hospitals. Data was collected using a semi-structured self-administered questionnaire.Results :Response rate was 91%. This included 31, 136 and 168 physicians from the district, regional and university hospitals, respectively. In the district hospitals the source of medicines information reported to be most available was colleagues (100%), while in the regional and university hospitals it was literature from pharmaceutical companies (98%) and hard copy of research publications (99%) respectively. The most frequently used source in the district and regional hospitals was National Standard Treatment Guideline (90% and 73% respectively), and colleagues in university hospitals (89%). Accessibility problems with reported available sources were commonest with research publications in medical journals, both hard copy and through the internet, MIMS, pharmacists and pharmacologists. Need for a medicines information centre was indicated by 80% of the respondents.Conclusion : Majority of the physicians in public hospitals in Uganda have limited access to unbiased drug information. Therefore, there is need to assess the feasibility of establishing a drug information centre, and then assess its use during a trial period

Use of drugs and their effects during pregnancy

"Drugs are chemical compounds that act by interacting with body tissues and alter their activity. The most actively dividing cells are more susceptible. Pregnancy is a condition where cells multiply very rapidly during conception and formation of the fetus. When drugs are given to a pregnant mother; they may interfere with cell division; growth and development. The effect depends on the time of drug exposure. Drugs given in the early pregnancy (first trimester); when fetal parts are being formed; result in severe anatomical defects (teratogenic). After 12 weeks; most body parts are already formed and drugs given during this time would interfere with the normal growth and physiological functions of the fetus. Medicines can still reach the fetus after delivery when nursing mothers take certain drugs. The potential of harming the fetus by prescribing drugs to the mother is considerable; and this was demonstrated by the Thalidomide disaster. The only way to ensure that drugs are safe and efficacious is by a randomized and placebo controlled study. for obvious ethical reasons; there are few studies designed to evaluate the safety and efficacy of drugs in pregnancy. Some studies have; however; been done on the efficacy of aspirin in the prevention of pre-eclampsia and some antihypertensive agents. Information given on many drugs includes non-specific and unhelpful warnings like ""not to be used in pregnancy unless the benefits outweigh the risks"". But we know that the ""risks"" and ""benefits"" have neverand; because of ethical problems; cannot be evaluated in any large clinical trials. Also; the disease being treated may affect or be affected by pregnancy. Despite this fear and uncertainty; we have to prescribe drugs during pregnancy. This review is to summurize some of the important points that should be borne in mind when prescribing drugs for pregnant women."