Use of References in Responses from Scandinavian Drug Information Centres.

Background: The aim of this study was to compare use of references in responses from Scandinavian drug information centres (DICs). Methods: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The six queries concerned adverse effects, pharmacokinetics, pregnancy, complementary medicine, polypharmacy, and breast feeding. References in the responses were categorised into five types of drug information sources: primary (original studies), secondary (reviews), tertiary (drug monographs, handbooks, etc.), DIC database, or personal communication. Results: Two hundred and forty-four references were used in the 42 responses. The mean number of references varied from 3.0 to 10.6 for the six queries. The largest difference between centres with regard to number of references used (range 1⁻17) was found for the query on complementary medicine. In total, 124 references (50.8%) were tertiary, and only 10 of the 42 responses (23.8%) did not have any tertiary references included. Complementary medicine, breast feeding, and pregnancy were query types associated with relatively frequent use of primary references. Use of DIC database was not uncommon, but personal communications were seldom used. Conclusions: Scandinavian DICs differ substantially in number and type of references to identical drug-related queries. Tertiary sources are mainly preferred irrespective of type of query.

Quality assessment of structure and language elements of written responses given by seven Scandinavian drug information centres.

PURPOSE: The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). METHODS: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts). In addition, linguistic aspects of the responses were evaluated by a plain language expert. RESULTS: The quality of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some experts preferred the use of primary sources to the use of secondary and tertiary sources. Both internal and external experts criticised the use of abbreviations, professional terminology and study findings that was left unexplained. The plain language expert emphasised the importance of defining and explaining pharmacological terms to ensure that enquirers understand the response as intended. In addition, more use of active voice and less compressed text structure would be desirable. CONCLUSIONS: This evaluation of responses to DIC queries may give some indications on how to improve written responses on drug-related queries with respect to language and text structure. Giving specific advice and precise conclusions and avoiding too compressed language and non-standard abbreviations may aid to reach this goal.

Factors associated with time consumption when answering drug-related queries to Scandinavian drug information centres: a multi-centre study.

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.

[Adverse events related to substitution of generic products in Norway 2005]. / Bivirkninger ved generisk bytte i Norge i 2005.

BACKGROUND: The Norwegian Medicines Agency has since 2003 encouraged health professionals to report adverse events (AEs) related to generic substitution through the spontaneous reporting system. Goals of this study were to evaluate the quality of these reported AEs and to assess whether there were signals of altered efficacy or AEs related to substitution of such products. MATERIAL AND METHODS: The World Health Organisation's (WHO) tool for documentation grading was used to evaluate the AE reports. Signals of AEs were identified based on WHO's signal definition. RESULTS: 423 spontaneous reports concerning substitution of generic products were identified; 232 (55 %) of these reached documentation grade 1?-?3 and could be used to detect signals of AEs. The AEs were mostly common symptoms that also appear in the general population not treated with drugs. Only two of the 423 reports were classified as serious AEs. Signals of dizziness and muscle pain were identified after substitution of the original product Norvasc with the generic product Amlodipin Ratiopharm. Amlodipine was the substance associated with most AE reports; i.e. 79 (19 %) reports. INTERPRETATION: About half the spontaneous reports regarding substitution of generic products could be used for signal detection. The substitution of generics does not seem to represent a safety problem.