1. Drug Information Resources Review
Jennifer L. Rodis, PharmD, BCPS
The Ohio State University College of Pharmacy
October 25, 2011

2. Objectives
Review the differences between primary, secondary, and tertiary resources
Discuss the value of each resources type
Provide a refresher on searching Pubmed

3. Types of Literature

4. Types of literature 3 main types of drug information literature
Tertiary
Interpretation of primary data
Secondary
No interpretation, just helps you find sources
Primary
Original research & analysis

5. Real-life Research

6. Tertiary Literature Summarizes and interprets the primary literature
Information generally well accepted
Place to start for basic information and guidance
Can inform your subsequent research

7. Tertiary Literature Advantages Disadvantages Convenient, accessible
Often available online
Review process of information is already done
Disadvantages
Lag time
Not as complete
Author’s interpretation

8. Tertiary Literature Textbooks Compendia
Electronic also
Compendia
Full-text computer databases (Internet)
Review articles

9. Tertiary Resources – Drug Databases
Online
Lexi Comp CRL
MICROMEDEX
Drug Facts and Comparisons
MD Consult
AHFS Drug Information
Epocrates
Print
PDR (Physician’s Desk Reference)

10. Tertiary Resources - Books
Print Books
Remington’s
Trissel’s (2 titles)
Handbook of Nonprescription Drugs
Redbook
Drugs in Pregnancy & Lactation (aka: Brigg’s)
Martindale: The Complete Drug Reference

11. Tertiary Resources - Other
UpToDate
Pharmacist’s Letter
Natural Medicines Comprehensive Database
Ohio Administrative Code (pharmacy.ohio.gov)
FDA.gov (Orange Book,
CDC.gov
Professional Organizations
APhA’s MTM Central
Package Insert
Manufacturer web sites
Orange book: approved drugs, patent expiration, and therapeutic equivalents / package inserts, Dear Doctor letters, review info, therapeutic equvalents
CDC.gov: vaccines, international travel prophylaxis, infections/bioterrorism

12. Using Tertiary Literature
Does author have expertise?
Is the information current?
Is the information supported with citations?
Does the resource contain relevant information?
Is the resource free of bias or errors?
Is it clear/concise/easy-to-use?

13. Secondary Literature Guides you to the primary and tertiary literature
Indexing
Bibliographic info only
Abstracting
Bibliographic citation plus brief summary of article or resource
Almost all are electronic format

14. Secondary Literature Advantages Disadvantages Simple search strategies
Very current citation information
Access point for tremendous amount of primary sources
Disadvantages
Understanding coverage of the database
Tweaking search strategies unique to each database

15. Secondary Resources ClinAlert EMBASE (Elsevier)
International Pharmaceutical Abstracts (IPA)
Iowa Drug Information System (IDIS)
Journal Watch
Lexis-Nexis
MEDLINE / PubMed
Shouldn’t cite a secondary resource

16. Primary Literature Primary research Journal articles that are:
Case reports
Drug studies
Original reports of data
Meta-analysis?
Unpublished studies

17. Primary Literature Considerations
Evaluating the basics
Peer-reviewed
Journal reputation
Source of funding
Digging deeper
Study methodology
Clinical relevance
Patient populations

18. Primary Literature Advantages Disadvantages
Most current published source
Tremendous range of information
Personally assess utility/validity
Disadvantages
Overwhelming volume
Interpretation of results
Not yet vetted by experts

19. Primary Literature Peer-reviewed journals Non-peer reviewed journals
JAMA
New England Journal of Medicine
American Journal of Health-system Pharmacy
Annals of Internal Medicine
Non-peer reviewed journals
Supplements
Pharmacy Today

20. What’s the difference?
Ease of Use
Tertiary
Secondary
Primary

21. What’s the difference?
Most Current
Primary
Secondary
Tertiary

22. Alternate Sources of DI
Internet, Listservs, and medical news briefs
Local and national professional organizations and meetings
Pharmaceutical manufacturers
Drug information and poison control centers

23. Searching Strategies Begin broad, then narrow your search
Start with tertiary sources
Use “related articles”
Bibliographies
Secondary resource guides
Always be sure to assess most up to date information available
Primary sources

24. Searching Pubmed

25. Searching Strategies Develop focused question and break into parts
What is the question asking?
“Is peptic ulcer prevention with proton pump inhibitors and NSAIDs dose-related?”
proton pump inhibitors, dose, non-steroidal anti-inflammatory agents, prevention of peptic ulcer disease
Other forms of the above words and phrases

26. Searching Strategies
Putting together an answerable question is key to successful evidence-based medicine practice
Use PICO method
Patient or problem
Intervention
Comparative intervention
Outcome
Be Specific!

27. Example: PICO What is the minimum or maximum dose of NSAIDs at which
proton-pump inhibitors are
effective for peptic ulcer disease prophylaxis?
Patient or problem
Intervention
Comparison
Outcome

28. Searching Strategies Read up on the basics of the question
Start with tertiary resources for foundation
Build on information gathered from texts, review articles, and drug databases with a primary literature search

29. Searching Strategies
Gather as many articles as possible for all of the parts of the search
Use MeSH headings to help narrow or broaden your search
MeSH = Medical Subject Headings
Official indexing terms for MEDLINE

30. Searching Databases: Basic Boolean
“AND”
Combines 2 terms (shrinks search)
“OR”
Gives database more choices (broadens search)
“NOT”
Limits search (removes undesired terms)

31. Basic Boolean Both words must be present in results
paroxetine AND suicide

32. Basic Boolean Either word can be present in results
paroxetine OR suicide

33. Basic Boolean
The first but not the second term will be present in the results
paroxetine NOT suicide

34. effective for peptic ulcer disease prophylaxis?
Pubmed Search Example
What is the minimum or maximum dose of NSAIDs at which proton-pump inhibitors are
effective for peptic ulcer disease prophylaxis?

35. Search keywords
Proton pump inhibitors and dose and non-steroidal anti-inflammatory agents
proton pump inhibitors and dose and non-steroidal anti-inflammatory agents and prevention of peptic ulcer disease
MeSH term search: PPIs, NSAIDs, PUD
1=226
2=96
3=45

36. Resources
Adapted from lectures by Bridget Protus, PharmD, CGP, MLS delivered 1/2010.
Thrower MR. Literature retrieval and Finding Resources Electronically. In: Felkey BG, Fox BI, Thrower MR. Health care informatics: a skills-based resource. Washington DC: American Pharmacists Association; p
West, PM. Literature evaluation. In: Pharmacotherapy self-assessment program: science and practice of pharmacotherapy, 5th ed. (PSAP V). Kansas City: American College of Clinical Pharmacy; p
Shields, KM. Drug information resources. In: Malone PM, Kier KL, Stanovich JE. Drug information: a guide for pharmacists, 3rd ed. New York: McGraw Hill; p

37. Resources
Thrower MR. Literature retrieval and Finding Resources Electronically. In: Felkey BG, Fox BI, Thrower MR. Health care informatics: a skills-based resource. Washington DC: American Pharmacists Association; p
West, PM. Literature evaluation. In: Pharmacotherapy self-assessment program: science and practice of pharmacotherapy I, II, III. Kansas City: American College of Clinical Pharmacy; p