Health Services Evidence, the Message and the Audiences

Abstract

This extends beyond an individual prescriber and patient. Nurses, pharmacists, doctors and dentists should be adequately informed and have access to a clinical advisory service to ensure that the new medicine is used as safely as possible, and that unexpected problems can be recognised and reported promptly.The introduction of dabigatran into clinical practice also highlights the importance of prospective monitoring of new drugs in defined populations. The need to evaluate oral warfarin replacements in chronic conditions should justify the investment required for prospective monitoring of outcomes. There are important public health and economic issues in the new world of warfarin alternatives and we may not have made the best start. However, pharmacists will continue to have an important role in the pharmacovigilance of these drugs as we explore their benefits and implications for patient safety.