Quality of Pharmacotherapy Consultations Provided by Drug Information Centers in the United States

Abstract

We evaluated the performance of 116 U.S. drug information centers in responding to specific questions about drugs. The primary measures were correctness of responses and extent of probing for patient data. Questions addressed the effect of ranitidine on blood alcohol concentrations, the potential interaction between didanosine and dapsone, prevention of nonsteroidal antiinflammatory drug (NSAID)-induced peptic ulcers, and use of erythromycin for diabetic gastroparesis. The percentages of centers providing correct overall responses were 70% for the ranitidine question, 90% for the didanosine-dapsone question, 8% for the NSAID question, and 20% for the erythromycin question. For the three patient-specific questions, the percentages of centers eliciting vital patient data were 27% for the didanosine-dapsone question, 86% for the NSAID question, and 5% for the erythromycin question. In providing pharmacotherapy consultations, drug information centers generally failed to obtain pertinent patient data, thereby risking incorrect responses and inappropriate recommendations.

Relationship Between Time Consumption and Quality of Responses to Drug-related Queries: A Study From Seven Drug Information Centers in Scandinavia

“…Compared with previous studies that used fictitious queries to assess the quality of the DIC services, [15][16][17][18][19] the overall quality of the responses in the present study was satisfactory. All centers produced responses to all study queries, and the mean scores were mostly satisfactory to good.…”

“…8,15,16 Yet another way of measuring the quality of responses from DICs has been to pose the same query to several DICs at the same time, comparing the responses given from different services to each other and/or to a "control response" giving the correct answer. [15][16][17][18][19] Previous studies aiming to compare responses from different DICs to identical queries have generally revealed unsatisfactory results. 15,[17][18][19] Halbert et al 19 posed the same telephone query to 90 different US DICs in 1977.…”

“…[15][16][17][18][19] Previous studies aiming to compare responses from different DICs to identical queries have generally revealed unsatisfactory results. 15,[17][18][19] Halbert et al 19 posed the same telephone query to 90 different US DICs in 1977. Ten centers were not able to identify the drug in question, and 22 centers provided information that was judged to be less than adequate.…”

“…Of the 56 centers that were successfully contacted, only 16 identified the drug as didanosine, and 4 recognized the clinical symptoms of pancreatitis and associated it with the use of didanosine. Calis et al 17 evaluated responses from US DICs responding to four drug-related queries. Of the 79 centers that responded to all four queries, none provided a correct overall response to all, 13 had three overall correct responses, 42 had two overall correct responses, 21 had one correct overall response; 3 centers failed to answer any of the queries correctly.…”

ASHP Guidelines on the Pharmacist’s Role in Providing Drug Information

“…1,13 The importance of gathering pertinent patient data and understanding the context of a question prior to answering a DI request is described in the literature. [14][15][16] Of note, a full systematic approach may not be practical for all requests, especially for urgent clinical needs in the direct patient care setting. In addition, consideration should be given to the ethical and legal aspects of responding to DI requests, including patient privacy concerns.…”