teaser
Simon Wills
PhD MSc MRPharmS
Head of Wessex Drug & Medicines Information Centre Southampton University Hospitals NHS Trust
UK
E:[email protected]
The UK Medicines Information network, formerly called “Drug Information”, is known as UKMi. It consists of about 250 local medicines information centres in hospitals around the country, and another 13 regional centres.
The regional centres have a national coordinating role and represent the interests and activities of their local centres. They work collectively to give UKMi a national identity, produce and implement national strategy, share outputs and avoid duplication of effort, and develop partnerships with other healthcare organisations. UKMi has been successful in developing important collaborations with many groups, including:
- Healthcare librarians (eg, National Electronic Library for Health).
- UK government offices responsible for healthcare (eg, Department of Health).
- Patient information services (eg, NHS Direct).
- Primary care support organisations (eg, National Prescribing Centre).
The UKMi network has a large number of outputs, but there are five key areas, which are
discussed below.
Enquiry answering
The first medicines information (MI) centres were founded in the UK in the 1960s to meet the developing need for clinical advice about drug therapy. This need for information arose and then grew quickly because of the rapidly expanding number of medicines available and because, at around this time, hospital pharmacists in the UK began to adopt a clinical role. Working with clinical pharmacists has created a symbiotic relationship in which two key pharmacy services have benefited by evolving together and supporting each other. Indeed, most MI pharmacists have a recent or current clinical role.
Although based almost exclusively in secondary care, MI centres in the UK answer enquiries from both primary and secondary care. The service was established to answer enquiries from healthcare professionals, although centres will usually answer enquiries from patients or members of the public if contact is made. Most callers require advice to manage the care of an individual patient, and are particularly concerned with issues such as choice of therapy, management of side-effects and dosage in unusual situations.
Some MI centres have developed a specialist interest in certain clinical areas, and they make their expertise available to the rest of UKMi for consultation as required. These specialist topics include the use of medicines in pregnancy, liver disease and breastfeeding.
Traditionally, MI centres have documented all enquiries answered on paper record forms. However, the network is currently developing national software to enable MI centres to log enquiries electronically. This will be a big step towards MI centres becoming paperless, and will allow all MI centres in the UK to share answers to enquiries if they wish, thus minimising duplication of effort. Another important recent development linked to this initiative has been the introduction of a database of “frequently asked questions” (FAQs). This national project provides definitive, evidence-based, written answers to enquiries which are commonly encountered. They are available
electronically and are regularly updated.
Education and training
Educational activities are an important part of the role of UKMi. During their preregistration year, hospital pharmacists receive about four weeks’ training in an MI centre, and during their first two years after qualifying they receive more extensive training. A 250-page national Training Workbook is provided to each pharmacist to ensure they receive a similar standard of training across the UK and to enable them to keep a record of training received from their local MI tutor. There is an interactive CD-ROM training package to accompany the Workbook.
Regional MI centres identify the training needs of local MI pharmacists and organise regular training sessions, and are presently developing an advanced training course for experienced MI pharmacists. These innovations are supported by a well-established national competency framework for MI pharmacists that can be used to identify personal training needs and as a basis for continuing professional development. There are also national training courses for technicians working in MI centres.
UKMi has hosted an annual conference for MI pharmacists for 30 years. This is an invaluable opportunity for MI pharmacists at all levels of experience to learn and share ideas. Details of the 2004 conference can be found on the UKMi website (see Resources).
Finally, MI pharmacists have a key role in educating other healthcare professionals, such as doctors, nurses and allied health professionals. This has proved particularly important, as the number of professionals able to prescribe in the UK has begun to increase.
Quality assurance
The UKMi network has prided itself on the quality of its outputs, and has set national standards for most of them. For example, all local and regional MI centres in the UK are subject to an extensive external audit at least every three years. Within the external audit standards are assessment tools for the quality of enquiry answering, the resources available, education and training activities, and so on.
There are also national standards for other activities, such as the checking of written material, clinical governance activities and computer purchases. MI centres are required to survey a proportion of their enquirers every year to ascertain their satisfaction with the service, and encouraged to subject their enquiry answering work to peer review annually.
Medicines management
At a local level, most MI centres participate in assessing medicines for use within their own healthcare community. MI pharmacists commonly provide evidence-based assessments to support Area Prescribing Committees and similar organisations aimed at improving the quality of prescribing and ensuring cost-effective use of resources.
At a national level, regional MI centres operate a number of schemes that provide UK health services with vital information. For example:
- An index of medicines in clinical development, and detailed evidence-based assessments of medicines before they are marketed in association with the UK National Prescribing Centre.
- Critical evaluation of new medicines after launch.
- An electronic compendium of UK patent expiry dates for medicines.
Active information
MI pharmacists often produce “current awareness” bulletins for their own local healthcare community. These keep clinicians updated about new local and national developments in the field of drug therapy. Nationally, regional MI centres produce a number of bulletins that are available to the whole health service. For example:
- A statistics bulletin aimed mainly at pharmacists who undertake critical evaluation.
- Complementary medicines summaries giving brief overviews of key efficacy and safety data for healthcare workers, mainly in primary care.
- Legal and ethical briefings for healthcare information providers.
All UKMi outputs are available via the UKMi websites (see Resources). There are currently two key websites, but these will shortly be merging. UKMi has its own daily electronic news service, which concentrates on news items related to medicines and pharmacy. This is free to anyone who registers. There is also an internet bibliographic database available by subscription called Pharm-line, which covers pharmacy practice and prescribing issues.
Conclusion
Since its inception, the UKMi network has displayed three key attributes that have enabled it to evolve. First, it has been adaptable: MI pharmacists have consistently identified the changing needs of healthcare professionals and have responded innovatively. This has ensured that users continue to find the service helpful. Secondly, the UKMi network has communicated well, both internally and externally. This has enabled the network to acquire an identity that many other groups of pharmacists lack. Thirdly, it has never compromised on quality. Quality speaks for itself.
Resources
UK Medicine Information
W:www.ukmi.nhs.uk
Drug Info Zone
(register there for news)
W:www.druginfozone.nhs.uk
Pharm-line
W:www.pharm-line.nhs.uk
Events
UKMi Conference
University of Warwick
2–4 Sept 2004
Warwick, UK
W:www.ukmi.nhs.uk/Training/UKMIConf.asp
