Medication Information Services

To develop some perspective for the reader on why the development of drug information centers and specialists was important, consider 4 of the 15 summary points in a congressional review of a survey by the National Library of Medicine on The Nature and Magnitude of Drug Literature published in 1963.

"Drug literature is vast and complex. The very problem of defining what constitutes the literature is difficult."

"Drug literature is growing rapidly in size. It is also increasingly complex, i.e., interdisciplinary and interprofessional in nature. Thus, drug information 'sprawls across' many professional journals of the most varied types."

"Literature on clinical experience with drugs is sizable and is growing. Its effective use by the practitioner offers many difficulties."

"Competent evaluation of masses of drug information is particularly necessary."

Interestingly, these statements still seem applicable even today when given the figures of more than 20,000 biomedical journals and approximately 17,000 new biomedical books published annually are considered. Many journals are now published both in print and on the Internet (i.e., e-journal or electronic journal). Training in computer and information technology was considered one of the five core areas of focus for health professionals' education in an Institute of Medicine (IOM) report published in April 2003. Drug information specialists can provide leadership in this area.

In the 1960s, the availability of new drugs (e.g., neuromuscular blockers and first-generation cephalosporins) was providing challenges for practitioners to keep abreast and make appropriate decisions for their patients. Part of the problem was finding a way to effectively communicate the wealth of information to those needing it. The information environment relied heavily on the print medium for storage, retrieval, and dissemination of information. The Medical Literature Retrieval and Analysis System (MEDLARS) was developed by the National Library of Medicine in the early 1960s. While it provided a computerized form of searching, requests for searches were submitted by mail and results returned by mail. The ability to transmit such information over telephone lines (online technology) was not available until 1971 when MEDLINE® was introduced and was limited to libraries. During this time, the drug information specialist was viewed as a person who could bridge the gap and effectively communicate drug information.

In describing the training required for a drug information specialist, the following areas were identified to either need strengthening or addition to pharmacy school curricula: biochemistry, anatomy, physiology, pathology, and biostatistics and experimental design (with some histology, embryology, and endocrinology incorporated into other courses). Such topics were either not incorporated or emphasized in curricula of the 1960s. In today's pharmacy curricula, most of these topics receive considerable emphasis. Pharmacists today use knowledge and skills to make clinical decisions about medication use in specific patients or a group of patients in conjunction with other health professionals. Pharmacists may be principal investigators or coinvestigators in research involving a variety of therapeutic topics including medication use, optimal dose, drug interactions, or adverse effects of new or existing medications. Likewise, publications in the area of therapeutic guidelines or other drug policy initiatives are frequently authored by a pharmacist, sometimes with support of the pharmacy professional organizations.

The development of drug information centers and drug information specialists was the beginning of the clinical pharmacy concept. It laid the groundwork for pharmacists to demonstrate the ability to assume more responsibility in providing input on patient drug therapy. Pharmacists were provided the opportunity to extend their patient care contribution by taking a more active role in the clinical aspects of the decision-making process as it related to medication therapy. By using their extensive drug knowledge and expanding their background in certain areas, pharmacists could offer their expertise as consultants on medication therapy. The tool the pharmacist would use to function in this capacity was the clinical drug literature. This role of consultant has expanded for all pharmacists and is discussed in more detail later.