Users Online: 288 | Home Print this page Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
REVIEW ARTICLE
Year : 2018  |  Volume : 8  |  Issue : 1  |  Page : 1-6

Drug information center in India: Overview, challenges, and future prospects


1 Drug Information Unit, Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India

Date of Web Publication11-Jul-2018

Correspondence Address:
Dr. Amol N Patil
Drug Information Unit, Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jphi.JPHI_103_17

Rights and Permissions
  Abstract 


Medicine is a forever-evolving science and commands continuous research. Pharmacologists and pharmacists contribute various amounts of medicine-related information to physicians, while clinicians face challenges in evidence-based medicine practice due to several reasons such as overloaded number of drug approvals, as well as the enormous quantity of scientific research data in medical journals published every day, making it more complicated for doctors to stay updated with the current advancements. This in addition, results in the call for more sophisticated crisis-targeting skills in order to respond to the more complex clinical difficulties that brazen out practitioners today. The drug information center (DIC) service run by Department of Pharmacology is the bridge between doctors by providing accurate, unbiased, up-to-date drug information for better patient care. Novel initiatives, such as antibiotic stewardship programs, therapeutic drug monitoring, pharmacovigilance, and materiovigilance are being considered by Department of Pharmacology. On a similar note, DIC activities have a huge potential to fit in as an integral part of pharmacology curriculum. Undergraduate, postgraduate, and superspeciality pharmacology curricula are deficient in formal teaching of evidence-based medicine. Western countries have been running variety of courses on drug information like residencies , fellowships for the training of pharmacy, pharmacology postgraduate students for last four decades. This is the need of the hour for a country like India to inculcate such practices for promoting rational use of drugs. This review will highlight how pharmacology and pharmacy curricula can be upgraded so as to contribute for improvement of rational therapeutics in the era where alternative medicines are also considered by patients in disease management.

Keywords: Drug information center, evidence-based medicine, pharmacology


How to cite this article:
Patil AN, Padhy BM, Prasanthi S K, Rohilla R. Drug information center in India: Overview, challenges, and future prospects. Int J Pharma Investig 2018;8:1-6

How to cite this URL:
Patil AN, Padhy BM, Prasanthi S K, Rohilla R. Drug information center in India: Overview, challenges, and future prospects. Int J Pharma Investig [serial online] 2018 [cited 2018 Jul 17];8:1-6. Available from: http://www.jpionline.org/text.asp?2018/8/1/1/236379




  Introduction Top


There is a specter haunting today's world; the specter of overload of information. This has not spared the medical field too, and it is associated with two challenges: first, the increased accessibility of medical information to patients without a quality check [1] and second, the doctors and medical personnel are being bombarded with information in the form of research articles published in journals as well as innumerable websites that pop up every day.[2] Development of science and research led to opening of new avenues and new inventions every day.[3] On an average, more than 7000 research articles are being published in all medical journals per specialty. It means 17 h/day are required for mere reading of these articles. If we assume that a clinician spends 6–8 h/day for patient care, it is humanly impossible to keep up to date with information.[4] Having recognized the problem of accessibility to the apt information that is appropriate for a given clinical situation, the USA has taken the first initiative to establish a drug information center (DIC) at University of Kentucky Medical Centre in 1962, with an objective of providing wide-ranging drug information to the physicians and dentists.[5] Thereafter, the first conference on drug information services was held in 1964.[6] By 1967, developed countries began various drug information courses.[7] In 1985, the WHO held a conference of experts in Nairobi with the theme of “Rational use of drugs.” This strongly emphasized the flow of drug information to physicians and the need of hospital-based DICs.[8] Such services are of utmost importance in providing accurate, current, unbiased information for improvement of rational use of drugs and providing effective safe drug therapy based on evidence-based medicine. India adopted the idea of providing DIC services for medical professionals in Karnataka initially in 1997 by Karnataka State Pharmacy Council. Few other states like as Andhra Pradesh, Maharashtra, Chattisgarh, and Rajasthan also adopted the idea of DIC. Two decades have passed, yet there are only few centers providing DIC services, and the concept of DIC in India is still in its infancy.[9] In this article, we explore the scope of services provided by the DIC and their possible utility and challenges of establishing DIC in academic and nonacademic medical institutions in India.


  What Is a Drug Information Centre? Top


DICs are defined as operational units that provide up-to-date scientific and technical information on medicines in an objective and timely manner. They represent an optimal strategy to address specific needs for information sought by health-care professionals. Ideally, DICs have adequate sources and specifically qualified professionals, who provide independent and appropriate information to the queries.[10] The users can contact the center by telephone, personally, fax, or e-mail and their queries are answered in verbal or structured written format.[11]

DIC services are rendered both in proactive and reactive approaches. The reactive approach [Figure 1] is commonly followed in hospital based DICs which serve health-care providers (doctors) by answering time-critical questions on the safe and effective use of therapeutic and diagnostic pharmaceuticals. The sample case record form [Box-1] for recording the communication is presented here as a supplementary file at the end of the article. Proactively, some DICs also publish and circulate regular updates on various topics such as dosing guidance in organ impairment, interpretation of therapeutic drug monitoring (TDM) levels, possible drug–drug or drug–disease interactions, safety profile including the Food and Drug Administration (FDA) alert, adverse event linked to a drug, efficacy comparison, recent updates in treatment guidelines, new drug approvals and local availability, drug use in any special situation, important study findings in reputed journals, guidance on procuring already approved drug in other countries, and many more types of questions from available literature sources.[8],[9],[12]

Figure 1: Workflow of drug information centre in PGIMER chandigarh

Click here to view


While most DICs cater to the health-care professionals, community-based DIC services provide patient counseling regarding drug use, conduct public awareness lectures, publish articles in newspapers, and answer queries on phone except commenting on prescription. A DIC Established in 2001 in Dresden, Germany, in 2001, that catered exclusively to patients, reportedly received 5587 inquiries between August 2001 and January 2007.[13]


  Organizational Structure, Resources, and Functioning of Drug Information Center Top


The organizational structure of DIC can vary considerably. A survey of DICs of 18 European countries had reported that they are mainly affiliated to hospitals (68%), but rather uncommonly with state departments (15%), other health-care organizations outside the hospital (12%), and faculty of pharmacy (6%).[14] Similar findings were also reported in an American survey carried out on 151 DICs.[15]

Within medical institutions or universities, DICs are usually affiliated with the Department of Pharmacology/Clinical Pharmacology or Clinical Pharmacy. The location of the DIC within the hospital has the advantage of being close to the different specialized departments, patient care areas, the hospital library, and the hospital pharmacy. Such a close proximity to different departments and service areas enable easier contacting.[16] They are usually staffed by clinical pharmacologists and pharmacists who review the queries of the clinicians, search the literature, and provide the information sought, in structured, evidence-based manner.[17] In certain centers, the DIC is manned by faculty members and postgraduate students of pharmacy practice.[18] In some places, DICs also provide poisoning-related information and primarily act as poison information centers.[19] The availability of qualified individuals to run the DIC is of paramount importance as they act as the first interface with the health-care professional. Proper communication skills, literature search and appraisal skills, and knowledge about the efficacy and safety of drugs are very important in order to provide quality services to those who contact the DIC.[20]

The staff of the DIC employs various resources such as the summary of product characteristics of the respective drug and the international drug databases such as DRUGDEX and DRUG-REAX interaction system to search for specific responses to the queries. Other online sources are available such as Facts and Comparisons, Martindale, Lexicomp Online, and FDA information for consumers and books such as Goodman and Gilman's the Pharmacological Basis of Therapeutics and Meyler's Side Effects of Drugs.[21] Various mobile phone-based applications such as the Drug Essentials application, Epocrates application, or Medscape application are also low-cost resources of information. Subscriptions to most of these mobile applications are priced <$10 per month.[22]

The requisitions received by the drug information units are recorded in a standard form (Presented at the end of the article in box-1) that includes information on the details of the inquirer; the questions asked and its urgency; patient details relevant to the question; the time and mode of response; the response provided; the reference materials used for preparing the response; and the signature and name of the staff providing the response.[16]


  Nature of Information Sought from Drug Information Center Top


There are many reports on the quantum and nature of inquiries received by the DIC around the world. A study from a regional DIC in Germany reported that questions concerning therapeutic use (34%), adverse drug reactions (28%), pregnancy/lactation (16%), and pharmacokinetics/dosage (15%) were asked most frequently. The major users of the DIC were internists (19%), general practitioners (19%), pediatricians (18%), and gynecologists (11%).[23] A similar pattern had been observed in a study in Slovak Republic, where questions concerning pregnancy/lactation (25%), adverse drug reactions (16%), basic information regarding drugs (14%), and interactions (13%) were frequently asked.[24] A study in a DIC in South India reported that questions most commonly asked were regarding dosage and administration (27%), adverse reactions (24%), and drug therapy (15%). Queries were also asked on many occasions for other purposes such as availability/cost, drug interactions, pharmacokinetics, pharmacodynamics, pregnancy and lactation, indication, content, contraindication, generics, drug profile, and poisoning.[18]

Similar trends have also been reported in various analyses conducted in Nepal,[16],[24] Iran,[25] Italy,[26] Israel,[27] Mexico,[28] and Finland.[29] The nature of queries to community-based DICs differs slightly from the hospital-based ones. A study in Finland analyzed and described the utilization of a community pharmacy-operated national drug information call center. Data were recorded for 2196 calls, 56% of which were drug related. The majority (83%) of these calls were therapeutic or pharmaceutical inquiries, with 26% concerning costs and reimbursements, 14% interactions, 14% dosages, and 11% related to adverse effects.[30] A recently published study on a Brazilian community-based DIC managed by the Federal Council of Pharmacy reported that mostly information on drug administration, indications, drug interactions, and legislations was sought from the DIC by pharmacists and pharmacy students.[10] The DIC in Dresden, Germany, that caters exclusively for patients has been frequently contacted for information pertaining to adverse drug reactions (22.1%), general information about prescribed drugs (19.9%), information about therapy (12.4%), and drug interactions (10.2%).[13]


  Challenges in Establishing a Drug Information Center in India Top


Although establishment of DICs offers benefits in terms of addressing the awareness gaps of health-care professionals and improved patient care, there are many challenges that have to be encountered while setting up these centers.[31]

Funds and resources

In resource-limited developing countries, the major hurdle in establishing a DIC comes in the form of constraint of funds.[16] Establishing and running DIC services successfully requires a good supply of recurring and non-recurring budgets, as mentioned in [Table 1].
Table 1: Budget for establishing and running drug information center services

Click here to view


Since DICs in hospital settings are affiliated to clinical pharmacology/pharmacy departments, the expenses are usually borne out of the departmental budget. Since departmental budgets in such disciplines are already low in India, the expenses may act as a deterrent to the establishment of a stand-alone DIC.[32]

Therefore, in addition to drug information, the DIC could also provide other value-added services such as poison information, adverse drug reaction monitoring, and training of postgraduate students of concerned and allied disciplines to justify its budgetary requirements. For example, the National Poisons Information Centre at AIIMS, New Delhi, established in 1995 in the Department of Pharmacology under the INTOX project of the International Programme on Chemical Safety/WHO provides round-the-clock information on poisoning, drug reactions, and analytical services on an emergency basis to help in diagnosis and management. It also provides training to residents posted in the center.[19]

Other funding models have also been explored to sustain the functioning of DIC. The DIC at Huddinge University Hospital was created in 1974 with initial support from the Karolinska Institute. However, after 2 years, the financial responsibility for maintaining the service was taken over by the Stockholm County Council.[17] The feasibility of subscription-based DIC services however has not been studied in developing countries.

Human resource

Providing quality drug-related information requires employment of trained and experienced individuals in the DIC. However, there is a dearth of such individuals within academic hospitals. Annually, only 15–16 students get trained in the D.M. Clinical Pharmacology course and approximately 550 students get trained in M.D. Pharmacology. These trainees are absorbed into the pharmaceutical industry, and only a few enter academic institutions.[33] This is compounded by the fact that the same faculty has to teach dental, nursing, and other paramedical courses, leaving little time to serve in the DIC.[34] To counter this lack of human resource, it has been suggested that there could be dual appointments of teachers from clinical specialities, public health departments, or industry in clinical pharmacology in academic institutions and increase in the number of students enrolled per teacher and in the number of departments of clinical pharmacology.[33]

A study from Brazil has suggested that a 5-week DIC training module was an effective tool for teaching evidence-based medicine to pharmacy students. A survey of DICs in the USA reported increased involvement of DICs in the residency program. It was suggested to be the result of the Residency Learning System model established in 1996 by the American Society of Health-System Pharmacists (ASHP), which included drug information and drug policy development as one of the four core areas of competency required by pharmacy practice residents. Similar approach of introducing drug information residency/fellowships for training of postgraduate students can also be followed in India to overcome the deficiency of trained workforce and also provide round-the-clock services in the DICs.[35]


  Evaluation of Performance of Drug Information Center Top


Evaluation of drug information services has been widely performed through the assessment of the processes against predetermined standard criteria, the assessment of user satisfaction, or the evaluation of clinical and economic outcomes.[11] However, the survey of DICs carried out in the USA reported that only half of the DICs surveyed had a formal quality assurance program.[15] The national German drug information service conducted a user's satisfaction study and concluded that there was high satisfaction among users, based on quality, understandability, timeliness, and helpfulness regarding counseling.[36] Response time to queries is a major determinant of user satisfaction.[37]

In Israel, Lustig reported that the mean response time varied according to the type of query; 1 min was the lowest response time for queries regarding the availability of products and 13.5 min was the highest response time for answers to questions on drug indications and interactions. In South India, George and Rao categorized the time needed to reply into three categories: immediately, within 2–4 h, and within a day or 2 days.[28],[11] A modeling study predicted that the most important workload factor predicting the time spent in handling the queries was the type of literature search that had to be performed. The categorization of queries, as judgmental or not, also affected the time spent answering the queries. However, the number of drugs involved did not seem to significantly influence the time spent in answering drug information queries.[37]

Although Chauhan et al. have stated that there are 36 functional drug or poison information centers in India, there is hardly any study evaluating their performance or user satisfaction.[9] At the very least, hosting an annual summary of queries received by the DIC on the institute's website could provide some insight about the working of these centers. In addition, periodic surveys by leading DICs in the country can possibly provide information on staffing, services, and funding pattern of these centers.

Future prospects

Although DICs have existed since the 1960s, their full potential has not been explored, especially in developing countries. Although future growth in the number of centers will be limited, their present activities will become more refined and productive if the above-mentioned challenges are appropriately addressed.

DICs can also provide information about complementary and alternative medicines, which would especially be beneficial in developing countries where a large number of patients consume these medicines.[38] In India, DICs within academic centers can collaborate with the existing in-house department of complementary and alternative medicines (AUYSH) to provide such information.

Novel initiatives such as providing TDM service, adverse drug monitoring and collaboration with forensic scientists for identification of illicit substances, forensic pharmacology, postmortem toxicology, and providing expert testimony have been successfully tried in Denmark and can be replicated in India too.[39] Other activities such as online or offline academic detailing where specially trained pharmacists/pharmacologists with detailed medication knowledge interact with physicians to share the best practices of prescribing have been described as a means of promoting evidence-based medicine practices and rational use of drugs. Such activities may also yield positive results if tried in Indian setting.[40],[41]

A sample case record form for recording the communication:

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW, et al. Patients' use of the internet for medical information. J Gen Intern Med 2002;17:180-5.  Back to cited text no. 1
    
2.
Ioannidis JP. Why most clinical research is not useful. PLoS Med 2016;13:e1002049.  Back to cited text no. 2
    
3.
Nikalje AP. Nanotechnology and its applications in medicine. Med Chem 2015;5:81-9.  Back to cited text no. 3
    
4.
Alper BS, Hand JA, Elliott SG, Kinkade S, Hauan MJ, Onion DK, et al. How much effort is needed to keep up with the literature relevant for primary care? J Med Libr Assoc 2004;92:429-37.  Back to cited text no. 4
    
5.
Pradhan SC. The performance of drug information center at the university of Kansas medical center Kansas city, USA-experiences and evaluation. Indian J Pharmacol 2002;34:123-9.  Back to cited text no. 5
  [Full text]  
6.
Drug Information Association; 2017. Available from: http://www.diaglobal.org/en/about-us. [Last accessed on 2017 Mar 03].  Back to cited text no. 6
    
7.
Walton CA. Education and training of the drug information specialist 1967. Ann Pharmacother 2006;40:311-5.  Back to cited text no. 7
    
8.
The Rational Use of Drugs: Report of the Conference of Experts, Nairobi, 1985. World Health Organisation; 2017. Available from: http://www.apps.who.int/medicinedocs/documents/s17054e/s17054e.pdf. [Last accessed on 2017 Mar 03].  Back to cited text no. 8
    
9.
Chauhan N, Moin S, Pandey A, Mittal A, Bajaj U. Indian aspects of drug information resources and impact of drug information centre on community. J Adv Pharm Technol Res 2013;4:84-93.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Escalante-Saavedra PA, Marques-Batista G, Maniero HK, Bedatt-Silva R, Calvo-Barbado DM. Brazilian drug information centre: Descriptive study on the quality of information 2010-2015. Farm Hosp 2017;41:334-45.  Back to cited text no. 10
    
11.
Fathelrahman AI, Awang R, Bashir AA, Taha IA, Ibrahim HM. User satisfaction with services provided by a drug information center in Sudan. Pharm World Sci 2008;30:759-63.  Back to cited text no. 11
    
12.
Guidance Document on Common Submission Format for Import and Registration of Bulk Drugs and Finished Formulations in India. CDSCO; 2017. Available from: http://www.cdsco.nic.in/writereaddata/Guidance%20documents.pdf. [Last accessed on 2017 Mar 03].  Back to cited text no. 12
    
13.
Huber M, Kullak-Ublick GA, Kirch W. Drug information for patients – An update of long-term results: Type of enquiries and patient characteristics. Pharmacoepidemiol Drug Saf 2009;18:111-9.  Back to cited text no. 13
    
14.
Müllerová H, Vlcek J. European drug information centres – Survey of activities. Pharm World Sci 1998;20:131-5.  Back to cited text no. 14
    
15.
Rosenberg JM, Koumis T, Nathan JP, Cicero LA, McGuire H. Current status of pharmacist-operated drug information centers in the United States. Am J Health Syst Pharm 2004;61:2023-32.  Back to cited text no. 15
    
16.
Joshi MP. University hospital-based drug information service in a developing country. Eur J Clin Pharmacol 1997;53:89-94.  Back to cited text no. 16
    
17.
Alván G, Andersson ML, Asplund AB, Böttiger Y, Elwin CE, Gustafsson LL, et al. The continuing challenge of providing drug information services to diminish the knowledge – Practice gap in medical practice. Eur J Clin Pharmacol 2013;69 Suppl 1:65-72.  Back to cited text no. 17
    
18.
Beena G, Padma GM. Assessment and evaluation of drug information services provided in a South Indian teaching hospital. Ind J Pharmacol 2005;37:315-8.  Back to cited text no. 18
    
19.
Lall SB, Peshin SS. Role and functions of poisons information centre. Indian J Pediatr 1997;64:443-9.  Back to cited text no. 19
    
20.
Hedegaard U, Damkier P. Problem-oriented drug information: Physicians' expectations and impact on clinical practice. Eur J Clin Pharmacol 2009;65:515-22.  Back to cited text no. 20
    
21.
Joy ME, Arana CJ, Gallo GR. Use of information sources at a university hospital drug information service. Am J Hosp Pharm 1986;43:1226-9.  Back to cited text no. 21
    
22.
Drug Interaction Mobile Apps. University of North Carolina; 2017. Available from: http://www.guides.lib.unc.edu/micromedex_alternatives. [Last accessed on 2017 Jun 22].  Back to cited text no. 22
    
23.
Schwarz UI, Stoelben S, Ebert U, Siepmann M, Krappweis J, Kirch W, et al. Regional drug information service. Int J Clin Pharmacol Ther 1999;37:263-8.  Back to cited text no. 23
    
24.
Lassanova M, Rajec J, Lassan S, Tisonova J, Kunzo M, Wawruch M, et al. Perception of drug risk in the database of drug information centre in Bratislava. Bratisl lek listy 2007;108:348-53.  Back to cited text no. 24
    
25.
Palaian S, Mishra P, Shankar PR, Bista D, Purwar B. Contribution of the regional drug information center towards drug safety. JNMA J Nepal Med Assoc 2006;45:216-8.  Back to cited text no. 25
    
26.
Entezari-Maleki T, Taraz M, Javadi MR, Hajimiri MH, Eslami K, Karimzadeh I, et al. Atwo-year utilization of the pharmacist-operated drug information center in Iran. J Res Pharm Pract 2014;3:117-22.  Back to cited text no. 26
  [Full text]  
27.
Kasilo O, Romero M, Bonati M, Tognoni G. Information on drug use in pregnancy from the viewpoint regional drug information centre. Eur J Clin Pharmacol 1988;35:447-53.  Back to cited text no. 27
    
28.
Lustig A. Experience with a recently introduced drug information service in an Israeli hospital pharmacy. Pharm World Sci 1999;21:32-4.  Back to cited text no. 28
    
29.
Escutia Gutiérrez R, Cortéz Álvarez CR, Alvarez Álvarez RM, Flores Hernández JL, Gutiérrez Godínez J, López Y López JG, et al. Pharmaceutical services in a Mexican pain relief and palliative care institute. Pharm Pract (Granada) 2007;5:174-8.  Back to cited text no. 29
    
30.
Pohjanoksa-Mäntylä MK, Antila J, Eerikäinen S, Enäkoski M, Hannuksela O, Pietilä K, et al. Utilization of a community pharmacy-operated national drug information call center in Finland. Res Social Adm Pharm 2008;4:144-52.  Back to cited text no. 30
    
31.
Khaliq A, Sayed SA. Drug and poison information centres: An emergent need for health care professionals in Pakistan. J Pak Med Assoc 2016;66:639-43.  Back to cited text no. 31
    
32.
Gitanjali B. Opportunities and challenges in conducting medical research in India: Food for thought. J Pharmacol Pharmacother 2011;2:71-3.  Back to cited text no. 32
[PUBMED]  [Full text]  
33.
Kshirsagar NA, Bachhav SS, Kulkarni LA, Vijaykumar. Clinical pharmacology training in India: Status and need. Indian J Pharmacol 2013;45:429-33.  Back to cited text no. 33
[PUBMED]  [Full text]  
34.
Ananthakrishnan N, Arora NK, Chandy G, Gitanjali B, Sood R, Supe A, et al. Is there need for a transformational change to overcome the current problems with postgraduate medical education in India? Natl Med J India 2012;25:101-8.  Back to cited text no. 34
    
35.
de Sousa IC, de Lima David JP, Noblat Lde A. A drug information center module to train pharmacy students in evidence-based practice. Am J Pharm Educ 2013;77:80.  Back to cited text no. 35
    
36.
Bertsche T, Hämmerlein A, Schulz M. German national drug information service: User satisfaction and potential positive patient outcomes. Pharm World Sci 2007;29:167-72.  Back to cited text no. 36
    
37.
Reppe LA, Spigset O, Schjøtt J. Which factors predict the time spent answering queries to a drug information centre? Pharm World Sci 2010;32:799-804.  Back to cited text no. 37
    
38.
Gregory PJ, Jalloh MA, Abe AM, Hu J, Hein DJ. Characterization of complementary and alternative medicine-related consultations in an academic drug information service. J Pharm Pract 2016;29:539-42.  Back to cited text no. 38
    
39.
Brøsen K, Andersen SE, Borregaard J, Christensen HR, Christensen PM, Dalhoff KP, et al. Clinical pharmacology in Denmark in 2016 – 40 years with the Danish society of clinical pharmacology and 20 years as a medical speciality. Basic Clin Pharmacol Toxicol 2016;119:523-32.  Back to cited text no. 39
    
40.
Wisniewski CS, Robert S, Ball S. Collaboration between a drug information center and an academic detailing program. Am J Health Syst Pharm 2014;71:128-33.  Back to cited text no. 40
    
41.
Ho K, Nguyen A, Jarvis-Selinger S, Novak Lauscher H, Cressman C, Zibrik L, et al. Technology-enabled academic detailing: Computer-mediated education between pharmacists and physicians for evidence-based prescribing. Int J Med Inform 2013;82:762-71.  Back to cited text no. 41
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Introduction
What Is a Drug I...
Organizational S...
Nature of Inform...
Challenges in Es...
Evaluation of Pe...
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed75    
    Printed0    
    Emailed0    
    PDF Downloaded32    
    Comments [Add]    

Recommend this journal