Correspondence: Swathi Swaroopa Borra, Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Ooty, Tamil Nadu 643001, India. Email: swathimasthani@hotmail.com
Search for other works by this author on:Journal of Pharmaceutical Health Services Research, Volume 12, Issue 3, September 2021, Pages 452–459, https://doi.org/10.1093/jphsr/rmab029
02 July 2021 30 April 2021 24 May 2021 02 July 2021G K Sadagoban, Aiswarya Baiju, Samantha Sanjeev, M Ayilya, Swathi Swaroopa Borra, A cumulative review on the utilisation of drug information services provided in India, Journal of Pharmaceutical Health Services Research, Volume 12, Issue 3, September 2021, Pages 452–459, https://doi.org/10.1093/jphsr/rmab029
Navbar Search Filter Mobile Enter search term Search Navbar Search Filter Enter search term SearchTo understand the utilisation of drug information services provided in India.
Key findingsThe quantitative aspects of drug information queries were assessed. Majority of the queries were raised from the General Medicine Department (43.64%) and by clinicians (41.77%), most of them were regarding adverse drug reactions (18.17%) and the prime purpose of the enquirer was to update knowledge (46.73%). The three steps for qualitative assessment and evaluation of drug information services were assessed and the overall response from the receiver’s perspective was found to be very good/satisfactory and the provider’s perspective was rendered excellent.
There is an increased need to expand the scope of drug information services and promote awareness regarding the services and it is recommended that every hospital have a Drug Information Centre.
The Pan American Health Organisation (PAHO) defines Drug Information Centres (DICs) as operational units that provide technical and scientific information about drugs in an objective and timely manner. [ 1] The aim of the drug information service (DIS) is to provide accurate, unbiased information primarily in response to patient-oriented drug and poison related queries received from various members of the healthcare team. [ 2] Providing drug information to patients and other healthcare professionals to ensure the safe and effective use of medications is the fundamental responsibility of pharmacists. [ 3]
In the early 1900s, the increase in the discovery of new drugs and literature on the existing as well as new drugs made it difficult for healthcare professionals to retrieve relevant information. This led to the establishment of the first DIC by the University of Kentucky in 1962. In later years, there was a rise in the number of pharmacists-operated DICs; however, many of these centres had to close down in the mid-1980s due to the lack of budget. This led to the broadening of the scope of DISs involving the inclusion of educating allied health professions, providing evidence-based medical information, drug consultation, supporting the institutions’ medication safety programmes and providing information systems support. [ 4]
In India, the national policies were more industry-focused than health-focused, hence the role of DIC needed to be enlightened and awareness had to be spread about the DIS and rational use of drugs. Recognising the importance of providing accurate and unbiased information to healthcare professionals and consumers, the World Health Organization India Country Office collaborated with the Karnataka State Pharmacy Council (KSPC) and initiated the first independent DIC at the state level, in 1997. [ 5] DISs was initiated by JSS College of Pharmacy, Ooty, at the institutional level and Trivandrum Medical College at the hospital level. [ 4] The DIC of the KSPC in coordination with the Delhi Society for Promotion of Rational Drug Use (DSPRUD) had developed a standard treatment guideline and an essential drug list for Karnataka. The National Human Rights Commission (NHRC) recommends the establishment of DICs in all hospitals. [ 6]
The objective of the DIC is to identify the minimum criteria for establishing DICs at various levels to guide in recognising the value of monitoring and assessment in ensuring the quality of drug information dissemination, to serve as a guide for other centres, to provide a structured database of specialised information on medicines and therapeutics to meet the drug information need of various healthcare practitioners and to promote patient care through the rational use of drugs. [ 7]
DIC services are available as both reactive and proactive approaches. The reactive approach is widely used in hospital-based DIC, which provides answers to time-critical questions about the safe and efficient use of therapeutic and diagnostic pharmaceuticals to healthcare professionals. In proactive approach, some DICs publish and distribute frequent reports on a wide range of topics that includes drug-drug and drug-disease interactions, interpretation of therapeutic drug monitoring, adverse drug events, comparison of drug efficacy, safety profile, interpretation of therapeutic drug monitoring (TDM) levels, dosing recommendation for organ impairment, treatment guideline updates, approval and availability of new drugs, usage of drugs in any special circumstances, guidance on obtaining previously licensed drugs in other countries, salient study finding in reputed journals and plethora of questions from available literature sources. [ 8]
To ensure that the services are provided in a professional manner, qualitative assessment and evaluation of DIS are done. This includes three steps: [ 9]
There exists a different Quality Assessment Checklist which consists of eight close-ended questions, where ‘Yes’ is given a score of 1 and ‘No’ is scored 0. The total score is then graded from grade A–D, where 7–8 points is Grade A and indicates the quality of service provided was excellent from the provider’s perspective and points below 4 is Grade D and indicates that the service requires improvement. [ 10]
The benefits of DIC include promoting safe and effective use of medications by detecting and minimizing drug-related issues with prescriptions, promoting good clinical care practices and providing medication use policies, increasing pharmacist productivity to reduce time consumption by healthcare professionals in reviewing drug information, promoting patient compliance and medication adherence and aiding in reducing widespread practice of self-medication and medication abuse. [ 11]
The International Register of Drug Information Services (IRDIS), which is maintained by the Society of Hospital Pharmacists of Australia (SHPA) is the registering authority of DICs. As of 2016, 22 DICs in India have been registered with the IRDIS. Few of the registered DICs are: [ 12]
So far, in India, studies on the services provided by the DIC have been conducted only at the institutional level. Hence, in this review, we aim at providing a cumulative review of the services provided by various DICs in the country.
A literature search in PubMed and ResearchGate was performed and articles published within the time frame of January 2002 to January 2021 were selected. A Boolean search of databases was implemented to combine a range of keywords: ‘Evaluation’ AND ‘Assessment’ OR ‘Appraisal’ AND ‘Drug Information Services’ OR ‘Drug Information Center’ AND ‘India’. Studies were also obtained from journals by manual electronic search ( Figure 1). The objective of this review is to understand the utilisation of DISs provided in India.
Literature search flowchart.
The quantitative aspects of DIC can be evaluated with professional status of the enquirer, medical speciality of enquirer, purpose of enquiry, type of drug query, mode of receipt of query, mode of reply and time frame to reply. From the aforementioned topics, we have selected four topics as the remaining topics are available only in few individualised articles.
All articles which did not detail the type of query, purpose of enquiry and the quantity of queries raised by various healthcare professionals and their specialised departments were excluded.
A total of 4459 queries were included from 12 articles regarding DICs in India ( Table 1).
Number of queries from articles regarding drug information services
| Articles regarding drug information services . | Number of queries . |
|---|---|
| George B et al. [ 9] | 666 |
| Rajanandh MG et al. [ 13] | 469 |
| Vishwanth J et al. [ 14] | 113 |
| Kumar SV et al. [ 15] | 344 |
| Rajanandh MG et al. [ 16] | 192 |
| Patel H et al. [ 10] | 1204 |
| Kumar MM et al. [ 17] | 122 |
| Krishnaveni K et al. [ 18] | 283 |
| Praveen KM et al. [ 19] | 277 |
| Malik KM et al. [ 20] | 205 |
| Jeevangi VM et al. [ 21] | 122 |
| Pradeep P et al. [ 22] | 512 |
| Total number of queries = 4459 |
| Articles regarding drug information services . | Number of queries . |
|---|---|
| George B et al. [ 9] | 666 |
| Rajanandh MG et al. [ 13] | 469 |
| Vishwanth J et al. [ 14] | 113 |
| Kumar SV et al. [ 15] | 344 |
| Rajanandh MG et al. [ 16] | 192 |
| Patel H et al. [ 10] | 1204 |
| Kumar MM et al. [ 17] | 122 |
| Krishnaveni K et al. [ 18] | 283 |
| Praveen KM et al. [ 19] | 277 |
| Malik KM et al. [ 20] | 205 |
| Jeevangi VM et al. [ 21] | 122 |
| Pradeep P et al. [ 22] | 512 |
| Total number of queries = 4459 |
Number of queries from articles regarding drug information services
| Articles regarding drug information services . | Number of queries . |
|---|---|
| George B et al. [ 9] | 666 |
| Rajanandh MG et al. [ 13] | 469 |
| Vishwanth J et al. [ 14] | 113 |
| Kumar SV et al. [ 15] | 344 |
| Rajanandh MG et al. [ 16] | 192 |
| Patel H et al. [ 10] | 1204 |
| Kumar MM et al. [ 17] | 122 |
| Krishnaveni K et al. [ 18] | 283 |
| Praveen KM et al. [ 19] | 277 |
| Malik KM et al. [ 20] | 205 |
| Jeevangi VM et al. [ 21] | 122 |
| Pradeep P et al. [ 22] | 512 |
| Total number of queries = 4459 |
| Articles regarding drug information services . | Number of queries . |
|---|---|
| George B et al. [ 9] | 666 |
| Rajanandh MG et al. [ 13] | 469 |
| Vishwanth J et al. [ 14] | 113 |
| Kumar SV et al. [ 15] | 344 |
| Rajanandh MG et al. [ 16] | 192 |
| Patel H et al. [ 10] | 1204 |
| Kumar MM et al. [ 17] | 122 |
| Krishnaveni K et al. [ 18] | 283 |
| Praveen KM et al. [ 19] | 277 |
| Malik KM et al. [ 20] | 205 |
| Jeevangi VM et al. [ 21] | 122 |
| Pradeep P et al. [ 22] | 512 |
| Total number of queries = 4459 |
The quantitative dimension of the drug information queries was assessed as a mean percentage.
From 23 different medical specialities, the Department of General Medicine (43.64%) generated the most queries in the papers included in our review, followed by Paediatrics (8.09%), Dermatology (4.87%), Gynaecology (4.56%) and Cardiology (4.28%).
Drug information queries received from different medical specialities
| Speciality . | Articles regarding Drug Information Centres in India (% of queries) . | . | . | . | . | . | . | . | . | . | . | . | Mean % . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | George B et al. [ 9] . | Rajanandh MG et al. [ 13] . | Vishwanth J et al. [ 14] . | Kumar SV et al. [ 15] . | Rajanandh MG et al. [ 16] . | Patel H et al. [ 10] . | Kumar MM et al. [ 17] . | Krishnaveni K et al. [ 18] . | Praveen KM et al. [ 19] . | Malik KM et al. [ 20] . | Jeevangi VM et al. [ 21] . | Pradeep P et al. [ 22] . | . |
| General Medicine | – | 13 | 21.23 | 42.4 | 52.6 | 26 | 77.85 | 62.89 | 34.8 | 89.76 | 67.21 | 35.93 | 43.64 |
| Surgery | 2.55 | – | 2.65 | – | – | 19.35 | – | 2.82 | – | 1.95 | 1.64 | – | 2.58 |
| Infectious diseases | – | – | – | – | – | – | – | 4.59 | – | – | – | – | 0.38 |
| Cardiology | 6 | 11.51 | – | 9 | 4.6 | – | – | – | 20.26 | – | – | – | 4.28 |
| Gastroenterology | – | – | – | – | – | – | – | – | 9.69 | – | – | – | 0.81 |
| Chest and Tuberculosis | – | 8.1 | 4.42 | – | 6.2 | – | – | – | 5.72 | – | – | – | 2.04 |
| ENT | – | 8.1 | – | – | – | – | – | – | 1.32 | – | – | – | 0.78 |
| Psychiatry | 2.55 | 8.1 | – | – | – | – | – | – | – | – | – | 6.05 | 1.39 |
| Endocrinology | – | 7.03 | – | – | – | – | – | – | – | – | – | – | 0.59 |
| Gynaecology | 6.75 | 6.82 | – | – | 9.3 | – | – | 9.18 | 1.76 | – | 9.01 | 11.91 | 4.56 |
| Paediatrics | 11.8 | 6.6 | 12.37 | 12 | 4.1 | 15.61 | 9.84 | 6.36 | – | – | 8.2 | 10.16 | 8.09 |
| Oncology | – | 5.97 | – | 3.1 | – | – | – | – | – | 3.41 | – | 8.01 | 1.71 |
| Nephrology | 21.17 | 5.75 | – | – | 3.1 | – | – | – | 3.96 | – | – | – | 2.83 |
| Neurology | 11.81 | 5.33 | – | – | – | – | – | – | 6.6 | – | – | 5.66 | 2.45 |
| Dermatology | 7.66 | 4.69 | 14.14 | 2.9 | 2.08 | 8.47 | 12.3 | – | – | – | – | 6.25 | 4.87 |
| Orthopaedics | – | – | 3.53 | – | – | – | – | 5.3 | 15.85 | – | 6.56 | – | 2.6 |
| Urology | 1.65 | – | – | – | – | – | – | – | – | – | – | – | 0.14 |
| Dentistry | 6 | – | – | – | – | – | – | – | – | – | – | – | 0.5 |
| Ophthalmology | – | – | – | – | 0.5 | – | – | – | – | – | – | – | 0.04 |
| Causality | – | – | – | – | – | – | – | – | – | – | – | 5.66 | 0.47 |
| Nursing | 3.45 | – | – | – | – | – | – | – | – | – | – | – | 0.29 |
| Pharmacy | – | 4.05 | – | – | 10.9 | – | – | – | – | 0.49 | – | – | 1.29 |
| Nutrition | – | 2.55 | – | – | – | – | – | – | – | – | – | – | 0.21 |
| Others | 18.62 | 2.34 | 41.58 | 30.2 | 6.2 | – | – | 8.83 | – | 4.39 | 7.38 | 10.35 | 10.82 |
| Speciality . | Articles regarding Drug Information Centres in India (% of queries) . | . | . | . | . | . | . | . | . | . | . | . | Mean % . |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| . | George B et al. [ 9] . | Rajanandh MG et al. [ 13] . | Vishwanth J et al. [ 14] . | Kumar SV et al. [ 15] . | Rajanandh MG et al. [ 16] . | Patel H et al. [ 10] . | Kumar MM et al. [ 17] . | Krishnaveni K et al. [ 18] . | Praveen KM et al. [ 19] . | Malik KM et al. [ 20] . | Jeevangi VM et al. [ 21] . | Pradeep P et al. [ 22] . | . |
| General Medicine | – | 13 | 21.23 | 42.4 | 52.6 | 26 | 77.85 | 62.89 | 34.8 | 89.76 | 67.21 | 35.93 | 43.64 |
| Surgery | 2.55 | – | 2.65 | – | – | 19.35 | – | 2.82 | – | 1.95 | 1.64 | – | 2.58 |
| Infectious diseases | – | – | – | – | – | – | – | 4.59 | – | – | – | – | 0.38 |
| Cardiology | 6 | 11.51 | – | 9 | 4.6 | – | – | – | 20.26 | – | – | – | 4.28 |
| Gastroenterology | – | – | – | – | – | – | – | – | 9.69 | – | – | – | 0.81 |
| Chest and Tuberculosis | – | 8.1 | 4.42 | – | 6.2 | – | – | – | 5.72 | – | – | – | 2.04 |
| ENT | – | 8.1 | – | – | – | – | – | – | 1.32 | – | – | – | 0.78 |
| Psychiatry | 2.55 | 8.1 | – | – | – | – | – | – | – | – | – | 6.05 | 1.39 |
| Endocrinology | – | 7.03 | – | – | – | – | – | – | – | – | – | – | 0.59 |
| Gynaecology | 6.75 | 6.82 | – | – | 9.3 | – | – | 9.18 | 1.76 | – | 9.01 | 11.91 | 4.56 |
| Paediatrics | 11.8 | 6.6 | 12.37 | 12 | 4.1 | 15.61 | 9.84 | 6.36 | – | – | 8.2 | 10.16 | 8.09 |
| Oncology | – | 5.97 | – | 3.1 | – | – | – | – | – | 3.41 | – | 8.01 | 1.71 |
| Nephrology | 21.17 | 5.75 | – | – | 3.1 | – | – | – | 3.96 | – | – | – | 2.83 |
| Neurology | 11.81 | 5.33 | – | – | – | – | – | – | 6.6 | – | – | 5.66 | 2.45 |
| Dermatology | 7.66 | 4.69 | 14.14 | 2.9 | 2.08 | 8.47 | 12.3 | – | – | – | – | 6.25 | 4.87 |
| Orthopaedics | – | – | 3.53 | – | – | – | – | 5.3 | 15.85 | – | 6.56 | – | 2.6 |
| Urology | 1.65 | – | – | – | – | – | – | – | – | – | – | – | 0.14 |
| Dentistry | 6 | – | – | – | – | – | – | – | – | – | – | – | 0.5 |
| Ophthalmology | – | – | – | – | 0.5 | – | – | – | – | – | – | – | 0.04 |
| Causality | – | – | – | – | – | – | – | – | – | – | – | 5.66 | 0.47 |
| Nursing | 3.45 | – | – | – | – | – | – | – | – | – | – | – | 0.29 |
| Pharmacy | – | 4.05 | – | – | 10.9 | – | – | – | – | 0.49 | – | – | 1.29 |
| Nutrition | – | 2.55 | – | – | – | – | – | – | – | – | – | – | 0.21 |
| Others | 18.62 | 2.34 | 41.58 | 30.2 | 6.2 | – | – | 8.83 | – | 4.39 | 7.38 | 10.35 | 10.82 |
“–”, not available; ENT, Ear, Nose and Throat.
