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Robert H. Schrimsher, MLIS, EdD Associate Professor of Pharmacy Practice and Pharmacy Librarian Maisha Kelly Freeman, PharmD, BCPS Assistant Professor of Pharmacy Practice and Drug Information Specialist Michael Kendrach, PharmD Associate Professor of Pharmacy Practice and Director, Drug Information Center McWhorter School of Pharmacy, Samford University, Birmingham, Alabama

A Survey of Drug Information Resources in Alabama Pharmacy Facilities

The primary purpose of this study was to evaluate the availability and usage of drug information (DI) resources in Alabama pharmacy facilities licensed by the Alabama State Board of Pharmacy. A survey consisting of questions regarding accessible DI resources and their usage was mailed to 1,430 pharmacy facilities, of which 604 (42%) were returned. The survey also consisted of other questions concerning personal data/digital assistant (PDA) usage, computer resources, types of DI questions answered, and other DI-related questions. Drug Facts and Comparisons was the most available and used resource for all pharmacy types; the PDR (Physicians Desk Reference) and OTC (over-the-counter) references were second and third, respectively. PDA usage was relatively low (19.5%) among all pharmacies, but hospital/mental health pharmacies had the highest usage (32.4%). The primary drug questions answered by pharmacists for all pharmacy types concerned drug interaction, adverse reactions, and OTC questions.

Key Words Drug information; Drug information resources; Drug information references; Alabama pharmacies; Drug interactions Correspondence Address Dr. Robert H. Schrimsher, McWhorter School of Pharmacy, Samford University, 800 Lakeshore Drive, Birmingham, AL 35229 (e-mail: rhschrim@samford.edu). Funding for this study was provided by a Faculty Development Grant, Samford University.

INTRODUCTION
Drug information (DI) resources vary for each pharmacy facility depending on the scope and practice of the organization. Resources could also vary greatly depending on budgets, state law, or other policy statements enforced by the state boards of pharmacy. The advent of electronic databases, especially the Internet, has enhanced database accessibility and availability of drug-related information. Some Internet sites are accessible free of charge and render extensive medical/pharmaceutical information. Recent DI resource availability studies are somewhat sparse. Rheney and Connelly (1) surveyed North Carolina physicians to identify accessible print and computer resources. They found that the most common print references were the Physicians Desk Reference (PDR) and several medical journals. An earlier Swedish study by Lundborg et al. (2) surveyed physicians and found that the most frequently used resource was the Farmaceutisha Specialitcher i Srerige (the Swedish equivalent to the Physicians Desk Reference). Although not published in the printed literature, several American Society of Health-System Pharmacists Midyear Clinical Meeting abstracts indexed in the International Pharmaceu-

tical Abstracts database reported on the availability of DI resources. Parker et al. (3) surveyed 200 pharmacists and found that Drug Facts and Comparisons was available at all practice settings and was the most useful reference. Haleem et al. (4) conducted a telephonic survey of DI centers (N = 50) to determine DI specialists perceptions of the advantages/disadvantages of frequently utilized DI resources. They found that the five most commonly used references were Micromedex, Drug Facts and Comparisons, American Hospital Formulary ServiceDrug Information (AHFS), Medline, and the Internet. A study in 2001 by Hailemeskel et al. (5) was conducted to determine third-year pharmacy students choice of reference for DI questions. A total of 59 students completed the survey, and they evaluated core references for ease of use, time and effort involved in acquiring information, difficulty in understanding the information provided, and so on. In general, students preferred using Drug Facts and Comparisons to answer DI questions and considered it the best reference for easily locating information. However, some references were ranked better than others for a specific area. For example, the USPDI (United States Pharmacopoeia Drug Information: Drug Information for the Health Care Professional) was the most preferred source for lo-

Drug Information Journal, Vol. 40, pp. 5160, 2006 0092-8615/2006 Printed in the USA. All rights reserved. Copyright 2006 Drug Information Association, Inc.

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cating information pertaining to drug therapy and pharmacology, and the AHFS was considered best for its presentation of pharmacokinetic information.

OBJECTIVES
There were two primary objectives for this study. The first objective was to assess via a survey the availability and utilization of pharmacy resources in Alabama pharmacy facilities licensed by the Alabama State Board of Pharmacy. To our knowledge, no DI resource study has ever been conducted in Alabama. The second objective was to ensure the most appropriate DI resources were taught in the DI classes at Samford Universitys McWhorter School of Pharmacy in Birmingham, Alabama. The faculty at Samford University Global Drug Information Service teach three DI courses (one each during the first, third, and fourth years) of pharmacy school. As a result of this current study, the core DI references used by Alabama pharmacists will be identified, and these identified references in turn will be emphasized in the DI courses.

METHODOLOGY
All Alabama pharmacy facilities licensed to dispense pharmaceuticals were eligible for the study except for facilities licensed in Alabama but operated out of state (eg, Internet or mail order pharmacies). The rationale for these omissions was to prevent duplication of results for two addresses for the same organization or a nonresponse to a survey designed for only Alabama pharmacies. Medical supplies facilities were also excluded from the survey. In Alabama, medical supply facilities that dispense oxygen must be licensed by the Alabama Board of Pharmacy; however, these types of facilities do not have or dispense pharmaceuticals. At the time of this survey, there were over 3,000 licensed pharmacy facilities in Alabama. Mailing address labels for each licensed facility were obtained from the Alabama State Board of Pharmacy. Types of facilities surveyed included all hospital/mental health, industry, and ambulatory care facilities; home infusion sources; and re-

tail/community pharmacies. The survey included a cover letter to the pharmacy director/manager explaining the purpose of the study and a self-addressed, stamped return envelope. The cover letter also emphasized that this was a onetime survey, that no follow-up letter/survey would be sent, and that no individual or facility would be identified in the results. Furthermore, facility participation in this study was strictly voluntary. There were 1,430 surveys mailed to the above types of pharmacy facilities. This study was approved by the Samford University Institutional Review Board. The survey instrument (see appendix A) consisted of six questions, and most questions had multiple response choices. The type of pharmacy, available DI resources, types of computer resources, PDA usage, most frequent resources utilized, and types of DI questions asked by clients were requested from the contact person at the pharmacy. Space was also provided for comments. No follow-up survey or reminder notice was sent. Returned surveys were entered into an SPSS for Windows (version 12.0) data file and were analyzed via descriptive statistics. All fill-in-theblank survey responses were entered into a Microsoft Excel spreadsheet and tallied.

R E S U LT S
Of the 1,430 surveys sent to pharmacy facilities, 604 (42%) were returned. Alabama pharmacies were classified by facility type on their returned survey (see appendix A). Return rates by pharmacy facility type (N = 604) were as follows: 480 surveys (79%) from retail/community; 74 (12%) from hospital/mental health; 39 (6%) from other types of pharmacies (eg, compounding, longterm care, nuclear, hospice, mail order); 10 (2%) from home infusion; and 1 (0.2%) from ambulatory care/clinics. Because there was only 1 ambulatory care pharmacy clinic and 10 home infusion surveys returned, these 1 1 responses were reclassified into the other pharmacy category, thus making the other category total 50. Therefore, this study describes three major types of pharmacies: retail/community, hospital/mental health, and other. Estimates by the address la-

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Availability of Drug Information Resources by All Pharmacies (N = 604) Resource Name* Drug Facts and Comparisons PDR OTC references Drug Information Handbook Medical/pharmacy journals Drug interaction texts PubMed/Internet USPDI AHFS Micromedex Mosbys Drug Consult
*Pharmacies may not have the current or exact version. Physicians Desk Reference United States Pharmacopoeia Drug Information. AHFS Drug Information.

Indicated (Yes) Resource Available 550 310 289 209 209 204 102 97 73 54 14

Total Indicating Yes (%) 91.1 51.3 47.8 34.6 34.6 33.8 16.9 16.1 12.1 8.9 2.3

TABLE 1

bels indicated that Alabama had 1,197 retail/ community and 159 hospital/mental health pharmacies. Based on this estimate, the total survey return rates for these facilities were 34% and 46%, respectively. AVAILABLE RESOURCES BY ALL PHARMACIES Enumeration of available DI resources for Alabama pharmacies was one of the major objectives for this study; Table 1 depicts the survey results of the resources in ascending order of availability for all pharmacies. Slightly over 90% of all pharmacies indicated that Drug Facts and Comparisons was available, and 51% indicated that the PDR was available. Micromedex and Mosbys Drug Consult were the least available of the options provided. AVAILABLE RESOURCES BY PHARMACY TYPE Table 2 illustrates survey results for the major drug monograph texts available by pharmacy type. Table 3 also depicts resources by pharmacy type; however, these resources are more by groups of resources (eg, OTC references) rather

than a specific single text, except for the Drug Information Handbook and Micromedex. Retail/Community Pharmacies. The survey results (Table 2) indicated that Drug Facts and Comparisons had the highest availability among retail/community pharmacies, and slightly less than half (44.2%) indicated that they had the PDR. Of the 480 retail/community pharmacies that responded to the survey, half (50.8%) indicated that they had OTC references available (see Table 3). Hospital/Mental Health Pharmacies. Drug Facts and Comparisons also had the highest (95.9%) availability (Table 2) among hospital/ mental health pharmacies; medical/pharmacy journals were second with 60.8%, and the Drug Information Handbook (58.1%) had the highest availability among grouped references (Table 3). Other Pharmacies. The other pharmacy types group included compounding pharmacies, long-term care facilities, clinics, hospices, nuclear agencies, home infusion agencies, and so on. Again, Drug Facts and Comparisons (Table 2)

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TABLE 2
Resource Name Drug Facts and Comparisons

Availability of Drug Monographs by Pharmacy Type (N = 604) Retail/Community (n = 480) Yes (n) % Yes No (n) % No PDR * Yes (n) % Yes No (n) % No USPDI Yes (n) % Yes No (n) % No AHFS Yes (n) % Yes No (n) % No Mosbys Drug Consult Yes (n) % Yes No (n) % No
*Physicians Desk Reference. United States Pharmacopoeia Drug Information. AHFS Drug Information.

Hospital/Mental Health (n = 74) 71 95.9 3 4.1 64 86.5 10 13.5 16 21.5 58 78.5 49 66.2 25 33.8 6 8.1 68 91.9

Other (n = 50) 46 92.0 4 8.0 34 68.0 16 32.0 11 22.0 39 78.0 11 22.0 39 78.0 3 6.0 47 94.0

Total (N = 604) 550 91.1 54 8.9 310 51.3 294 48.7 97 16.1 507 83.9 73 12.1 531 87.9 14 2.3 590 97.7

433 90.2 47 9.8 212 44.2 268 55.8 70 14.6 410 85.4 13 2.7 467 97.3 5 1.0 475 99.0

had the highest availability (92%), and the PDR was second (68%). For grouped resources (Table 3), medical/pharmacy journals had the highest availability at 42%, and the Drug Information Handbook was second at 40%. OTHER RESOURCES Alabama pharmacies were requested to indicate additional available print and computer resources (see questions 2 and 4, appendix A). Pharmacists Letter (n = 18), Remington (Remington: The Science and Practice of Pharmacy) (n = 13), and Clinical Pharmacology (n = 26) were the most available other resources from all pharmacy respondents. Many pharmacies also noted Internet or online (n = 41) capability on the survey form, which was interpreted to mean that Internet or some type of online capacity existed.

PERSONAL DATA/DIGITAL ASSISTANTS Survey results indicated that relatively few pharmacies within Alabama have or utilize PDAs. Table 4 reveals that only 19.5% of all pharmacies used PDAs, and hospital/mental health-type pharmacies had the highest percentage (32.2%) of use; retail/community pharmacies indicated only 17 .1% usage. Pharmacies were requested to indicate which PDA programs they used; hospital/mental health pharmacies indicated the highest percentage (20.3%) for both Lexi-Comp and ePocrates PDA programs. There were very few write-ins for other types of PDA programs used. MOST FREQUENTLY USED RESOURCES Not only was Drug Facts and Comparisons the most available resource, it was also the most utilized resource (n = 470), which means that of the total respondents (n = 604), 77.8% used

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Availability of Other Specific References by Pharmacy Type (N = 604) Resource Name OTC references Yes (n) % Yes No (n) % No Drug Information Handbook Yes (n) % Yes No (n) % No Medical/pharmacy Yes (n) journals % Yes No (n) % No Drug interaction references Yes (n) % Yes No (n) % No PubMed/Internet Yes (n) % Yes No (n) % No Micromedex Yes (n) % Yes No (n) % No Retail/Community (n = 480) 244 50.8 236 49.2 146 30.4 334 69.6 143 29.8 337 70.2 165 34.4 315 65.6 63 13.1 417 86.9 15 3.1 465 96.9 Hospital/Mental Health (n = 74) 30 40.5 44 59.5 43 58.1 31 41.9 45 60.8 29 39.2 27 36.5 47 63.5 29 39.2 45 60.8 33 44.6 41 55.4 Other (n = 50) 15 30.0 35 70.0 20 40.0 30 60.0 21 42.0 29 58.0 12 24.0 38 76.0 10 20.0 40 80.0 6 12.0 44 88.0 Total (N = 604) 289 47.8 315 52.2 209 34.6 395 65.4 209 34.6 395 65.4 204 33.8 400 66.2 102 16.9 502 83.1 54 8.9 550 91.1

TABLE 3

Drug Facts and Comparisons above all other resources (see question 5, appendix A). The PDR was the second most frequently used with 19.9% (n = 120), and the Drug Information Handbook was third with 16.9% (n = 102). TYPES OF DRUG INFORMATION QUESTIONS Pharmacies surveyed were requested to indicate which types of DI questions were asked by their clients/patients. Table 5 depicts these results; within retail/community pharmacies, the majority of questions answered by the pharmacists concerned drug interactions (94.0%), OTC medications (94.2%), and adverse effects (94.8%). For hospital/mental health pharmacies, the highest yes percentage reported was for drug interaction questions (86.5%), and new

drug and adverse effect questions both were answered 78.4% of the time. For other pharmacy types, adverse effects and dosing information questions were the most commonly answered (82.0%). COMMENTS ON SURVEY There were very few written respondent comments regarding the survey. Of the comments, most pertained to the desire of having Internet connectivity or a PDA at the pharmacy for DI purposes. There were no negative comments regarding the survey. EVALUATION OF RESOURCES FOR DRUG INFORMATION COURSES As mentioned, a second objective of this study was to identify the most accessible references

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TABLE 4

Availability of Personal Data (or Digital) Assistants (PDAs) by Pharmacy Type (n = 604) Resource Name PDA use Yes (n) % Yes No (n) % No Retail/Community (n = 480) 82 17.1 398 82.9 Hospital/Mental Health (n = 74) 24 32.4 50 67.6 Other (n = 50) 12 24.0 38 76.0 Total (N = 604) 118 19.5 486 80.5

available to Alabama pharmacists and to ensure these are included in the DI class material at Samford Universitys McWhorter School of Pharmacy. After evaluation of each courses syllabus, the DI resources taught and emphasized in the three DI courses included the resources mentioned in Table 1 except for Micromedex.

DISCUSSION
Drug Facts and Comparisons was the most available DI resource. The extensive availability of this reference in pharmacies may be explained by its special features. These include monthly updates, both prescription and nonlegend med-

TABLE 5
Resource Name Drug interactions Yes (n) % Yes No (n) % No Adverse effects Yes (n) % Yes No (n) % No OTC Yes (n) % Yes No (n) % No Dosing information Yes (n) % Yes No (n) % No Herbal products Yes (n) % Yes No (n) % No New drugs Yes (n) % Yes No (n) % No

Drug Information Questions by Pharmacy Type (N = 604) Retail/Community (n = 480) 451 94.0 29 6.0 455 94.8 25 5.2 452 94.2 28 5.8 380 79.2 100 20.8 356 74.2 124 25.8 294 61.3 186 38.7 Hospital/Mental Health (n = 74) 64 86.5 10 13.5 58 78.4 16 21.6 25 33.8 49 66.2 68 91.9 6 8.1 27 36.5 47 63.5 58 78.4 16 21.6 Other (n = 50) 41 82.0 9 18.0 38 76.0 12 24.0 18 36.0 32 64.0 41 82.0 9 18.0 13 26.0 37 74.0 23 46.0 27 54.0 Total (N = 604) 556 92.1 48 7.9 551 91.2 53 8.8 495 82.0 109 18.0 489 81.0 115 19.0 396 65.6 208 34.4 375 62.1 229 37.9

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ication information, extensive drug monograph information, and numerous medication comparison tables. Another possible reason for the high availability of this resource is because the Practice of Pharmacy Act for the state of Alabama stipulates that Every pharmacy licensed in this State shall have on hand the following technical equipment; the last edition and/or revision of Facts and Comparison or any reference book or electronic media sufficient to meet the level of its pharmacy practice (6). The statue does not mandate Drug Facts and Comparisons but simply names this reference as an example to have within the pharmacy or to have any other sufficient reference book or electronic media. The statue could be interpreted that Drug Facts and Comparisons is required; however, this is not the case. Furthermore, 100% of the respondent pharmacies did not have Drug Facts and Comparisons, suggesting that it is not required by state law. Not surprisingly, the PDR was the second most available resource. This resource has been published for many years (currently in its 58th edition) and provides Food and Drug Administration approved product labeling information for drugs via the pharmaceutical manufacturer. The high availability for both Drug Facts and Comparisons and the PDR also corresponds well with their frequency of use as reported by this survey. Drug Facts and Comparisons was used in Alabama pharmacy facilities more than any other resource (77.8%), followed by the PDR (19.9%). The high availability and use of Drug Facts and Comparisons and the PDR also correlate with other previous studies (15). Interestingly, the Drug Information Handbook was third (16.9%) in usability, yet only 34.6% of all respondents indicated that it was in their pharmacy. Almost half (47.8%) of the respondents indicated that they had OTC references, which is not surprising because of the overwhelming number of OTC products and the volume of questions related to these products by patients. The AHFS was noticeably more available (66.2%, Table 2) in hospital/mental health pharmacies than other pharmacy types. This result is predictable because the AHFS is primarily designed for hospital pharmacy practice.

Medical/pharmacy journals were also distinctly more available (60.8%) in hospital/mental health pharmacies than other types. There are two probable reasons for this: First, many hospitals have medical or pharmacy libraries that have medical/pharmacy journals; second, hospital pharmacists have responsibilities that require the use of information from journals (eg, clinical studies) as opposed to textbooks to accomplish their daily tasks. PDAs have been well documented as emerging technology for pharmacy care, especially for clinical applications, DI, and patient records (79). Samford Universitys McWhorter School of Pharmacy is one of the few schools of pharmacy that issues PDAs for curriculum use to students and faculty (10). Although the usage of PDAs was not appreciably high (only 19.5% for all pharmacies) and hospital/mental health pharmacies reported the highest usage (32.4%), there is no reason to believe that PDA usage will not continue to grow. As the PDA technology and memory enhancement expand, the PDA prevalence will likely increase, especially for pharmacists (8). Types of drug questions asked by clients/patients revealed some noteworthy items (see Table 5). Drug interactions received the highest number of yes responses to questions across all pharmacy types (92.1%), and for hospital/mental health pharmacies, 86.5% indicated yes for receiving drug interaction questions. Even though drug interactions received the highest number of yes responses for questions asked, according to the data in Table 3, drug interaction references ranked fourth (33.8%) in overall availability. The most likely explanation for this noticeable paradox is that pharmacies likely have their own internal computerized system for identifying drug interactions. Interestingly, a study conducted by Drug Topics (1 1) reported that the technology most important to hospital pharmacists was a drug interaction database, with 86% (n = 203 responding) indicating that they had such a system. The specific type of drug interaction system or technology was not mentioned. The study of Parker et al. (3) study also correlated very well with the current study, which found that the most frequently

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asked question involved drug interactions, and community pharmacists were most likely to be asked questions regarding OTC medications, herbal products, new drugs, and foreign drugs. Hospital pharmacists were also asked questions related to drug interactions, side effects, indications, and dosing. OTC questions were indicated as very high (94.2%) at retail/community pharmacies, which would be somewhat predictable because of their high interest and use by patients. Adverse effects questions were also very high (94.8%) for retail/community pharmacies, and the total for all pharmacies was 91.2%. This high percentage of yes responses is reasonable and expected because most patients are very interested in the adverse effects they may experience while receiving a drug. As mentioned, a secondary objective was to ensure that the most appropriate DI resources were taught in the DI classes; consequently, this survey was also conducted as a quality assurance process for the pharmacy academic program. We recognize that teaching only those references within pharmacies would be underserving the students. The most appropriate resources should be taught, and it is hoped the student will acquire and use these while in practice. However, we sought to validate the most common references available in actual pharmacies to ensure these were included in the curriculum. Throughout the three DI courses in this pharmacy program, students are exposed to a multitude of print and electronic resources. For instance, the first-year DI course was designed for students to identify appropriate references to use in answering questions and solving problems. Students are required to answer drug- and disease-related questions that require the use of general plus specialized references deemed appropriate to obtain information (ie, Drug Interaction Facts to answer drugdrug interaction questions). The intent of the first-year course is for students to learn the resources so that the learning objectives can be applied to other courses throughout the curriculum. The remaining two DI courses expand on the first DI course not only by selecting the most appropri-

ate resources, but also by properly analyzing and utilizing the resource content in completing course projects. The course instructors recognize that the possibility exists that the resources taught are not available in all pharmacies, but students should be familiar with all of the resources available to practicing pharmacists.

L I M I TAT I O N S
There were several limitations for this study. First, the survey pertained only to Alabama pharmacies licensed by the Alabama Board of Pharmacy to dispense pharmaceuticals. Second, if a licensed Alabama pharmacy had an out-ofstate address, it was not surveyed because of the concern that the survey might have duplicate results of its parent in-state organization or not be returned at all because the primary purpose was for Alabama pharmacies only. Third, no medical supplies organizations were surveyed because they do not dispense pharmaceuticals, although they are licensed by the Alabama Board of Pharmacy. The most serious limitation to any direct mail survey is normally a low response rate. A 10% response rate is often the norm, and over 30% is considered very good for mail surveys (12). This study had an overall response rate of 42%, which is very reasonable for this type of study.

CONCLUSIONS
Pharmacists practicing in Alabama pharmacy facilities primarily have access and utilize Drug Facts and Comparisons and the PDR for their DI resources. Previous research regarding DI resources, even though very limited, also noted this finding. Based on these findings and that the resources mentioned are very much standard resources for pharmacists throughout most states, it is assumed that these resources would be prevalent in most states. PDA usage is rather low in Alabama pharmacies; however, widespread usage is expected to grow in the future, especially as the cost of PDAs continues to decline and memory capability increases. Finally, of all the facilities surveyed, drug interaction questions were predominantly asked by pharmacies clientele.

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APPENDIX A
Alabama Pharmacy Facilities Access and Use of Drug Information Resources 1. What specific area of pharmacy best describes your site? (please check only one) Retail/community Hospital/mental health Industry Ambulatory care (eg, asthma clinic, coumadin clinic, etc) Home infusion Other (specify) ________________________ 2. Which of the following drug information resources/references are immediately (5 minutes or less) accessible in your pharmacy practice? (check all that apply) Drug Facts and Comparisons AHFS (American Hospital Formulary Service) USPDI (United States Pharmacopoeia Drug Information) PDR (Physicians Desk Reference) Micromedex Mosbys Drug Consult (formerly Mosbys GenRx) Drug Information Handbook OTC references (eg, Handbook of Nonprescription Drugs, Nonprescription Drug Therapy, etc) Drug interaction texts (eg, Drug Interaction Facts) PubMed and other Internet resources Medical/pharmacy journal(s) Other resources (please specify) __________________, ________________ 3. Personal data assistants are used at this facility for drug information purposes No (or None) If Yes, which programs do you use (check all that apply) Lexi-Comp ePocrates Micromedex Others________________________, _______________________, ____________________ 4. Other computer resources (please list)______________, _________________, ________________ 5. Please list the SPECIFIC name of the three most frequently utilized resources (eg, a specific book, PDA program, Web site, etc) 1.________________________ 2.________________________ 3._______________________ 6. Which of the following types of drug questions are asked by your clients/patients and/or health care professionals? (check all that apply) Drug interactions Over-the-counter (OTC) products Herbal products New drugs Dosing information Adverse effects Others (please specify) __________________, ________________, __________________ Comments regarding drug information resources:

REFERENCES
1. Rheney CC, Connelly JF. North Carolina physician access to drug information resources. Drug Inf J. 2000;34:6972.

2. Lundborg CS, Hensjo LO, Gustafsson LL. Drug information sources: reported preferences by general practitioner. Drug Inf J. 1998;32:777785. 3. Parker L, Egbunike I, Eze U, Dunlop D. Survey of drug information resources utilized by practic-

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4.

5.

6. 7.

8.

9.

10.

ing pharmacists [abstract]. International Pharmacy Abstracts [database online]. Accessed June 7, 2003. Haleem SS, Egbunike IG, Eze UA, Dunlop D. Assessment of the advantages and disadvantages of references utilized at drug information centers [abstract]. International Pharmacy Abstracts [database online]. Accessed June 7, 2003. Hailemeskel B, Nyarko EA, Thompson M, White DP. Survey of students preferences in using drug information resources to answer mock drug information questions [abstract]. International Pharmacy Abstracts [database online]. Accessed June 7, 2003. Al Stat 34 Adm Rule 680-X-2-04. Felkey B, Fox BI. Emerging technology at point of care. J Am Pharm Assoc. 2003;43(5 suppl 1): S50S51. McCreadie SR, Stevenson JG, Sweet BV, Kramer M. Using personal digital assistants to access drug information. Am J Health-Syst Pharm. 2002;59:1 3401 343. Lynx DH, Brockmill HR, Connelly RT, Crawford SY. Use of PDA-based pharmacist intervention system. Am J Health-Syst Pharm. 2003;60: 23412344. DeHart RM, Monk-Tutor MR, Worthington MA, Price SO, Sowell JG. School-wide implementation of personal digital assistant (PDA) use at the McWhorter School of Pharmacy: a first-year report. Am J Pharm Edu. [serial on-line]. 2004; 68(4): article 98. Available at: http://www.ajpe .org/view.asp?art=aj680498&pdf=yes. Accessed November 1 1, 2005.

1 1. Sipkoff M. Pharmacists views on technology. Drug Topics. 2004;148:3744. 12. Alreck PL, Settle RB. The Survey Research Handbook. New York: McGraw-Hill; 1995:35.

SUGGESTED READINGS
Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons. Physicians Desk Reference. 58th ed. Montvale, NJ: Thomson PDR; 2004. Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook. 12th ed. Hudson, OH: LexiComp; 2004. United States Pharmacopoeia Drug Information: Drug Information for the Health Care Professional. 24th ed. Greenwood Village, CO: Thomson Micromedex; 2004. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists; 2004. Micromedex Healthcare Series [computer program]. Greenwood Village, CO: Thomson Micromedex; 2004. Nissen D, ed. Mosbys Drug Consult. St. Louis, MO: Facts and Comparisons; 2004. Gennaro, AR, ed. Remington: The Science and Practice of Pharmacy. 20th ed. Philadelphia: Lippincott, Williams and Wilkins; 2000. Pharmacists Letter. Available from: Therapeutic-Research-Center, 2453 Grand Canal Boulevard, Suite A, Box 8190, Stockton, CA 95208. Clinical Pharmacology. Available at: http://cpip.gsm .com/.