Establishing DI Centre.

Establishing a Drug Information
Centre
www.revolutionpharmd.com
Definition
World Health Organization (WHO) defines drug
information centre as an independent centre that is
accessible to any healthcare professional to ask all
questions about drug therapy
Introduction
There are three physical criteria, which define an
information centre:
1. Specific room set aside as location for drug

information centre
2. At least one dedicated and trained pharmacist
must be available to answer queries
3. Sufficient information resources should be
available to answer a broad scope of queries
Introduction
A strategic plan should be developed when establishing a
drug information centre
The plan should include:

mission statement
goals and objectives
action plan with performance indicators
details of budget
methods for evaluating the services provided
Introduction
Establishment of a drug information centre needs the
consideration of:
Justification of the need for a centre

Services to be offered by the centre
Resources, facilities and ongoing maintenance for the
centre.
Establishment and minimum requirements

To be successful, DI centre requires a
-- stable location and environment
-- idealistic commitment to provide needed drug
information
-- physical space to house the service
-- basic information references
-- staff
-- equipment to support information access and
dissemination, and communication equipment

Essential components
-- Philosophical commitment
-- Location of the centre
-- Space allocation
-- Facilities and equipments
-- Financial issues
-- Staff

Essential components
-- Organization
-- Resources
-- Operational Procedures
-- Documentation
-- Quality assurance
Philosophical commitment
Drug information centers should work both in
reactive and proactive ways
The reactive or passive responsibilities of the centers include
providing the information to the individuals who approach
the centre
Proactive responsibilities include reaching out with drug
information for the people who need it, in a format that is
convenient and effective
The centers should work according to the needs and
expectations of its users and should create demand and
expectations
Location of the centre

Should be centrally located & the location selected should
have good access to requestors and not too much of
distraction
Few ideal locations

-- In or adjacent to a hospital
-- Medical teaching institution
-- Within the hospital
-- University/academic institution
-- Within/adjacent to a medical / pharmacy association
-- Relevant governmental agency (such as ministry of health,
drug control authority, drug approval unit, or quality control lab)
Space allocation
An independent area must be set aside for the drug
information services
It may depend upon the size of the centre and the number of
queries received by the centre
A secure space of 25 square meters in one or two rooms

allows for office workspace, storage of references, placement
of communication equipment, research and educational
activities, and space for visitors to use the drug information
resources
Facilities and equipments

DIC should have sufficient lighting, ventilation and aeration
It should also have essential access to a medical library
The basic equipments needed for effective functioning of a
drug information centre include, basic office equipment,
photocopier
(preferably),
microfiche
reader/printer,
computer equipment and Internet, printer, telephones,
calculator (or computer programs), visual aids and fax
machine.
The minimum equipments required for effective operation of a major

teaching hospital based drug information centre
Equipment
Number(s)
Chair
10
Desk
Working table with chair
Filing systems/cabinet
Microfiche filing system cabinet
Book and journal shelf
Journal display rack
Notice board
Teaching board
Computer desk with chair
Table for microfiche reader/printer
Photocopier* (with facility to produce multiple collated copies, capable of copying bound volumes,
capable of photocopying overhead transparencies, facility to reduce and enlarge)
Microfiche reader/printer (compatible with database requirements)
Computer (compatible with the database requirements, with printing facility, appropriate
software programs, internet access with separate telephone lines)
Telephone (preferably with STD access)
Calculator or computer program (with facility for pharmacokinetic calculations and basic
statistical functions)
Overhead projector
Fax machine
1
1
Financial issues
The source of finance depends on the objectives and
operational modalities
Ideally funding may be sought from governmental
authorities [as DI is public service]
Other sources
--donors supporting essential drugs projects
-- professional associations,
-- universities/pharmacy and medical institutions
-- non-governmental organizations
Collation of several of these groups can also fund the drug
information centers
Financial issues
No matter how the drug information centre is financed, the
integrity of the unit is paramount
No special interests should be able to influence what
information is or is not given out
Drug information centre should devote suitable amount for both
human resources and non human resources
Sample budget for establishing & maintaining a DI centre

* Approximate annual cost
Set up costs*
(Rs)
(First year)
Running costs*
(Rs)
(Subsequent years)
Salaries (1 pharmacist, 1 assistant / clerical staff)
180,000=00
180,000=00
Journals
50,000=00
50,000=00
Books
200,000=00
50,000=00
Databases
300,000=00
300,000=00
Equipment & office furniture
200,000=00
Nil
Bulletins/Newsletters (4 per year)
30,000=00
30,000=00
Telephone and Internet
20,000=00
15,000=00
Stationary
15,000=00
15,000=00
Conferences/Continue education programs

(2 per year)
10,000=00
10,000=00
Photocopying costs
5,000=00
5,000=00
Item
Total
10,10, 000=00
6, 55, 000=00
Staff
The DI centre should have a multidisciplinary team
Ideally the number of personnel should be related to call
volume
In case of hospital based drug information centre, the number
depends on beds strength
Staff
Number of full time equivalent pharmacists and other staff required for
operating a drug information centre (minimum required)
No. of beds in
the hospital
Less than 200
200 - 500
More than 500
No. of full time

equivalent
pharmacists
required
1
Assistant / clerical
staff
3-4
Staff
Basic requirements for drug information pharmacists
-- Master of Pharmacy degree

(Preferably Clinical Pharmacy / Pharmacy Practice)
-- Registered pharmacist
-- Training in computer based information systems
-- Two years of experience in DI services
Staff
Basic requirements for drug information pharmacists
-- Knowledge about literature identification, selection,

utilization and critical
evaluation
--Training in verbal,
communication skills
written
and
telephone
-- Involvement with in-service educational activities

Organization
The drug information services should have an organization
that should involve in the preparation of
guidelines & policies

procedures
manuals
establishment of staff
allocation of staff
deciding the hours of the operation
Organization
The policy and procedure prepared by the organization
should answer the following questions:
What must be done?

What is the purpose?
When it should be done?
Who should do it?
How it should be done?
Organization
The guidelines and policies prepared by the centre should
serve as:
Guide for training new employees

Control tool in ensuring a defined procedure for
performing a task
Means for evaluating job performance
Important element for action arising from an
error
Resources
The drug information centre must well equipped with
current information resources based on services
provided
The source of information may include primary,
secondary and tertiary resources
The collection of resources must represent variety of
pharmaceutical and therapeutic literature available and
must be adequate to ensure timely response to the
enquiries
Resources
The drug information centre should have:
Access to the medical journals (local and international),

which may be through a library attached to the hospital
Adequate number of appropriate reference texts
In house information system (with relevant articles)
Access to on-line data retrieval systems and drug
information databases for obtaining the published
articles
Tertiary sources
(minimum requirements)
Title
Standard references and textbooks
AHFS Drug Information. Mc Evoy GK, ed.
Australian Medicine Handbook
Averys Drug Treatment. Speigth TM, ed.
Basic skills in interpreting the laboratory data illustrated with
case studies. Traub SL, ed
Current Medical Diagnosis and Treatment. Tierney LM, ed.
Davidsons principles and practice of medicine. Haslett C, ed.
Drug Information Handbook. Lacy C.
Drugs in Pregnancy and Lactation. Briggs GG.
Drug Interactions. Stockley IH.
Drug Interaction and updates. Hansten PD.
Drug Interaction facts. Tatro DS, ed.
Drug Prescribing in Renal Failure: Dosing Guidelines for
Adults. Aronoff GR.
Ellenhorns Medical Toxicology.www.revolutionpharmd.com
Ellenhorn MJ.
Requirement
E
D
E
D
D
D
E
E
E
E
E
E
E
Tertiary sources
Formulary manuals
British National Formulary
Indian Pharmacopoeia
British Pharmacopoeia
United States Pharmacopoeia
USP National Formulary
Australian Pharmaceutical Formulary and Handbook
Pediatric Pharmacopoeia. Kemp CA, ed.
Tertiary sources
Standard treatment manuals
Essential Drug List
Hospital Level Standard Treatment Guidelines
Periodicals
Current Index for Medical Specialties
Drug Index
Drug Today
Indian Drug Review
E
Medical Dictionaries
Stedmans Medical Dictionary
Oxford Concise Medical Dictionary
Dorlands Medical Dictionary
Tertiary sources
Drug bulletins and newsletters
Australian Adverse Drug Reactions Bulletin
Uppsala Reports
Clinical Pharmacy Newsletter JSS College of Pharmacy,

Mysore
Clinical Pharmacy Newsletter JSS College of Pharmacy, Ooty
Clinical Pharmacy Newsletter College of pharmaceutical

Sciences, Manipal.
Secondary sources
Title
Requirements
Medline
International Pharmaceutical Abstracts
Chemical Abstracts
Iowa Drug Information Service
Drugdex
Poisindex
E
Primary sources
Title
Annals of Pharmacotherapy
Journal of American Medical Association
British Medical journal
Drugs
Drugs and Therapeutics Bulletin
Lancet
Medical Letter on Drugs and Therapeutics
New England Journal of Medicine
Australian Prescriber
Pharmaceutical Journal
Hospital Pharmacist
Journal of Clinical Pharmacy and Therapeutics
Indian Journal of Clinical Practice
Journal of Association of Physicians of India
National Medical Journal of India
Indian Journal of Medical Sciences
Drugs safety
Requirement
EA
EA
EA
D
EA
EA
EA
EA
EA
E
E
D
D
D
E
E
EA
Operational Procedures
A. Services to be offered
The drug information centre should clearly indicate

the scope of service provided
For example:
Oncology services
Pregnancy lactation services
Drug information centre should involve in following activities:
Providing medication information to patients, healthcare professionals and other personnel/public

Establishing and maintaining formulary based on
scientific evidence of efficacy and safety, cost, and
patient factors
Developing and participating in efforts to prevent
medication misadventure, including adverse drug
event and medication error reporting and analysis
programs
Developing methods of changing patient and healthcare provider behaviors to support optimal
medication use
Educating health-care providers about medication
related policies and procedures
Publishing newsletters to educate patients, families,
and health-care professionals on medication use
Coordinating program to support population-based
medication practices
Coordinating investigational drug services

Providing continuing-education service to healthcare professional staff
Educating pharmacy students and residents
Applying health economic and outcome analysis
Developing and maintaining the active research

program
Drug utilization evaluation program
Toxicology service
Therapeutic drug monitoring
B. Enquiry response
The drug information can be initiated by

pharmacists or requested by other health care
professionals, patients and their caretakers or the
general public
The pharmacist must not only accumulate and
organize the literature but also objectively evaluate
and apply the information from the literature to a
particular patient or situation
Modified systematic approach should be followed
for answering the drug information enquiries
C. Hours of Service
The drug information centre must make known

when it will be available to receive the enquiries
As a minimum the centre should operate during the
normal working hours of the hospital
In case of after hours of service appropriate
arrangements should be in place for after hour
enquiries [e.g., use of answering machine/ automatic call diversion system]
D. Fee for Service
Services must be free of charges to the enquirers,

particularly in the emergency cases
If the charges are to be fixed only minimum charges
may be collected and the charge per call should be
fixed on the basis of no loss and no profit
Documentation
Documentation is one of the essential elements in the
practice of drug information service in terms of both
legal and future reference purpose
should maintain the documentation of drug
information queries received and the responses
provided
All the documented enquiries should be stored for a
minimum of 5 years and may be for the longer
period (25 years) for the queries related to pregnancy
and lactation
Documentation
The documentation of the drug information requests and
responses should include the following:
Date and time of receipt of the enquiry.

Requesters
name,
address,
professional
status/occupation/discipline, method of contact (e.g.,
telephonically, direct access)
Previous references consulted by the enquirer
Information about the pharmacist receiving the
enquiry
Documentation
Category of the enquiry

Question asked
Patient data [specific information related to the enquiry]
Answer provided
Date and time of answering
Documentation
References used for answering the enquiry

Mode of reply [e.g., verbal, written, printed literature]
Method of delivery [e.g., telephone, personal visit, mail]
Time spent in answering the enquiry
Documentation
Information about the pharmacist answering

the enquiry
Follow-up information
[e.g., impact on patient outcome,

improvement in medication use, requestor satisfaction]
Quality assurance
The aims of the drug information centre need to be
met and this can be assessed by the application of
quality assurance program
The drug information centre should measure how
well the services were provided, and if the services
were not found to be acceptable or optimal, centre
should undertake some correctional measures to
ensure that future services will be acceptable
Quality assurance
General assessment techniques that can be used for the
quality assurance of DI services
Workload statistics
Auditing
Peer review
Enquirers assessment/Users survey
Quality
assurance
Key areas of drug information where in the quality should be monitored
Inputs level
Staff
Resources
Organization
Processes level
Receiving enquiries
Search strategy
Data collection
Literature evaluation
Formulation and communication of response
Documentation and storage
Outputs level
User satisfaction
Patient outcome
DIwww.revolutionpharmd.com
publications
Quality assurance
A quality assurance program for a drug information centre
should involve the following steps:
Assigning responsibility for monitoring quality

assurance activities
Describing the scope of services provided by the
centre
Identification of the most important aspects of the
services provided
Quality assurance
Identification of the indicators for monitoring the

important aspects of services provided
Establishment of the threshold/minimum expected
level of performance
Monitoring by collecting and organizing the data on
indicators
Quality assurance
Identification of the problems and opportunities to

improve the services offered by evaluation of the
data collected
Taking actions to improve the services or correct the
identified problems
Quality assurance
Assessment of the effectiveness of correction and

documentation of the improvement in services
provided
Communication of the results of quality assurance
program
Conclusion
Adequate infrastructures with well-qualified and
trained staff are must for the effective functioning of
any drug information centres
Pharmacists as "medication managers" can not only
play a vital role in the patient management but may
also find suitable place in the healthcare system by
developing and maintaining image and credibility
through effective provision of drug information
services

Establishing DI Centre.

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Establishing a Drug Information

1. Specific room set aside as location for drug

The plan should include:

Justification of the need for a centre

Establishment and minimum requirements

Establishment and minimum requirements

Establishment and minimum requirements

Location of the centre

Few ideal locations

A secure space of 25 square meters in one or two rooms

Facilities and equipments

The minimum equipments required for effective operation of a major

Working table with chair

Microfiche filing system cabinet

Book and journal shelf

Journal display rack

Computer desk with chair

Table for microfiche reader/printer

Microfiche reader/printer (compatible with database requirements)

Telephone (preferably with STD access)

Sample budget for establishing & maintaining a DI centre

Salaries (1 pharmacist, 1 assistant / clerical staff)

Equipment & office furniture

Bulletins/Newsletters (4 per year)

Telephone and Internet

Conferences/Continue education programs

Less than 200

More than 500

No. of full time

-- Master of Pharmacy degree

-- Knowledge about literature identification, selection,

-- Involvement with in-service educational activities

guidelines & policies

What must be done?

Guide for training new employees

Access to the medical journals (local and international),

United States Pharmacopoeia

USP National Formulary

Australian Pharmaceutical Formulary and Handbook

Pediatric Pharmacopoeia. Kemp CA, ed.

Hospital Level Standard Treatment Guidelines

Indian Drug Review

Stedmans Medical Dictionary

Oxford Concise Medical Dictionary

Dorlands Medical Dictionary

Clinical Pharmacy Newsletter JSS College of Pharmacy,

Clinical Pharmacy Newsletter JSS College of Pharmacy, Ooty

Clinical Pharmacy Newsletter College of pharmaceutical

International Pharmaceutical Abstracts

Iowa Drug Information Service

The drug information centre should clearly indicate

Drug information centre should involve in following activities:

Providing medication information to patients, healthcare professionals and other personnel/public

Coordinating investigational drug services

Developing and maintaining the active research

The drug information can be initiated by

The drug information centre must make known

Services must be free of charges to the enquirers,

Date and time of receipt of the enquiry.

Category of the enquiry

References used for answering the enquiry

Information about the pharmacist answering

[e.g., impact on patient outcome,

Assigning responsibility for monitoring quality