Organizing Drug and Poison Information Centres

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Drug and Poison Information Centres

Anantha Naik Nagappa and Uday Venkat Mateti

Manipal College of Pharmaceutical Sciences, Manipal University, Karnataka, Manipal, India-576104

What are Drug Information Centres?

Drug Information Centres (DIC) are the service centers established in hospitals, community pharmacies and patient counseling centres who are providing an information sought by a doctor, nurse or patients on demand about a drug and its actions, dosage and administration and all other precise information based on which a clinical decision can be taken by a clinicians .

What are Poison information Centres?

The Poison Information Centres (PIC) are usually located in the hospital to provide quick precise and latest information on demand by a clinician where emergency treatment of poison cases are treated.

What is the scope of Drug information services?

DICs have a responsibility to provide classified authentic information on demand by clinicians about drugs. They are also should provide the information arising during ward rounds and enquires by patients. Drug information demand may also come from nurses and other hospital staff including pharmacist. The pharmacist in-charge should be able to assess the emergency and gravity of condition to meet the challenge of providing timely information. The Drug information is very vast and keeps on changing due to research all across the world.

What is the scope of Poison information services?

The Poison information services are usually emergency enquiries and timely reporting is very essential unlike drug information. Drug information may range from emergency to a casual enquiry. Hence the poison information services are attended on priority basis. The timely delivered information can save a patient life.

Who is a competent person to head DIC?

The Clinical pharmacist who is on ward rounds is an appropriate professional. The pool of clinical pharmacist on rotation of the duty is competent to head a DIC. If a dedicated clinical pharmacist is made the sole in-charge of DIC. He will not be aware about the developments and patient environment of the hospital. In case DIC is attached to community pharmacy where in patients ask the pharmacist for information. The in charge pharmacist can also act as DIC head.

Who is a competent person to head PIC?

The toxicologist is a natural competent person to head a poison information center. However clinical pharmacist can assist a toxicologist to provide poison information services as there is similarity in the approach of handling a DIC enquiry.

What are the suitable locations for DIC?

The drug information is sought by doctors, nurses and patients. The objective of the doctors and nurses is to clarify their doubt and ensure authenticity of information related to drugs while clinical practice and administration of drugs. The patients likely to ask the questions regarding drugs about dosage, storage, usage, ADRs and specifications for drug-drug interactions about the drugs they have been prescribed. For the doctors and nurses the ideal location would be department of pharmacy practice located in the hospital. For patients the ideal location is community pharmacy or independent pharmacy consultant rooms.

What are the suitable locations for PIC?

The information regarding poisons is usually sought from ICUs while treating the poison cases admitted in the hospital. The poison information Centre should be located in a hospital preferably near to drug information centers. This would help quick two way communication for DIC and PIC it would help to deliver the quality information timely.

What are the advantages of having an independent of DIC?

The independent DIC headed by a clinical pharmacist can offer better services and strive to achieve good quality information being provided to clients in a competitive manner. The independent DIC has to generate enough clients and earn a reputation through professional practice. The drug information can be sought for legal advisers a part from conventional clients like doctors, nurses and patients. The DIC can also run a pharmacovigilance program.

What are the advantages of having an independent of PIC?

The poison information center may be a resource and source of evidence for medico legal cases involving poison cases. The model independent PIC may be established by a state or local government as a point of reference for public and government. The PIC can also run a toxicovigilance program.

What is the suggested protocol for DIC and PIC services?

The suggested protocol for DIC and PIC services involves 7 steps

Figure 1: Protocol for DIC and PIC services

What are the resources for management of DIC and PIC?

It is the responsibility of the clinical pharmacist and toxicologist to safeguard that the up-to-date resources should be utilized in answering a variety of drug or poison information requests. There are three resources are required for the management of DIC and PIC services. The clinical pharmacist should first refer the tertiary resources like textbooks, review articles, clinical practice guidelines followed by secondary resources such as indexing and abstracting service such as Medline or international pharmaceutical abstracts, Micromedex and primary resources for example peer reviewed original studies.

What are the mechanisms of audit for DIC?

The criteria for audit should check the quality of the services delivered and also the time management in providing services. The quality of services can be checked at different service points mentioned in Figure 1. The time management can be documented and used for audit. The numbers of errors and omissions during service, laps in communication system are also important for audit.

What are the mechanisms of audit for PIC?

The poison information center functions on the critical enquiries which have serious consequence on outcomes of treatments. Especially patients admitted to hospital for poisoning in ICU. The demand for time management and precision of information are very important for audit of PIC.

What are the educational roles for DIC?

The DIC has a responsibility to train the human resources for its own operational function. Hence it should have programs of training the pharmacy practice students and involve them actively in the functioning of DIC. Apart from enquires from hospital the DIC also receives enquires from patients and health consumers. It becomes necessary to train the students in the skill area of communication with public. The program defines the need for continuous educational programs in data search and retrieval of information from data bases like Micromedex and Medline.

What are the educational functions for PIC?

The training of the toxicologist in the management of PIC is the major educational activity. The trainees should be experts in data extraction and interpretation with communication from a standard poison data bases. It serves to enhance epidemiological surveillance for identification of poisoning risk in the community, the substances, circumstances, and the populations involved, and to strengthen investigation of poisoning incidents of public health significance so as to implement control measures in a timely manner.

How to run 24 X 7 services for DIC and PIC?

The emergency services of ICU are functioning 24X7 in delivering treatment. In order to save life who are in critical state of health. The requirement for information of DIC and PIC are very urgently needed and there is a necessity to run a hotline for meeting challenge of services regarding the drugs and poison information. The 3 shifts of 8 hour model followed in production units of industry can be adapted.

References

1. SHPA Standards of Practice for Drug Information Services. Available from: http://www.shpa.org.au/lib/pdf/practice_standards/drug_info_ro.pdf

2. Surulivel Rajan M, Fayazkhan M, Kishore GS, Leelavathi DA, Padma GMR. Evaluation of Drug Information Service provided by clinical pharmacy department based on provider and enquirer's perspective. Indian J Pharm Pract. 2008;1(1):37-44.

3. Mateti UV, Rajesh V, Laddha A, Sharma S, Anantha NN. Activities of Pharm D students in Indian Hospital. Pharma Rev. 2011;7:133-4.

4. Guidelines for poison control. Available from: http://teach-vip.edc.org/documents/Child_poisoning/WHO_Guidelines_for_poison.pdf

5. Sam KG, Sharma MR, Khan KA, Thunga G, Padma Rao GM, Nagappa AN. Need for poison information centres in India - A review. Pharma Rev 2009;5:37-43.

6. Goulding R. Poison's information services: A look ahead. Hum Exp Toxicol 1991;10:401-4.

7. Mateti UV, Adla N, Sharma S, Rajakannan T, Nagappa AN. A critical and comprehensive review on toxicovigilance. Chron Young Sci 2011;2:182-5

About the Author

Anantha Naik Nagappa's picture

I am professor, intrested in developing the community pharmacy services in India, We have an association called ASSOCIATION OF COMMUNITY PHARMACISITS OF iNDIA. CHECK AT www.acpi.in for further detials

Comments

Hitesh Patel's picture

Sir,

Is there any national level centers available in India.  According to my friend in USA, people  just need to call

1 (800) 222-1222 (American Association of Poison Control Centers)
Hours: 24 hours, 7 days a week
 
Is it same in India ?  DO we have any national body to call ?

 

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