The many changes that are taking place in the healthcare arena have precipitated the need for gathering accurate up-to-date information. For example:

• The Worldwide trend to move from a product-oriented to a knowledge-based practice makes it necessary for all pharmacists to be "information literate". There is more emphasis now on how the medicine is used and by whom. Pharmaceutical care is the responsibility of the pharmacist and this is an important facet in the whole healthcare management scenario.
• The Worldwide Drug Information explosion - The number of new medicines is increasing rapidly - many of them are more potent and more complex, requiring a greater depth of knowledge to use them safely and effectively. The volume of information has expanded at an alarming rate - more than 10,000 medical journals are published annually throughout the world.
• The adoption of a National Drug Policy. Countries throughout the world are implementing National Drug Policies - The objective is to provide rational, safe, effective and affordable patient care. One of the fundamental requirements in order to achieve this, is that the health professionals have an in depth knowledge and understanding of the medicines. Pharmacists should take responsibility for this.
• The demand for public access to health-related information is growing. The patient is taking more responsibility for his or her health and to do this they need drug related information. Pharmacists should be aware of what information the patient is accessing and should be able to supply accurate and pertinent information in a user-friendly and practical manner.
• Changes to the various Acts and Regulations governing drug use in South Africa and the restructuring of the Medicines Control Council - MCC (MRA) Pharmacists in South Africa will need to keep abreast of the new legislation and regulations currently being forumlated.

Having ascertained the need for current and accurate information lets look at the information resources available and their advantages and disadvantages.

Journals - these are excellent for up-to-date information and for original articles, but they are expensive and it is difficult to retrieve articles.

Books - These supply comprehensive information but are not always up to date. They are also costly as you need to keep the latest edition.

CD Rom databases - These offer comprehensive, up to date and easy to find information, but can be rather expensive. Examples include:

• Medline - 3400 journals are scanned and 30000 abstracts are added annually
• Drugdex - This database includes monographs of drugs as well as an adverse drug reaction program
• IDIS - indexes 200 journals. The entire article can be accessed. 1600 articles are added to the database monthly
• Cochrane Collaboration - This is an evidence-based database

The Internet -

Many of the above resources (as well as a host of other information) are available on the Internet, making it the most comprehensive information resource available. There are however, primarily 2 problems that need to be addressed.

Information overload -
Information is being added to the Internet at a phenomenal rate and as it continues to grow and develop, it is becoming more and more difficult to rapidly access relevant and reliable information.

Disinformation
The information supplied may not always be correct as there is no watch dog to ensure accuracy. It is difficult to distinguish the useful information from the harmful as information may be incomplete, misleading and inaccurate. it is important therefore to assess and evaluate the information carefully before using it.

Of particular concern is the quality of information aimed at the consumers as they have no way of assessing the accuracy.

This latter problem is being addressed in various ways:

• HON - Health On the Net. This is a Foundation Code of Conduct for medical and health web sites, which deals with issues relating to reliability of information and possible biases through advertising.
• FDA - Are going to regulate advertising and promoting on the internet.
• The Advertising Standards Agency in the UK will also be monitoring advertising and promoting, but only from companies originating in the UK.
• Medicines Control Agency - will monitor prescription medicine marketed on the internet.

The objectives of PHARMNET are:

• to provide easy access to accurate and up-to-date pharmaceutical and related information to all users.
• to provide easy communication with your colleagues, other health care workers and the public

PHARMNET reviews and evaluates information sources and links users to relevant sites so that they do not have to search for hours to find the required information. In addition, PHARMNET also hosts information specific to South Africa, such as Travel Health information, District Health Services and generic substitution. This site is constantly being updated and expanded.

Below are examples of some of the information available through PHARMNET.

Clinical information: Drug-based (found under the Drug information section)

The South African Medicines Formulary

Raymot’s International drug dictionary

Martindale’s virtual pharmacy

Clinical information: Disease-based (also found under the drug information section)

Merck Manual - This is currently being updated and will be unavailable for awhile, but it is an excellent source of clinical information

The University of IOWA Family Practice Handbook

South African specific information

The Essential Drug List for Primary Health Care

Health legislation and policy (found under the regulatory services section)

Government departments (found under the regulatory services section)

District Health Systems (found under the regulatory services section)

Package inserts

The South African Medicines Formulary

Prescribing guidelines (all under the drug information section)

Healthlink

WHO Guide to good prescribing

Martindale’s Virtual Pharmacy

There is also a comprehensive section on Evidence based medicine and links to drug information queries

PHARMNET is constantly expanding and will continue to review information on the Internet and will endeavor to make appropriate information available to meet the needs of all its users.

www.pharmnet.co.za

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