Drug Information
Resources Review
Jennifer L. Rodis, PharmD, BCPS
The Ohio State University College of
Pharmacy
October 25, 2011
Objectives
Review the differences between primary,
secondary, and tertiary resources
 Discuss the value of each resources type
 Provide a refresher on searching Pubmed

Types of Literature
Types of literature

3 main types of drug information literature
– Tertiary
 Interpretation of primary data
– Secondary
 No interpretation, just helps you find sources
– Primary
 Original research & analysis
Real-life Research
Tertiary Literature
Summarizes and interprets the primary
literature
 Information generally well accepted
 Place to start for basic information and
guidance
 Can inform your subsequent research

Tertiary Literature

Advantages
– Convenient, accessible
– Often available online
– Review process of information is already done

Disadvantages
– Lag time
– Not as complete
– Author’s interpretation
Tertiary Literature

Textbooks
– Electronic also

Compendia
– Electronic also

Full-text computer databases (Internet)

Review articles
Tertiary Resources – Drug
Databases

Online
– Lexi Comp CRL
– MICROMEDEX
– Drug Facts and Comparisons
– MD Consult
– AHFS Drug Information
– Epocrates

Print
– PDR (Physician’s Desk Reference)
Tertiary Resources - Books

Print Books
– Remington’s
– Trissel’s (2 titles)
– Handbook of Nonprescription Drugs
– Redbook
– Drugs in Pregnancy & Lactation (aka: Brigg’s)
– Martindale: The Complete Drug Reference
Tertiary Resources - Other







UpToDate
Pharmacist’s Letter
Natural Medicines Comprehensive Database
Ohio Administrative Code (pharmacy.ohio.gov)
FDA.gov (Orange Book, Drugs@FDA)
CDC.gov
Professional Organizations
– APhA’s MTM Central


Package Insert
Manufacturer web sites
Using Tertiary Literature
1.
2.
3.
4.
5.
6.
Does author have expertise?
Is the information current?
Is the information supported with
citations?
Does the resource contain relevant
information?
Is the resource free of bias or errors?
Is it clear/concise/easy-to-use?
Secondary Literature
Guides you to the primary and tertiary
literature
 Indexing

– Bibliographic info only

Abstracting
– Bibliographic citation plus brief summary of
article or resource

Almost all are electronic format
Secondary Literature

Advantages
– Simple search strategies
– Very current citation information
– Access point for tremendous amount of
primary sources

Disadvantages
– Understanding coverage of the database
– Tweaking search strategies unique to each
database
Secondary Resources
ClinAlert
 EMBASE (Elsevier)
 International Pharmaceutical Abstracts
(IPA)
 Iowa Drug Information System (IDIS)
 Journal Watch
 Lexis-Nexis
 MEDLINE / PubMed

Primary Literature

Primary research
– Journal articles that are:
 Case reports
 Drug studies
 Original reports of data
– Meta-analysis?
– Unpublished studies
Primary Literature
Considerations

Evaluating the basics
– Peer-reviewed
– Journal reputation
– Source of funding

Digging deeper
– Study methodology
– Clinical relevance
– Patient populations
Primary Literature

Advantages
– Most current published source
– Tremendous range of information
– Personally assess utility/validity

Disadvantages
– Overwhelming volume
– Interpretation of results
– Not yet vetted by experts
Primary Literature

Peer-reviewed journals
– JAMA
– New England Journal of Medicine
– American Journal of Health-system Pharmacy
– Annals of Internal Medicine

Non-peer reviewed journals
– Supplements
– Pharmacy Today
What’s the difference?
Ease of Use
Tertiary
Secondary
Primary
What’s the difference?
Most Current
Primary
Secondary
Tertiary
Alternate Sources of DI
Internet, Listservs, and medical news
briefs
 Local and national professional
organizations and meetings
 Pharmaceutical manufacturers
 Drug information and poison control
centers

Searching Strategies

Begin broad, then narrow your search
– Start with tertiary sources

Use “related articles”
– Bibliographies
– Secondary resource guides

Always be sure to assess most up to date
information available
– Primary sources
Searching Pubmed
Searching Strategies
1.


Develop focused question and break into parts
What is the question asking?
“Is peptic ulcer prevention with proton pump
inhibitors and NSAIDs dose-related?”
–
–
proton pump inhibitors, dose, non-steroidal antiinflammatory agents, prevention of peptic ulcer
disease
Other forms of the above words and phrases
Searching Strategies

Putting together an answerable question is
key to successful evidence-based medicine
practice
– Use PICO method
 Patient or problem
 Intervention
 Comparative intervention
 Outcome
Be Specific!
Example: PICO

What is the minimum
or maximum dose of
NSAIDs at which

Patient or problem
proton-pump
inhibitors are

Intervention

Comparison

Outcome
effective for peptic
ulcer disease
prophylaxis?
Searching Strategies
2.
Read up on the basics of the question

Start with tertiary resources for foundation
Build on information gathered from texts,
review articles, and drug databases with a
primary literature search

Searching Strategies
3.
Gather as many articles as possible for
all of the parts of the search
Use MeSH headings to help narrow or broaden
your search
 MeSH = Medical Subject Headings
– Official indexing terms for MEDLINE

Searching Databases: Basic
Boolean

“AND”
– Combines 2 terms (shrinks search)

“OR”
– Gives database more choices (broadens search)

“NOT”
– Limits search (removes undesired terms)
Basic Boolean
Both words must be present in results
paroxetine AND suicide
Basic Boolean
Either word can be present in results
paroxetine OR suicide
Basic Boolean
The first but not the second term will be present in the results
paroxetine NOT suicide
Pubmed Search Example
What is the minimum or maximum dose of
NSAIDs at which proton-pump inhibitors are
effective for peptic ulcer disease prophylaxis?
Search keywords
Proton pump inhibitors and dose and nonsteroidal anti-inflammatory agents
 proton pump inhibitors and dose and nonsteroidal anti-inflammatory agents and
prevention of peptic ulcer disease
 MeSH term search: PPIs, NSAIDs, PUD

http://www.ncbi.nlm.nih.gov/pubmed/19240698
Resources

Adapted from lectures by Bridget Protus, PharmD, CGP, MLS
delivered 1/2010.

Thrower MR. Literature retrieval and Finding Resources
Electronically. In: Felkey BG, Fox BI, Thrower MR. Health care
informatics: a skills-based resource. Washington DC: American
Pharmacists Association; 2005. p. 191-228.

West, PM. Literature evaluation. In: Pharmacotherapy self-
assessment program: science and practice of pharmacotherapy, 5th
ed. (PSAP V). Kansas City: American College of Clinical Pharmacy;
2005. p. 93-110.

Shields, KM. Drug information resources. In: Malone PM, Kier KL,
Stanovich JE. Drug information: a guide for pharmacists, 3rd ed.
New York: McGraw Hill; 2006. p.61-101.
Resources

Thrower MR. Literature retrieval and Finding Resources
Electronically. In: Felkey BG, Fox BI, Thrower MR.
Health care informatics: a skills-based resource.
Washington DC: American Pharmacists Association;
2005. p. 191-228.

West, PM. Literature evaluation. In: Pharmacotherapy
self-assessment program: science and practice of
pharmacotherapy I, II, III. Kansas City: American
College of Clinical Pharmacy; 2005. p. 93-5.