Limitations of Common Information Sources used by UKMi
version 11.0, February 2016 – Major changes since last edition in October 2015, picked out in red
This is not a comprehensive guide. It is a list of observations from experienced pharmacists that has been shared to help others appreciate that no
information source is “perfect”.
General Issues
(1) No single source is totally comprehensive or completely up-to-date in all respects and all databases have the potential to have search
function anomalies; use your professional judgement to decide when you need to verify facts in another resource.
(2) Think about synonyms when searching books, databases or websites since cross-referencing is not always reliable
(e.g. “hypericum” vs. “St John’s Wort”; “alopecia” vs. “hair loss”).
(3) In US texts remember that some generic names differ from the UK. There is a UKMi Q&A that addresses this issue:
http://www.medicinesresources.nhs.uk/upload/documents/Evidence/Medicines%20Q%20&%20A/QA62_4USdrugnames.doc
(4) You should expect most books to be at least 1-2 years out-of-date at the point of publication. Even paper texts that are updated on a
regular basis eg Martindale, Stockley and Hale, have online versions that are updated more regularly
(5) A webpage retrieved from a search engine such as Google may be an old version (a ‘cache’ page). For more information see:
www.googleguide.com/cached_pages.html so ‘refresh’ web pages to be sure you get the current version. (If you want to find an old
version of a webpage try www.searchengineshowdown.com/others/archive.shtml )
(6) Some governmental websites can hold several versions of the same document.
(7) UKMi provides guidance to help you decide on the reliability of information on the web:
www.ukmi.nhs.uk/filestore/misc/EffectiveuseoftheInternetforEnquiryAnswering_v1.1Dec.doc
(8) When using any database, including Embase and Medline, be aware that keywords and subheadings may have been chosen by nonmedical personnel and as such may not always be entirely consistent or logical.
(9) Some websites are particularly difficult to search eg MHRA and NICE. For a general search of these sites, use Google Advanced Search
and cut and paste the website address eg www.mhra.gov.uk into the box labelled “Search within a site or domain”. Then enter your search
terms.
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Risks with Specific Sources
Source
Risk Issues
BNF
(1) Wherever possible the web version of the BNF should be used in preference to the printed version as it is updated
monthly (including errors and clarifications).
(2) All users of the BNF should read the section How to use the BNF.
(3) The introductory paragraphs to sections often contain important information which can be missed if users consult
individual monographs only.
(4) Listed side effects may not indicate frequency of occurrence.
(5) Indications/ uses/ unlicensed uses etc sometimes reflect the views/ practice of experts and so may not be evidencebased or the same as in the SPC.
Department of Health website
The site’s search engine does not always function well. It is often better to use Google instead. Use Advanced Search
and cut and paste www.dh.gov.uk into the box labelled “Search within a site or domain”. Then enter your search terms.
Embase via NHS Evidence
(platform is Ovid)
eMC
(1) Years covered are less than for Medline – consider the implications of this when searching for older drugs.
(2) Remember to think laterally and try a variety of search strategies to find relevant results.
(1) Individual SPCs may not list certain excipients if the medicine contains extremely small (“trace”) amounts. If it is vital
to avoid all exposure to a given excipient it would be wise to ring the manufacturer and check.
(2) Although coverage is continually improving, not all SPCs for generic products are available through the eMC.
Fridge Database
If you do not find what you are looking for, search using generic name or brand name. Only updated every 2 years –
manufacturing process may have been updated during this time.
Handbook on Injectable Drugs
(previously known as Trissel)
Gives information mainly on American preparations. Note that formulations may differ between the US and UK and this
can affect compatibility.
Homeopathic Pharmacy
UKMi does not endorse the use of homeopathy, however this book may provide information to help answer questions on
this subject matter.
A few monographs have not been updated recently. Check with more recent sources if necessary.
IV Guide on Medusa
Medications in Mothers’ Milk
(“Hale”)
(1) Some monographs are based on more complete literature searches than others. Be careful about relying upon as a
sole source.
(2) An on-line subscription to Hale is preferable, since this is updated on an ad-hoc basis in between published editions.
However, when a new paper edition is published, for a short period, this may be the most up-to-date version. There
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Source
Risk Issues
is a lag time, of around a couple of months, until the on-line version is updated and brought in-line. During this time,
if a Centre has both a print and an on-line version, both copies should be checked. Alternatively, if the information
cannot be clarified elsewhere, one of the specialist breast-feeding centres can be contacted to double check both
versions.
Medline via NHS Evidence
MHRA website
Micromedex
National Travel Health Network
and Centre (NaTHNaC)
Natural Medicines Comprehensive
Database
(1) This resource does not include ePub Ahead of Print publications. In order to access these it is necessary to search
PubMed
(2) Remember to think laterally and try a variety of search strategies to find relevant results.
(3) NICE Evidence has changed provider for Medline from OVID to Proquest. Currently (September 2015) searches
may not be working as anticipated. Users are advised to be aware of this and to consider repeating searches in
Embase and PubMed. NICE is aware and is working to resolve this issue.
(1) If searching Drug Analysis Prints online check which term the database uses for the side effect in question (e.g.
dysgeusia or ageusia rather than ‘taste disturbance’).
(2) Also remember that the term you are looking for may appear under more than one heading – suggest using ctrl F
function with different possible spellings.
(1)
(2)
(3)
(4)
These are mainly US databases. Check they reflect UK practice.
Check currency via the “last modified” date after the references list at the end of monographs.
Whilst SPCs are held – users are advised that they may not be as up-to-date as those on the eMC.
Be careful of American spellings – if looking down a lot of interacting drugs make sure you check the American
name (e.g. pethidine/meperidine; salbutamol/albuterol etc. See Q+A (Point 3 of general issues above) for more
examples).
(5) Martindale – symbol denoting withdrawn brands does not appear – access Martindale via Medicines Complete if
available.
Change of name – see Travel Health Pro.
(1) Some natural medicines have very similar or identical names but contain different ingredients. Check names
carefully.
(2) This is a US database, and European brand names are not always included.
(3) Beware using the ‘interaction checker’ in isolation as this might miss pharmacodynamic interactions as well as drug/
disease interactions.
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Source
Palliative Care Formulary 5th
edition
Renal Drug Handbook 3rd edition
+
Renal Drug Database
Risk Issues
(1) If the paper format is purchased, ensure you are registered on-line since the syringe driver tables remain free to
access. Also ensure that you have ticked to receive emails and alerts, and you will then be notified of any further
errors identified.
(1) Despite some references to published data, some dose recommendations are based upon specialist
experience/practice.
(2) As the doses given may therefore differ from the licensed doses, it is particularly important to check the SPC as well.
Stockley’s Drug Interactions
(1) This is not and was never intended to be a definitive guide to every possible drug interaction so should not be used
as a sole source for “screening” patients’ medications for potential interactions.
Tic-Tac
(1) Sometimes colours are described oddly within the database so, if possible, focus on other characteristics instead/as
well to aid identification where possible.
(2) Sometimes the shape/plan descriptions of tablets can be misleading. When searching consider all the potential
options that could have been used.
(3) Avoid using the size function to narrow down your search, as this risks excluding matching products.
(4) Products that have recently been added and for which a sample is awaited will only be found by searching the ‘any
product form’.
(1) Enquiries on the treatment of acute poisoning are not normally handled by MI pharmacists but where this is agreed
local practice Toxbase should only be used as part of the search strategy if training in its use has been undertaken.
Toxbase
Travax
(1) This advice is based on that produced by NHS Scotland and may differ from advice in other sources (i.e. NaTHNac).
However, all advice is evidence based. It is advised that one resource only is used in these circumstances.
Travel Health Pro (formerly
NaTHNaC)
(1) This advice is based on that produced by the HPA (now part of Public Health England) and may differ from advice in
other sources (i.e. Travax, Fit for Travel). However, all advice is evidence based. It is advised that one resource only is
used in these circumstances.
UCL Hospitals Injectable Medicines
Administration Guide – 3rd edition
(1) This edition contains a number of errors which were not notified on the publication’s website. These have been
shared via the UKMi network. If any other errors are found, UKMi will circulate them via its network.
(2) The information contained in the guide mainly reflects local practice.
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