Evidence based prescribing

Question 1

Define clinical pharmacology

Answer 1

Is the science of drugs and their clinical use. It is underpinned by the basic science of pharmacology, with added focus on the application of pharmacological principles and methods to the real world

Question 2

Define therapeutics

Answer 2

Is the provision of treatment and care to combat disease or alleviate pain or injury. It’s tools include drugs, surgery, radiation therapy, mechanical devices diet and psychiatry

Question 3

What is the information needed for safe and effective therapeutics

Answer 3

Increasing therapeutic complexity
Extension of prescribing to non medical professional groups
Patient engagement in therapeutic decisions

Question 4

The problem for today’s prescribers

Answer 4

Increasing morbidities
Complex therapies
Too much info
Too many formats

Question 5

What is the 5 step approach to using evidence based practice

Answer 5

1- asking relevant questions
2- finding the most robust evidence to answer the question
3- using skills of critical appraisal to review the evidence
4- applying the findings to the realities of clinical practice and the needs of the individual patient/client
5- reviewing the first 4 steps and considering changes for the next time

Question 6

Important to consider when prescribing

Answer 6

Harm vs benefit balance

Question 7

Golden rules of prescribing

Answer 7

Maximises benefits
Minimising harms
Minimise the benefit: harm ratio

Problem :society vs the individual

Question 8

What evidence do you need to licence a drug

Answer 8

Safety
Efficacy
Cost

Question 9

What is opportunity cost

Answer 9

If the NHS spends more on one thing it ha sleds the spend on another

Value of the best alternative use of the resources

Question 10

What do you need to consider when applying study results to a patient

Answer 10

Would this patient
Meet the inclusion criteria of the study
Does not meet any of the exclusion criteria

Are results from trials generalisable

Question 11

What is the role of pharmacists

Answer 11

Pharmacists are involved at all stages in medication use process
Recommendation that prescribers have access to a pharmacist who is able to provide advice on drug treatment plans
Most NHS providers have access to medicine info department / pharmacists
Pharmacists will conduct medicine use reviews suggesting strategies to optimise treatment