A question–answer pair (QAP) database integrated with websites to answer complex questions submitted to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS): a descriptive study

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Abstract

Objective

To assess a question–answer pair (QAP) database integrated with websites developed for drug information centres to answer complex questions effectively.

Design

Descriptive study with comparison of two subsequent 6-year periods (1995–2000 and 2001–2006).

Setting

The Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS).

Participants

A randomised sample of QAPs from the RELIS database.

Primary outcome measure

Answer time in days compared with Mann–Whitney U test.

Secondary outcome measure

Number of drugs involved (one, two, three or more), complexity (judgemental and/or patient-related or not) and literature search (none, simple or advanced) compared with χ ² tests.

Results

842 QAPs (312 from 1995 to 2000 and 530 from 2001 to 2006) were compared. The fraction of judgemental and patient-related questions increased (66%–75% and 54%–72%, respectively, p<0.01). Number of drugs and literature search (>50% advanced) was similar in the two periods, but the fraction of answers referring to the RELIS database increased (13%–31%, p<0.01). Median answer time was reduced from 2 days to 1 (p<0.01), although the fraction of complex questions increased from the first to the second period. Furthermore, the mean number of questions per employee per year increased from 66 to 89 from the first to the second period.

Conclusions

The authors conclude that RELIS has a potential to efficiently answer complex questions. The model is of relevance for organisation of drug information centres.

Article summary

Article focus

A model with a national network of drug information centres in Norway (RELIS) with a common QAP database integrated with websites has been developed.
This article describes how the model makes it possible to effectively answer complex questions.

Key messages

A randomised sample of QAPs from two subsequent 6-year periods after RELIS started in 1995 were analysed retrospectively.
Comparison of the second to the first period shows RELIS' potential to answer complex questions with reduced answer time and more frequent use of previous answers in the database.

Strengths and limitations of this study

A randomised sample from the two periods was analysed.
The study is descriptive, and analysis is retrospective with poorly defined variables.
Development of RELIS (personnel and technology) as well as the internet during the total study period suggests that interpretation of the results should be performed with caution.

Related collections

Most cited references 12

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Update on the status of 89 drug information centers in the United States.

Britto P Nathan, H McGuire, Sara Schilit … (2009)

Previously identified U.S. drug information centers (DICs) were surveyed to determine whether they were still in existence and whether changes had occurred in the DICs since 2003. Eighty-nine DICs identified in a 2003 survey were surveyed in April 2008. For DICs still in existence, questions were designed to determine whether there were changes in the mission, time spent on activities, staffing, and drug information questions (number, complexity, and time required to answer) compared with five years earlier. Respondents' projected need for their DIC over the next five years was also surveyed. Seventy-five (84%) of the 89 DICs were still active. The most notable changes in activities were increases in time spent on educating health-professions students (53%), supporting the institution's medication safety program (44%), and providing information-systems support (36%). The majority of respondents (73%) reported no change in the number of employed drug information personnel. The percentages of DICs reporting an increase, decrease, and no change in the number of drug information requests received were 29%, 42%, and 29%, respectively. Seventy percent reported an increase in the number of complex questions, while 53% reported an increase in the time required to answer each question. Ninety-seven percent of respondents projected no change or an increase in the need for their DIC over the next five years. Eighty-four percent of the previously identified DICs were still in existence. The most notable changes in these DICs were increases in the number of DICs focusing on educating health-professions students, the complexity of drug information questions, and the amount of time required to answer each request.

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Problem-oriented drug information: physicians' expectations and impact on clinical practice.

U Hedegaard, P Damkier (2009)

Problem-oriented drug information (POD) is a service in which health professionals provide evidence-based answers to clinical questions posed by physicians. The objective of this study was to evaluate the user satisfaction and clinical impact of POD, to investigate predictors for use and to examine the kind of sources physicians search before applying for POD. To evaluate POD, a questionnaire was distributed with problem-oriented answers sent from a drug information centre to physicians during the period of April 2006 to March 2007. Of 197 questionnaires, 183 (93%) were returned. The information from the POD service was highly valued by the physicians, and 90% of the answers led to reported impact on clinical practice in the specific clinical situation. Furthermore, 74% of the answers were intended to be used in a wider context either for future patients (67%) or for dissemination to colleagues (51%). Secondary-care physicians more often than general practitioners (GPs) used the information for dissemination to colleagues (63 vs. 39%, P = 0.0008), while GPs more often used the answer to support patient information (88 vs. 70%, P = 0.0029). The most prominent motive for applying for POD was a request for evidence-based information (78%), and the service was used to overcome barriers to practicing evidence-based medicine such as lack of time (36%), skills for searching (26%), and appraising the literature (13%). Before inquiring, 74% of the physicians had tried other information sources; the most frequent sources used were a drug reference (68%) and consulting a colleague (24%). Secondary-care physicians reported fewer barriers than GPs when seeking information, and secondary-care physicians searched other sources more often than GPs before contacting the service (81 vs. 67%, P = 0.031). POD represents a useful source for acquiring evidence-based drug information by physicians. POD is highly valued by the users. It was reported to have an impact on clinical practice for the specific patient but is also intended to be used in a wider context for future patients or for dissemination to colleagues. GPs' and secondary-care physicians' use of POD differs with GPs having more focus on patient information and secondary-care physicians having more focus on dissemination of the information to colleagues.

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Which factors predict the time spent answering queries to a drug information centre?

Linda Reppe, Olav Spigset, Jan Schjøtt (2010)

Objective To develop a model based upon factors able to predict the time spent answering drug-related queries to Norwegian drug information centres (DICs). Setting and method Drug-related queries received at 5 DICs in Norway from March to May 2007 were randomly assigned to 20 employees until each of them had answered a minimum of five queries. The employees reported the number of drugs involved, the type of literature search performed, and whether the queries were considered judgmental or not, using a specifically developed scoring system. Main outcome measures The scores of these three factors were added together to define a workload score for each query. Workload and its individual factors were subsequently related to the measured time spent answering the queries by simple or multiple linear regression analyses. Results Ninety-six query/answer pairs were analyzed. Workload significantly predicted the time spent answering the queries (adjusted R 2 = 0.22, P < 0.001). Literature search was the individual factor best predicting the time spent answering the queries (adjusted R 2 = 0.17, P < 0.001), and this variable also contributed the most in the multiple regression analyses. Conclusion The most important workload factor predicting the time spent handling the queries in this study was the type of literature search that had to be performed. The categorisation of queries as judgmental or not, also affected the time spent answering the queries. The number of drugs involved did not significantly influence the time spent answering drug information queries.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (publisher-id): bmjopen

Journal ID (hwp): bmjopen

Title: BMJ Open

Publisher: BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2012

Publication date (Electronic): 15 March 2012

Publication date PMC-release: 15 March 2012

Volume: 2

Issue: 2

Electronic Location Identifier: e000642

Affiliations

[1 ]Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway

[2 ]Section of Pharmacology, Institute of Medicine, University of Bergen, Bergen, Norway

[3 ]Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway

[4 ]Faculty of Health Sciences, Nord-Trøndelag University College, Steinkjer, Norway

[5 ]Regional Medicines Information and Pharmacovigilance Centre (RELIS Midt-Norge), St. Olav's Hospital, Trondheim, Norway

[6 ]Regional Medicines Information and Pharmacovigilance Centre (RELIS Sør-Øst), Oslo University Hospital, Oslo, Norway

Author notes

Correspondence to Dr Jan Schjøtt; jan.didrik.schjott@ 123456helse-bergen.no

Article

Publisher ID: bmjopen-2011-000642

DOI: 10.1136/bmjopen-2011-000642

PMC ID: 3307033

PubMed ID: 22422916

SO-VID: aa21e44a-dcee-4dce-8895-5d45d429fd99

Copyright © © 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

A question–answer pair (QAP) database integrated with websites to answer complex questions submitted to the Regional Medicines Information and Pharmacovigilance Centres in Norway (RELIS): a descriptive study

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Abstract

Objective

Design

Setting

Participants

Primary outcome measure

Secondary outcome measure

Results

Conclusions

Article summary

Article focus

Key messages

Strengths and limitations of this study

Related collections

Herbal Medicines Journal (Herb Med J)

Most cited references 12

Update on the status of 89 drug information centers in the United States.

Problem-oriented drug information: physicians' expectations and impact on clinical practice.

Which factors predict the time spent answering queries to a drug information centre?

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