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About this chapter
This is an introduction to evidence-based practice for pharmacist. The following chapters will provide academic and practical information including tools, sources and resources for how to best practice evidence-based pharmacy. In this chapter we give some basic information and some examples of problems and limitations from studies and practices.
What do we mean by “evidence-based clinical practice?”
Evidence-based clinical practice describes the complex process of decision making and places it in the context of basing decisions on a systematic appraisal of the best evidence available.
It requires a number of skills and an ability to:
define criteria, such as effectiveness, safety and acceptability
find the evidence
assess the quality of the evidence
assess whether the results of the research are generalisable or applicable to the whole population from which the subjects have been drawn
assess whether the results of the research are applicable to the local or patient specific situation.
The challenge for evidence-based pharmacy is twofold. First to develop evidence-based medicine skills for use in clinical pharmacy whether in the secondary care setting on the ward or in primary care dealing with patients who present with problems or issues surrounding prescribed medicines.
The second challenge is to find the evidence to support existing practice and to inform practice developments.
Much has been written on this subject but two definitions are useful. The first from Professor David Sackett:1
“Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”
Sackett et al1
The authors go on to state that the practice of Evidence Based Medicine requires the integration of individual clinical expertise with the best available external clinical evidence from systematic research.
The second definition is from a team at McMaster University in Canada:
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