About this chapter

The aim is to help pharmacists working in different settings to identify, evaluate and use their own evidence-based sources for improving outcome of patient/client care.

We describe strategies for assessing your potential sources for evidence-based medicine information, that is, what resources can you use and trust? Dependent on the type of question (selecting medication, route/dose individualisation or follow-up on effects) we help you to navigate among local, national and international information sources from healthcare providers, authorities and commercial sources; from written publications, internet databases, and smartphone Apps. We base our assessment on patient and client cases.

In previous chapters we have described the fundamentals of evidence-based medicine and pharmacy practice including asking the right questions, tools for searching literature, calculating effect sizes and appraising the evidence. In this chapter, we aim at helping pharmacists to assess and use evidence applicable for their local practice and environment. But can we trust and use local, regional, national and international guidelines, recommendations and information?

We focus on the perspective of selecting, individualising and ensuring follow-up for the best treatment outcomes for a patient (client, customer etc). The aim is to optimise prescribing that is, medication appropriateness. A research tool has been developed for measuring this, the Medication Appropriateness Index (MAI).1 The tool evaluates each drug based on ten items; indication, drug effectiveness, correct dosage, correct directions, practical directions, drug–drug interactions, drug–disease interactions, drug duplication, duration of treatment and expense. Each drug is rated as appropriate (A), marginally appropriate (B) or inappropriate (C) for each of the ten items in the analysis. According to a weighting scheme, a summed MAI score between 0 and 18 can be produced for …