The Pharmacist's Guide to Evidence-Based Medicine for Clinical Decision Making

by Patrick J. Bryant PharmD, FSCIP (Editor), Heather A. Pace PharmD (Editor)

Overview

Take the Practical Approach to Applying EBM Principles

Pharmacists who make clinical decisions based on experience alone overestimate the efficacy and underestimate the safety risks of drugs. This leads to variations in services and treatment that result in inappropriate care, lack of care, and increased healthcare costs.

Evidence-based medicine (EBM) employs the scientific method as the key source of knowledge for making clinical decisions. This easy-to-use new guide provides a practical approach for confidently applying EBM principles in daily practice. It's a straightforward process that allows pharmacists to incorporate their own clinical judgment while they make firm decisions and recommendations based on results of rigorously conducted clinical trials.

Based on a five-step process perfected over 10 years at the University of Missouri, Kansas City, School of Pharmacy, this exciting new method makes it easy to apply the EBM approach in clinical settings. The new process streamlines the highly technical and complex original EBM method, greatly reducing its complexity while maintaining rigor. Categorizing quality of the evidence in a simple and logical manner, it provides critical, time-sensitive support for clinical decision-making.
 

Product Details

ISBN-13:	9781585282708
Publisher:	ASHP
Publication date:	08/31/2008
Sold by:	Barnes & Noble
Format:	eBook
Pages:	208
File size:	2 MB

About the Author

Patrick J. Bryant, PharmD, FSCIP is Director of the Drug Information Center and Clinical Professor at University of Missouri – Kansas City School of Pharmacy. Prior to his academic career, he spent 15 years in clinical research, licensing and development, and competitive intelligence within the pharmaceutical industry. 

Bryant led the conceptualization, design, development, and implementation of a 5 credit hour course teaching the use of a novel 5-step evidence-based medicine process to make clinical decisions. This course received honorable mention from the American Association of Colleges of Pharmacy (AACP) Innovations in Teaching Competition. 

He led the development and implementation of the ASHP Accredited Specialty Drug Information Residency, Natural Product Information Fellowship, Competitive Technical Intelligence Fellowship, and Drug Information Fellowship programs. These programs have created over 15 post-docs practicing in retail, academic, private business, and industry positions to date. 

Dr. Bryant has focused his scholarly activities in the drug information and competitive intelligence areas. He has made multiple presentations both nationally/internationally and published articles and book chapters on these subjects. In addition to his co-authorship of The Pharmacist’s Guide to Evidence-based Medicine, Dr. Bryant is also the lead author of the chapter entitled, “Literature Evaluation II:  Beyond the Basics” in Malone PM, Kier KL, Stanovich JE, eds. Drug Information: A Guide for Pharmacists, 4th ed., 2009.

Heather A. Pace, PharmD is Assistant Director of University of Missouri School of Pharmacy Drug Information Center and Clinical Assistant Professor, Pharmacy Practice Division. Her specialty areas include Drug Information Practice and Evidence-Based literature analysis. She received her Pharm.D. from the University of Missouri Kansas City in 2005 and completed her post doctorial training at UMKC Drug Information Center’s ASHP Accredited Drug Information Specialty Residency in August 2006. 

Dr. Pace currently participates in formulary decisions on a Pharmacy and Therapeutics committee for a major institution and a state prescription assistance program as well as extensive Evidence Based Medicine research. She serves as newsletter editor for the Missouri Society of Health System Pharmacists.  In addition, she participates in various didactic lectures and precepts experiential rotation students.

Table of Contents

Table of Contents
Acknowledgments ....................................................................... iv
Preface ......................................................................................... vi
Contributors .............................................................................. viii
Chapter 1: Introduction ........................................................... 1
Chapter 2: Basics for Interpretation .................................... 11
Chapter 3: Step 1 – Define the Clinical Question .............. 41
Chapter 4: Step 2 – Retrieve Pertinent Information ........... 51
Chapter 5: Step 3 – Evaluate Literature .............................. 61
Chapter 6: Step 4 – Categorize Quality of Evidence .......... 87
Chapter 7: Step 5 – Develop a Conclusion and
Recommendation ............................................... 103
Chapter 8: Alternative Sources of Evidence ..................... 119
Chapter 9: Applications ....................................................... 127
Chapter 10: Applying Evidence-Based Medicine
Principles to Dietary Supplement
Therapeutic Decisions ...................................... 151
Appendixes
Appendix 1 –Glossary of Evidence-Based Medicine Terms
(including the Biostatistical Glossary) ........... 171
Appendix 2 –Evidence-Based Medicine Tool Kit .................. 187
Index ........................................................................................ 191

Editorial Reviews

Reviewer: Melissa M. Potts, BS, PharmD (Temple University School of Pharmacy)
Description: This book outlines a simple, systematic approach to evaluating literature and applying current findings to clinical practice. Intended for pharmacy students and practitioners, it focuses on five steps to analyze literature in a scientific and informed manner.
Purpose: It attempts to simplify the process of evaluating evidence-based medicine while helping practitioners accurately interpret findings. The ultimate goal of this process is to apply current research to the clinical practice setting. The book relies on the scientific method in interpreting and applying the literature in making clinical decisions. This process allows for informed decisions in caring for patients, rather than relying on tradition or trial and error, which are commonly used and less reliable. The book succeeds in fulfilling its purpose in allowing readers to easily evaluate literature and develop recommendations for the clinical setting. It guides practitioners with five simple steps to evaluate evidence-based medicine, uses examples from the literature, and provides further reading recommendations.
Audience: Although intended for pharmacy students and practitioners, the book could be used by any one who has had basic training in evaluating literature as a guide or as an update in interpreting evidence-based medicine. The authors are both professors at the University of Missouri-Kansas City School of Pharmacy. Many of the concepts in the book have been taught as a course in evidence-based medicine for nine years. The authors outline their recommendations for evaluating literature in an organized, scientific, and understandable fashion.
Features: A chapter is dedicated to each of the five steps used to evaluate evidence-based medicine: define the clinical question, retrieve patient information, evaluate the literature, categorize quality of evidence, and develop a conclusion and recommendation. These concepts are discussed in a comprehensive, logical and easy to interpret manner. Thus, the book succeeds at simplifying the process of evaluating literature without compromising the integrity of the information. Key concepts are highlighted throughout the book. These "Key Ideas" serve as a quick reference, while emphasizing crucial points. Tables and figures visually convey important learning tools. Examples from the literature appear throughout the book to highlight concepts, which helps readers apply them in interpreting the literature. Finally, a glossary at the end of the book defines important terms.
Assessment: This is an important contribution and a practical tool that can be used to interpret evidence-based medicine. The book simplifies the process and allows readers to easily understand the steps needed to accurately analyze the literature and apply the findings to patient care.

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