The adequacy of physicians’ and pharmacists’ sources for drug information by Presley M. Johnston, Pharm.D., Jim H. Harelik, Pharm.D., Nelson P. Rivers, Pharm.D., and Michael R. Ryan, Ph.D.
INTRODUCTION Since the advent of drug information centers in 1962,l several literature reports have appeared concerning the evaluation and predictions of on-going centers.2-4. NO references were found which evaluated whether health practitioners were satisfied with the information sources currently available. The Drug and Toxicology Information Center was established in 1972 at the University of Tennessee Medical Units in conjunction with Mooney Memorial Library. The initial objectives were 1. to provide unbiased drug information to the medical staff when necessary; 2. to render more complete back up for sources of information to the practicing pharmacists; and 3. to aid the Doctor of Pharmacy candidates and the undergraduate pharmacy students at the University of Tennessee College of Pharmacy in the development of competency in literature retrieval and evaluation.
After an initial period the increased use of the center required the expansion of facilities. A program was implemented similar to that reported by Pearson ef aL,5 which would entail the development of the original Drug Information Center into the data base for a comprehensive drug information network to cover the State of Tennessee. The planning would include the literature support needed b y pharmacists to become primary sources of drug information for physicians and other prescribers. In addition, the physicians in the area would be provided access to the center on a direct basis if they so desired. FrFKf FeTig-a-i- ~ x ~ c ~ g o ~ r - m a ~ o
University of Tennessee M e d i a l Units, Memphis, TN 38163 This paper is a revised version of a report presentad at the Tenth Annual Meeting, Drug Information Association. Chicago, June 26-28. 1974.
This was the reasoning behind the present project, w h i c h w a s designed to determine the opinions of pharmacists and physicians about six frequently used sources of drug information under nine basic drug information-related categories, and to determine if these health care practitioners would use a drug information network or center if one were available to them. This i n f o r m a t i o n would then be used to assist in the development and expansion of the Drug Information Center.
METHODOLOGY The first stage of the project was the development of a questionnaire which would obtain the information necessary to meet the objectives stated above. Initially, a four-page questionnaire was constructed which included an evaluation of sources plus several questions pertaining to the adequacy of sources and the use of drug information service. This questionnaire was pretested on five physicians and suggestions were solicited on how the questionnaire could be improved. The most frequent suggestion was a reduction in length of the questionnaire to a single page. Further evaluation of the information desired and the current literature led to development of the questionnaire used in the survey (Figure 1). Included in the questionnaire was a table on w h c h the practitioner could evaluate six sources of information for each of nine categories of drug information on a scale ranging from very good to very poor. Also included on this one-page format was the. question, “Would you be interested in the services of a university-based center that provides written and telephone information about drugs in the above categories?” The nine categories of drug information included in ~ the ~ questionnaire n ~ e ~ ~ were ~ - those most frequently mentioned in the literature on currently operating drug information services2.4,I 1 ,I 4 and most often represented in requests received by the Drug and Toxicology Information Center. Patterson14 found that therapeutic use, pharmaceutical
16
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
determining the mean score for each source over all categories for pharmacists and physicians separately and comparing these means. The Z values were tested at the .05 level for each of the six sources for the null hypothesis: There is n o significant difference in the evaluation of this source between pharmacists and physicians. (Ibr
YDr
1
AM.d.y
1
4
6
l
a
4
6
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I
4
6
1
3
4
6
1
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r.nn
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No."
L
rinhg
kmnt+*J
IV h-wUbyh uYIlW
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r.nn I w b
u.u-
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~
__.___~~_ a
s
4
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1
4
6
LD.R pw bkn d mu t.h-dd rn it. dm#mhms~c..IorId W
or. Ym-
ulmnw bud OID*~(b.~ p,&&
RESULTS AND DISCUSSION Completed questionnaires were received from 101 pharmacists and I90 physicians representing 37 and 40 percent of each sample, respectively. The question concerning the use of a university-based drug information center was answered positively by 87% of responding physicians and 9 1% of pharmacists. Mean scores for the sources by categories are reported in Table 1, with the figures representing the response of pharmacists and that of physicians placed beside each other for comparison. Z values for the differences of means between the two groups are listed at the foot of Table 1. A significant difference was found between the evaluations by physicians and pharmacists concerning the adequacy of professional journals for all categories of drug information, b u t t h e r e w e r e n o significant differences between evaluations of the remaining five sources.
.od u~hor uo-
.l(-
N -
Professional Journals
Survey Questionnaire
Fig. 1 compatibility, adverse or side effects, dosage, availability, drug interactions, and toxicity comprised 65.7% of requests received from pharmacists. Rosenberg and Peritore4 r e p o r t e d t h a t requests for information on dosage, therapeutic use, adverse and side effects, compatibility, toxicity, contraindications, and availability comprised 79% of requests from physicians, nurses and pharmacists. The six sources which were evaluated for adequacy (professional journals, textbooks, pharmacists, physicians, PDR and detail men) have been discussed in several studies evaluating frequency of use,7.9,10,13 although only Smith et a1.2 attempted to evaluate which sources were used for specific categories of drug information. Since this study was intended to obtain the practitioners' evaluation of sources for each category, it was decided to study the same sources which had appeared in earlier studies of frequency of use. The questionnaires were mailed with a cover letter and a return mail envelope to a 10% random sample of practicing pharmacists and physicians (270 and 477 r e s p e c t i v e l y ) i n t h e S t a t e o f T e n n e s s e e . After approximately 25% of the practitioners had responded by the deadline date, a second letter with a questionnaire was s e n t t o those practitioners not yet responding. An additional 10 to 15% responded to the second mailing, bringing the total response to approximately 40%. Each returned questionnaire was scored by assigning values to the possible responses (very good = 4, good = 3, adequate = 2, etc.) A mean score was tabulated for each source under each category. A difference of means test was used to determine whether a significant difference existed b e t w e e n physicians and pharmacists in the overall evaluations of sources. The difference was calculated by
The table reveals that pharmacists and physicians agreed that professional journals were adequate in providing information regarding adverse reactions and side effects. Pharmacists generally felt that journals were poor sources for information about drug interactions and for toxicity information, while physicians believed that they were adequate. Physicians generally rated journals as good for therapeutic use information while pharmacists only rated them adequate. This difference probably reflects the difference in the journals with which the pharmacist and physician are familiar. Also, the physician probably places more importance on the current literature than does the pharmacist. In the remainder of the categories the two groups fairly well agreed, although mean scores by physicians are higher in all but one category. Both groups rated journals inadequate for IV incompatibility or stability and availability information.
Textbooks In general, pharmacists rated textbooks somewhat h i g h e r a s information sources than did physicians. Physicians rated textbooks less than adequate for drug interaction information while pharmacists rated them as adequate. Likewise, physicians rated textbooks poor for IV incompatibility and stability while pharmacists rated them adequate. Both types of practitioners said that textbooks w e r e a p o o r source for information on new and investigational drugs and on availability.
Pharmacists
For this source, the practitioners were to evaluate the pharmacist as an information source. In the category of
DRUG INFORMATION JOURNAL
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
January/ March 76 p I7
Table 1 Mean scores in evaluation of information sources by pharmacists and physicians
I
Source Category
Professional Journals RPh MD
I
Adverse Reactions & Side Effects
2.16 2.69
2.05
k g Interactions
1.84 2.22
1.73
Therapeutic Use
2,59 3.01
2.41
1.69 2.49
1.80
n Toxicity and Poisoning
/
New or Znvestigational
/I
2.21 2.66
1.52
or Stability
1.78 1.84
1.43
Dosage
2.64 2.72
2.33
Availability
1.93 1.93
1.78
2.29 2.64
2.10
h P
1
I1
IV Incompatibility
~~~
Contraindications Z Values
11
1
11
2.41 3.00
/I
1.99 1.74
1.81 2.20
1.61 1.56
2.92 2.76
2.65 2.28
1.74 2.52
(1
1.37 11.51
1 1 ::::
1.91 1.68
0.93 1.32
1.39 2.17
1.57
--
2.59
2.82 3.18
1
1
1.72 2.26 2.52 2.97
11
1
2.64 2.64 I__
1.84 2.01
1.97
adverse reactions and side effects, pharmacists evaluated the pharmacist as a poor source while physicians evaluated him as an adequate source. Conversely, physicians considered the pharmacist inadequate for information concerning therapeutic use, while pharmacists considered other pharmacists to be an adequate source. This probably indicates that physicians do not rely on pharmacists for this infomation. Both groups agreed that the pharmacist is a poor source of information for drug interactions, toxicity and poisoning, new o r investigational drugs, IV compatibility or stability, and contraindications.
Physicians For this portion of the study the practitioners were to evaluate the physician as a source of information. It has been known f o r quite some time that physicians consistently consult colleagues for information; however, pharmacists do not readily call on physicians for a professional opinion on drugs. Results indicated that pharmacists evaluated the physician as a poor source for most categories, while physicians felt that a colleague was an adequate source for information on contraindications and on adverse reactions and side effects. However, pharmacists and physicians alike agreed that the physician
is a poor source for information concerning drug interactions, toxicity and poisoning, new or investigational drugs, IV incompatibility or stability, and availability.
Physicians' Desk Reference Physicians evaluated this source as adequate to good in all information categories except new and investigational drugs. Pharmacists, on the other hand, evaluated this source as poor for drug interactions, toxicity and poisoning, new and investigational drugs, IV incompatibility and stability, and availability. This difference is probably due to the ready availability of the PDR to physicians.
Detail Men Pharmacists and physicians generally agreed on all categories of drug information except contraindications. Physicians felt that the detail man was an adequate source for information about contraindications while pharmacists did not. Both groups rated detail men a poor source for information on adverse reactions and side effects, drug interactions, toxicity and poisoning, new or investigational drugs, and IV incompatibility or stability, and an adequate source on therapeutic use, dosage, and availability.
I8
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
CONCLUSION
9.
Since pharmacists and physicians agree that the pharmacist and the physician are poor sources of drug information in most categories, it appears that these practitioners might prefer written documented information which can be provided in a comprehensive form by a university-based drug information center. Although the written sources received ratings implying more adequacy, these sources would not appear adequate for all categories of information. With a majority of respondents indicating a desire f o r t h e services of a university-based drug information center, it becomes necessary to expand the services to provide more drug information in the areas where other sources are least adequate, and to emphasize these areas in the communiques of the drug information center.
REFERENCES
Weiblen, Jack W.: Staff attitudes toward clinical pharmacy. Hospitals 47:56-59, Feb. 16, 1973.
10. Groth, Paul E.: Regional drug information services benefits: Free vs. fee-for-services. Presented at the E i g h t Annual ASHP Midyear Clinical Meeting, December 1 1 , 1973. 11.
Walton, Charles A.: The problem of communicating clinical drug information. Am. J. Hosp. P h a m 22:458-463, Aug. 1965.
12.
Pellegrino, E. D.: Drug information services and the clinician. Am. J. Hosp. Pharm. 22:3841, Jan. 1965.
13.
Miller, Russell R.: Prescribing habits of physicians, Parts VII-VIII. Drug InrelI. Clin. Pharm. 8:81-91, Feb. 1974.
14. Patterson, Larry E.: Drug information services and the community pharmacist. Personal communication.
1.
B u r k h o l d e r , D a v i d : Some experiences in the establishment and operation of a drug information center. Am. J. Hosp. Pharm. 20:506,1963.
2.
Smith, Gary H. et al.: An evaluation of the drug information resources: Needs and attitudes of a physician population. Personal communication.
3.
A m e r s o n , Ann B. a n d W a l t o n , Charles A.: Cooperative drug information and medical library services in a regional medical program. Am. J. Hosp. Pharm. 26:267-269, Apr. 1971.
4.
Rosenberg, Jack M. and Peritore, Salvatore P.: A drug information service in a community hospital. Am. J. Hosp. Pharm. 28~270.274,Apr. 1971.
5.
Pearson, R. E., et al.:Michigan Regional Drug Information Network, Part I: Concepts. Am. J. Hosp. m a n . 27:911-913,~0v. 1970.
6.
Dillon, William A.: Survey shows doctors favor use of a drug information specialist. Hosp. Topics pp. 79-81, Jan. 1971.
LIBERAL ARTS
7.
H e n l e y , S c o t t e t al.: Dissemination of drug information. Hospitals 42:99-105, June 16, 1968.
Want lists for single issues, volumes, and sets answered promptly.
8.
Hamm, Melvin N. et al.: Survey of physicians’ drug information. J. Am. Pharm. Assoc. NS13:349-352. July 1973.
back issue periodicals MEDICAL
TECHNICAL
SCIENTIFIC
U.S. 8 FOREIGN
Reprints of single volumes and sets. Duplicates bought or exchanged.
G. H. ARROW CO. 5. E. Cor. 4th 8 Brown Sts. Philadelphia, Pa. 19123 Telephone 21 5-WA 2-321 1
DRUG INFORMATION JOURNAL
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
JanuarylMarch 76 p19
INTRODUCTION Since the advent of drug information centers in 1962,l several literature reports have appeared concerning the evaluation and predictions of on-going centers.2-4. NO references were found which evaluated whether health practitioners were satisfied with the information sources currently available. The Drug and Toxicology Information Center was established in 1972 at the University of Tennessee Medical Units in conjunction with Mooney Memorial Library. The initial objectives were 1. to provide unbiased drug information to the medical staff when necessary; 2. to render more complete back up for sources of information to the practicing pharmacists; and 3. to aid the Doctor of Pharmacy candidates and the undergraduate pharmacy students at the University of Tennessee College of Pharmacy in the development of competency in literature retrieval and evaluation.
After an initial period the increased use of the center required the expansion of facilities. A program was implemented similar to that reported by Pearson ef aL,5 which would entail the development of the original Drug Information Center into the data base for a comprehensive drug information network to cover the State of Tennessee. The planning would include the literature support needed b y pharmacists to become primary sources of drug information for physicians and other prescribers. In addition, the physicians in the area would be provided access to the center on a direct basis if they so desired. FrFKf FeTig-a-i- ~ x ~ c ~ g o ~ r - m a ~ o
University of Tennessee M e d i a l Units, Memphis, TN 38163 This paper is a revised version of a report presentad at the Tenth Annual Meeting, Drug Information Association. Chicago, June 26-28. 1974.
This was the reasoning behind the present project, w h i c h w a s designed to determine the opinions of pharmacists and physicians about six frequently used sources of drug information under nine basic drug information-related categories, and to determine if these health care practitioners would use a drug information network or center if one were available to them. This i n f o r m a t i o n would then be used to assist in the development and expansion of the Drug Information Center.
METHODOLOGY The first stage of the project was the development of a questionnaire which would obtain the information necessary to meet the objectives stated above. Initially, a four-page questionnaire was constructed which included an evaluation of sources plus several questions pertaining to the adequacy of sources and the use of drug information service. This questionnaire was pretested on five physicians and suggestions were solicited on how the questionnaire could be improved. The most frequent suggestion was a reduction in length of the questionnaire to a single page. Further evaluation of the information desired and the current literature led to development of the questionnaire used in the survey (Figure 1). Included in the questionnaire was a table on w h c h the practitioner could evaluate six sources of information for each of nine categories of drug information on a scale ranging from very good to very poor. Also included on this one-page format was the. question, “Would you be interested in the services of a university-based center that provides written and telephone information about drugs in the above categories?” The nine categories of drug information included in ~ the ~ questionnaire n ~ e ~ ~ were ~ - those most frequently mentioned in the literature on currently operating drug information services2.4,I 1 ,I 4 and most often represented in requests received by the Drug and Toxicology Information Center. Patterson14 found that therapeutic use, pharmaceutical
16
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
determining the mean score for each source over all categories for pharmacists and physicians separately and comparing these means. The Z values were tested at the .05 level for each of the six sources for the null hypothesis: There is n o significant difference in the evaluation of this source between pharmacists and physicians. (Ibr
YDr
1
AM.d.y
1
4
6
l
a
4
6
P
I
4
6
1
3
4
6
1
1
4
6
l
a
4
6
r.nn
1rw*
No."
L
rinhg
kmnt+*J
IV h-wUbyh uYIlW
Dwp.
r.nn I w b
u.u-
A.*Uil*
Or-.
~
__.___~~_ a
s
4
1
1
4
6
LD.R pw bkn d mu t.h-dd rn it. dm#mhms~c..IorId W
or. Ym-
ulmnw bud OID*~(b.~ p,&&
RESULTS AND DISCUSSION Completed questionnaires were received from 101 pharmacists and I90 physicians representing 37 and 40 percent of each sample, respectively. The question concerning the use of a university-based drug information center was answered positively by 87% of responding physicians and 9 1% of pharmacists. Mean scores for the sources by categories are reported in Table 1, with the figures representing the response of pharmacists and that of physicians placed beside each other for comparison. Z values for the differences of means between the two groups are listed at the foot of Table 1. A significant difference was found between the evaluations by physicians and pharmacists concerning the adequacy of professional journals for all categories of drug information, b u t t h e r e w e r e n o significant differences between evaluations of the remaining five sources.
.od u~hor uo-
.l(-
N -
Professional Journals
Survey Questionnaire
Fig. 1 compatibility, adverse or side effects, dosage, availability, drug interactions, and toxicity comprised 65.7% of requests received from pharmacists. Rosenberg and Peritore4 r e p o r t e d t h a t requests for information on dosage, therapeutic use, adverse and side effects, compatibility, toxicity, contraindications, and availability comprised 79% of requests from physicians, nurses and pharmacists. The six sources which were evaluated for adequacy (professional journals, textbooks, pharmacists, physicians, PDR and detail men) have been discussed in several studies evaluating frequency of use,7.9,10,13 although only Smith et a1.2 attempted to evaluate which sources were used for specific categories of drug information. Since this study was intended to obtain the practitioners' evaluation of sources for each category, it was decided to study the same sources which had appeared in earlier studies of frequency of use. The questionnaires were mailed with a cover letter and a return mail envelope to a 10% random sample of practicing pharmacists and physicians (270 and 477 r e s p e c t i v e l y ) i n t h e S t a t e o f T e n n e s s e e . After approximately 25% of the practitioners had responded by the deadline date, a second letter with a questionnaire was s e n t t o those practitioners not yet responding. An additional 10 to 15% responded to the second mailing, bringing the total response to approximately 40%. Each returned questionnaire was scored by assigning values to the possible responses (very good = 4, good = 3, adequate = 2, etc.) A mean score was tabulated for each source under each category. A difference of means test was used to determine whether a significant difference existed b e t w e e n physicians and pharmacists in the overall evaluations of sources. The difference was calculated by
The table reveals that pharmacists and physicians agreed that professional journals were adequate in providing information regarding adverse reactions and side effects. Pharmacists generally felt that journals were poor sources for information about drug interactions and for toxicity information, while physicians believed that they were adequate. Physicians generally rated journals as good for therapeutic use information while pharmacists only rated them adequate. This difference probably reflects the difference in the journals with which the pharmacist and physician are familiar. Also, the physician probably places more importance on the current literature than does the pharmacist. In the remainder of the categories the two groups fairly well agreed, although mean scores by physicians are higher in all but one category. Both groups rated journals inadequate for IV incompatibility or stability and availability information.
Textbooks In general, pharmacists rated textbooks somewhat h i g h e r a s information sources than did physicians. Physicians rated textbooks less than adequate for drug interaction information while pharmacists rated them as adequate. Likewise, physicians rated textbooks poor for IV incompatibility and stability while pharmacists rated them adequate. Both types of practitioners said that textbooks w e r e a p o o r source for information on new and investigational drugs and on availability.
Pharmacists
For this source, the practitioners were to evaluate the pharmacist as an information source. In the category of
DRUG INFORMATION JOURNAL
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
January/ March 76 p I7
Table 1 Mean scores in evaluation of information sources by pharmacists and physicians
I
Source Category
Professional Journals RPh MD
I
Adverse Reactions & Side Effects
2.16 2.69
2.05
k g Interactions
1.84 2.22
1.73
Therapeutic Use
2,59 3.01
2.41
1.69 2.49
1.80
n Toxicity and Poisoning
/
New or Znvestigational
/I
2.21 2.66
1.52
or Stability
1.78 1.84
1.43
Dosage
2.64 2.72
2.33
Availability
1.93 1.93
1.78
2.29 2.64
2.10
h P
1
I1
IV Incompatibility
~~~
Contraindications Z Values
11
1
11
2.41 3.00
/I
1.99 1.74
1.81 2.20
1.61 1.56
2.92 2.76
2.65 2.28
1.74 2.52
(1
1.37 11.51
1 1 ::::
1.91 1.68
0.93 1.32
1.39 2.17
1.57
--
2.59
2.82 3.18
1
1
1.72 2.26 2.52 2.97
11
1
2.64 2.64 I__
1.84 2.01
1.97
adverse reactions and side effects, pharmacists evaluated the pharmacist as a poor source while physicians evaluated him as an adequate source. Conversely, physicians considered the pharmacist inadequate for information concerning therapeutic use, while pharmacists considered other pharmacists to be an adequate source. This probably indicates that physicians do not rely on pharmacists for this infomation. Both groups agreed that the pharmacist is a poor source of information for drug interactions, toxicity and poisoning, new o r investigational drugs, IV compatibility or stability, and contraindications.
Physicians For this portion of the study the practitioners were to evaluate the physician as a source of information. It has been known f o r quite some time that physicians consistently consult colleagues for information; however, pharmacists do not readily call on physicians for a professional opinion on drugs. Results indicated that pharmacists evaluated the physician as a poor source for most categories, while physicians felt that a colleague was an adequate source for information on contraindications and on adverse reactions and side effects. However, pharmacists and physicians alike agreed that the physician
is a poor source for information concerning drug interactions, toxicity and poisoning, new or investigational drugs, IV incompatibility or stability, and availability.
Physicians' Desk Reference Physicians evaluated this source as adequate to good in all information categories except new and investigational drugs. Pharmacists, on the other hand, evaluated this source as poor for drug interactions, toxicity and poisoning, new and investigational drugs, IV incompatibility and stability, and availability. This difference is probably due to the ready availability of the PDR to physicians.
Detail Men Pharmacists and physicians generally agreed on all categories of drug information except contraindications. Physicians felt that the detail man was an adequate source for information about contraindications while pharmacists did not. Both groups rated detail men a poor source for information on adverse reactions and side effects, drug interactions, toxicity and poisoning, new or investigational drugs, and IV incompatibility or stability, and an adequate source on therapeutic use, dosage, and availability.
I8
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
CONCLUSION
9.
Since pharmacists and physicians agree that the pharmacist and the physician are poor sources of drug information in most categories, it appears that these practitioners might prefer written documented information which can be provided in a comprehensive form by a university-based drug information center. Although the written sources received ratings implying more adequacy, these sources would not appear adequate for all categories of information. With a majority of respondents indicating a desire f o r t h e services of a university-based drug information center, it becomes necessary to expand the services to provide more drug information in the areas where other sources are least adequate, and to emphasize these areas in the communiques of the drug information center.
REFERENCES
Weiblen, Jack W.: Staff attitudes toward clinical pharmacy. Hospitals 47:56-59, Feb. 16, 1973.
10. Groth, Paul E.: Regional drug information services benefits: Free vs. fee-for-services. Presented at the E i g h t Annual ASHP Midyear Clinical Meeting, December 1 1 , 1973. 11.
Walton, Charles A.: The problem of communicating clinical drug information. Am. J. Hosp. P h a m 22:458-463, Aug. 1965.
12.
Pellegrino, E. D.: Drug information services and the clinician. Am. J. Hosp. Pharm. 22:3841, Jan. 1965.
13.
Miller, Russell R.: Prescribing habits of physicians, Parts VII-VIII. Drug InrelI. Clin. Pharm. 8:81-91, Feb. 1974.
14. Patterson, Larry E.: Drug information services and the community pharmacist. Personal communication.
1.
B u r k h o l d e r , D a v i d : Some experiences in the establishment and operation of a drug information center. Am. J. Hosp. Pharm. 20:506,1963.
2.
Smith, Gary H. et al.: An evaluation of the drug information resources: Needs and attitudes of a physician population. Personal communication.
3.
A m e r s o n , Ann B. a n d W a l t o n , Charles A.: Cooperative drug information and medical library services in a regional medical program. Am. J. Hosp. Pharm. 26:267-269, Apr. 1971.
4.
Rosenberg, Jack M. and Peritore, Salvatore P.: A drug information service in a community hospital. Am. J. Hosp. Pharm. 28~270.274,Apr. 1971.
5.
Pearson, R. E., et al.:Michigan Regional Drug Information Network, Part I: Concepts. Am. J. Hosp. m a n . 27:911-913,~0v. 1970.
6.
Dillon, William A.: Survey shows doctors favor use of a drug information specialist. Hosp. Topics pp. 79-81, Jan. 1971.
LIBERAL ARTS
7.
H e n l e y , S c o t t e t al.: Dissemination of drug information. Hospitals 42:99-105, June 16, 1968.
Want lists for single issues, volumes, and sets answered promptly.
8.
Hamm, Melvin N. et al.: Survey of physicians’ drug information. J. Am. Pharm. Assoc. NS13:349-352. July 1973.
back issue periodicals MEDICAL
TECHNICAL
SCIENTIFIC
U.S. 8 FOREIGN
Reprints of single volumes and sets. Duplicates bought or exchanged.
G. H. ARROW CO. 5. E. Cor. 4th 8 Brown Sts. Philadelphia, Pa. 19123 Telephone 21 5-WA 2-321 1
DRUG INFORMATION JOURNAL
Downloaded from dij.sagepub.com at MICHIGAN STATE UNIV on June 12, 2015
JanuarylMarch 76 p19
