Medical editor, Dr Harry Brown continues his everyday tips series and reviews online prescribing resources to help doctors make therapeutic interventions.
Prescribing a therapeutic drug may on the surface seem to be a simple transaction but it sits at the apex of a complex interaction of a significant number of variables and episodes of information gathering. These steps can include making a diagnosis, creating a management plan and taking into account the risks and benefits of prescribing a particular therapeutic drug to a specific patient.
It is a complex decision process that often rapidly involves making multiple choices in order to reach a final conclusion which is in the best interests of a patient. In practice, this decision making process can take place over a tight timeline. So, it is good to have a look at some useful digital prescribing resources that may assist the clinician who is thinking of prescribing a therapeutic agent into making a more rational decision.
Before thinking of prescribing a therapeutic intervention, you might need to check some facts in a medical textbook to help you reach that clinical decision. One possible port of call could be the excellent general medical textbook, The Merck Manual, which is free and and no registration is needed. There are more resources available from this site and it is worthwhile checking out what else is available in this very handy facility. I also have the app associated with this website (again free) on my iPhone and it is also excellent and very useful.
You may want specific prescribing information and there are a number of very useful online resources available. The highly respected BNF (British National Formulary) can be found on line at https://bnf.nice.org.uk/ and again it is free, in full text and without the need for any registration. The BNF has concise and relevant information about therapeutic agents used in the UK. Like the Merck Manual site, there are also additional features available.
In this case, there is information about interactions and there are also treatment summaries whilst there is a link in the top bar to the BNF for children (BNFC). The latter is also laid out in a similar format and is it quite easy to navigate around these two impressive resources. I also have the app for these 2 BNF versions on my iPhone and it comes bundled with a useful drug interaction checker.
Bear in mind, these excellent resources mentioned so far, are all fully available to the general public as well. This should lead to a better-informed patient and means that a healthcare professional does not have unique access (and rightly so) to many therapeutic resources.
There is also the useful MIMs website which also has useful prescribing information. One gem within this website is the drugs shortages tracker. Drug shortages have become an increasing problem for both pharmacists and GPs as well as affected patients and this tracker is a useful method of monitoring what is going on. For an informative and interesting article about drug shortages, the Economist magazine recently published a review on this situation.
If you want up to date detailed information about a drug licensed for use in the UK then you may wish to check out another excellent resource https://www.medicines.org.uk/emc/ This contains the Summaries of Product Characteristics (SPC) and Patient Information Leaflets as well as other material and according to https://www.medicines.org.uk/emc/about-the-emc there are over 14 000 documents lodged here. There is also a useful links page which can signpost you to other therapeutic resources. If you want directions to even more online therapeutic resources then an excellent links page can be found at https://rdtc.nhs.uk/links
However, if you want specific information about drug safety, the Medicines and Healthcare products Regulatory Agency (MHRA) has a useful resource. Again this resource is free and openly accessible.
As you can see, the digital world has a large number of excellent resources to support prescribers in their quest to achieve best possible practice.
Dr Harry Brown is a GP from Leeds and Medical Editor GM Journal.