With Lexicomp, Kochi University Hospital facilitates drug safety, security, and quick searches for drug information
Mission: provide evidence-based drug information
We pharmacists receive "drug questions" from various departments in the hospital. In particular, as a university hospital, there are many patients with rare diseases, and there are many inquiries about drugs that are rarely used on a daily basis, dosages for pregnant patients and extremely premature babies.
We first check the "Attachment" to the drug to respond to the inquiry. However, while the package insert describes "cases where the drug must not be dispensed," there is no information about "cases where it can be dispensed." Even if you contact the pharmaceutical company, the cases that are out of the indication of the drug are not disclosed, so it will take several days to get an answer.
Of course, these cases are so rare that we do not encounter such situations every day. However, as drug professionals, we need to provide evidence-based information as soon as possible. In such a case, Lexicomp is used as a tool that easily finds the necessary and accurate information.
Use of Lexicomp in Pediatrics and Obstetrics and Gynecology
I am in charge of the pediatric unit, so I often receive inquiries about the dosage of drugs for newborns and children. For example, if a drug is not prescribed for children in Japan, Lexicomp may find information on dose adjustment in overseas guidelines, such as FDA (US Food and Drug Administration) standards. This is the best reason for me to use Lexicomp. Also, regarding drug preparation, we are asked about the amount of antibiotics dissolved. Lexicomp also helps in these situations, as the answers require the right information. The rich information on pregnancy and breastfeeding is another reason why I want to use Lexicomp.
Currently, I am not in charge of the ward, but with regard to drugs related to pregnancy and breastfeeding in obstetrics outpatient departments, I will discuss the drug contents with doctors and nurses and provide information to patients. One patient who was consulted in the outpatient department had been worried for a long time because she took the drug in the early stages of pregnancy. She was reassured by the information provided, and she said, "Thank you" to me in tears.
Of course, we cannot simply say a drug is "OK" for patients. However, we can tell that there is no information that it has a negative effect. In other words, when we look at drugs, we also need the perspective of "no information." Lexicomp plays an important role in terms of evidence-based, global drug information, and even enables us to say that there is "no information available."
Providing accurate and appropriate drug information
A pharmacist has various roles. There are specialists in the fields of cancer, pediatrics, and allergies, and I am involved in a wide variety of tasks such as belonging to an ICT (infection control) team in the hospital. As a pharmacist at a university hospital, in addition to the daily efforts to keep an eye on drug information, inquiries about drugs are required to provide accurate and appropriate information in a short time.
The other day, I investigated the relationship between exfoliative skin disorders in offspring of patients who continued to take a hyperthyroidism drug during pregnancy. As I searched in Lexicomp, I found that the drug had an effect on the thyroid gland of the offspring, but at the same time, I found that there was "no" information on skin disorders. Therefore, I provided information to the doctor, assuming that there is no relation to skin disorders in newborns. Although we usually provide the information examined verbally, we can share it by putting it in an electronic medical record or compiling it as a document.
Depth of information is the key to drug safety for the entire hospital
We aim to be the "point of medical safety regarding drugs" at this hospital. In a university hospital, many patients are at high risk, and the drugs used vary. In such an environment, pharmacists play a major role in ensuring the safety of drugs.
However, not all pharmacists are at the same level of knowledge. Some pharmacists are certified under specific specialties, but it is necessary for all pharmacists to provide a certain level of information even for professional matters, because it is not impossible to provide information without a professional qualification. I think Lexicomp may be useful in this situation as well.
Patients’ anxiety and the effects of drugs are everywhere. In order to provide accurate information that leads to the safety and security of patients, we would like pharmacists to use Lexicomp, not only in hospitals but also in other places. To me, Lexicomp is a “tool that enables us to search information quickly and accurately.”
About Kochi University Hospital
Kochi University Hospital is the only university hospital (special function hospital) in Kochi Prefecture that provides advanced medical care, develops and evaluates medical technology, and is an educational institution that trains junior doctors and nurses. Currently, the entire hospital is being renovated, and operating rooms, ICU, GCU, NICU, etc. equipped with the latest equipment are in operation. The hospital is also a core medical institution for acute care, disaster care, cancer care, etc., and contributes significantly to regional medicine. The hospital has been using Wolters Kluwer’s Clinical Effectiveness solution since 2005.
- Lexicomp has been chosen by the Pediatric Pharmacy Association as the only choice of electronic drug database for reference in the development of the “KIDs List” – a list of drugs that are potentially inappropriate for use in pediatric patients.