Problem-oriented drug monographs developed for physicians in Northern Ireland

Monographs prepared by a drug information pharmacist at a government hospital in Northern Ireland were evaluated by hospital and community physicians. The monographs related drug information to both the primary medical problem (e.g., angina) and secondary problems of individual patients (e.g., renal or hepatic dysfunction). The pharmacokinetic and pharmacodynamic properties of various agents in a drug group were compared. The initial monograph about beta blockers was evaluated by 13 pharmacists in government hospitals. The monograph was then revised and two additional monographs were written on the use of benzodiazepines in anxiety and insomnia and the use of organic nitrates in cardiovascular disease. The three monographs were distributed to 122 hospital physicians and 67 community physicians for evaluation of the information and the manner in which it was presented. Questionnaires were returned by 46% of the hospital physicians and 39% of the community physicians. Almost 50% of the responding prescribers said the monographs gave them new information. The lack of cost information in the monographs was cited as a problem by 25% of respondents. The most frequently suggested topics for additional monographs were antibiotics, analgesics, nonsteroidal anti-inflammatory agents, bronchodilators, and antidepressants. Physicians considered the monographs a useful source of education about selection of appropriate drug therapy.