Health

Beyond the labelling: Expert medication resources are essential for safe and effective patient care

Drug manufacturer labels and national formularies are often too limited in scope and depth to provide the patient-specific recommendations clinicians need to avoid adverse reactions.

The evolving landscape of medicine

As clinicians, we know that the field of medicine is a constantly evolving landscape, with new research emerging daily that enhances our understanding of diseases and expands the arsenal of drugs available to treat them.

For those on the front lines of patient care, this becomes even more challenging. Balancing the need for safe and effective treatment with the unique circumstances of individual patients and the limitations of existing resources is an issue that clinicians are dealing with around the world.

The foundation of safe prescribing: licensing and labelling

The foundation of safe prescribing lies in the licensing and labelling of medications. These regulations ensure that medications are rigorously tested and proven effective for their intended uses. However, the focus of this information is often on the broad strokes of regulatory approval, leaving out the finer details and nuances that are crucial for clinical decision-making. Regulatory approval and labelling primarily focus on approved uses, dosages, and safety warnings, which may not capture the dynamic nature of medical research. Emerging evidence on a drug’s effectiveness for off-label uses remains largely absent. Additionally, the latest prescribing strategies developed through real-world clinical experience may not be reflected in these documents, leaving clinicians out of the loop on potentially life-saving advancements.

The limitations of current resources for clinicians

National formularies, which are commonly relied upon by clinicians for prescribing information, frequently draw heavily from these licensing documents. While they provide essential general information about a medication, they fall short in several key areas.

  • Limited scope of information: The information available in formularies and labels often adheres to a one-size-fits-all approach. Labels cater to a broad audience, offering a simplified version of a drug’s interaction with the human body. However, each patient is unique. Factors such as age, weight, existing health conditions, and genetic makeup can significantly impact how a drug behaves within an individual. Limited information can lead to dosage miscalculations, increasing the risk of a medication being, at best, ineffective. At worse, it could cause adverse reactions and patient harm.
  • Lack of depth and breadth: Manufacturer labelling often prioritizes brevity, omitting detailed information on a drug’s mechanism of action, potential side effects at different dosages, or how the drug interacts with specific foods or supplements. This lack of depth hinders a clinician’s ability to fully understand a medication’s intricacies. Without a thorough understanding of how a drug works, potential side effects may be difficult to anticipate or manage. Similarly, omitting details on the severity and prevalence of adverse reactions at various dosages makes it harder to discuss potential downsides with patients and make truly informed decisions together.
  • Drug interactions and adverse reactions: A medication prescribed for one condition might interact poorly with another drug or supplement a patient is taking for a different indication, leading to reduced effectiveness or serious health complications. Whilst labelling and formularies often provide concise lists of interactions, there is a lack of actionable recommendations. Limited information on potential interactions makes it challenging for clinicians to identify these risks and manage them, potentially jeopardizing patient safety.

These limitations highlight a clear need: The current resources available to clinicians are insufficient for navigating the complexities of modern medicine. A high-quality, evidence-based solution is needed to empower clinicians to diagnose effectively, prescribe medications with greater precision, and ultimately deliver superior patient care.

The impact of comprehensive resources on patient care

More comprehensive resources that seamlessly integrate the latest research findings, such as UpToDate® Lexidrug™ drug reference solution and Medi-Span® embedded drug data, enable clinicians to stay informed about the most recent, evidence-based prescribing strategies. These resources provide patient-specific guidance, considering a patient’s medical history, potential drug interactions, and even down to their genetic variations. This level of personalized information would significantly reduce the risk of adverse reactions and optimize treatment effectiveness. Providing clinicians access to detailed information allows them to identify and anticipate potential side effects and manage them proactively.

A trusted solution partner backed by trusted evidence and a rigorous editorial review process will not only highlights potential issues with prescriptions and treatments but will also provide clinicians with a clear action plan on how to manage these situations. One clinical resource that covers all stages of the medication process – from diagnosing, to prescribing, to administration and onto monitoring and management – aligns clinicians and clinical teams, providing all with the consistent access to the information that they need, at the right time, and allowing them to find guidance specific to the patient that they are treating.

Streamlining medication prescribing, administration, and monitoring

How could a more personalized medication decision support solution work for you and your clinical teams in the real world?

Step 1: prescribing

Let’s consider the following clinical situation: An elderly patient with a background of epilepsy has been diagnosed with hospital-acquired aspiration pneumonia. The usual local hospital guidelines recommend meropenem for this indication, but how do we adjust this for our specific patient at the prescribing stage? Firstly, we consider:

  • Do they have any renal impairment associated with their advanced age?
  • Is their infection susceptible to meropenem, and how would we test for that?
  • What medicines are they taking for their epilepsy that could interact with the treatment?

In this case, the labelling states that the use of meropenem with valproic acid and its derivatives are not recommended, but no practical information is provided to the clinician on how this should be managed in practice. What alternatives can be given?

Step 2: verification

Once a prescribing decision has been safely made, the pharmacist has additional considerations prior to verification.

  • How should the treatment be monitored?
  • When should this be reviewed?
  • How do we step the patient down?

Step 3: administration

Even when the medication is verified and ready to be administered, the nursing team will have additional questions that need to be answered to ensure safe administration.

  • What infusion options do I have for this treatment?
  • Can I safely administer this IV medication alongside the others prescribed for my patient, or will I need to set up a new line?
  • Is there any administration-associated reactions that I need to be aware of?

Without a trusted solution, these various clinicians can end up working from disparate resources, with varying degrees of accuracy. Resources such as UpToDate®, UpToDate Lexidrug, and Medi-Span align the highest-quality evidence with patient management recommendations. All members of the care team have access to the answers that they need, in one place.

The role of trusted resources in medication management

The current information provided by labelling and national formularies is not enough for modern medicine. The limitations of existing resources force clinicians to balance adhering to regulations with providing the best possible care for their patients. A more comprehensive solution that integrates the latest research, offers patient-specific guidance, and provides in-depth drug information is essential. Empowering clinicians with such a tool would not only streamline the prescribing process but also lead to safer, more effective, and ultimately better patient care.

Learn more about Wolters Kluwer medication decision support solutions.

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Jordan Fulcher headshot
Clinical pharmacist and clinical solution consultant for the EMEA region at Wolters Kluwer, Health
Jordan Fulcher is a clinical pharmacist and clinical solution consultant for the EMEA region at Wolters Kluwer Health. He also provides clinical pharmacy support to acute admissions wards and emergency departments of Norfolk and Norwich University Hospitals NHS Foundation Trust as a bank pharmacist.
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