USEFUL LINKS TO EVIDENCE BASED INFORMATION

Academic Detailing Choosing WiselyJune 1 2019PamSt. Andrews NBPam McLean-Veysey mclean-Veysey October 13 2018

DISCLOSURE

Pam McLean-Veysey, Team Leader Drug Evaluation Unit

DEU is funded by the Drug Evaluation Alliance of NS. (DEANS).

DEU prepares Drug Evaluation Reports for the Atlantic Common Drug Review (ACDR)

She has no conflicts of interest

OBJECTIVES

To provide practitioners with links to useful Evidence Based resources

To describe the type of information and useful tools on each site.

To identify useful Apps

DAL CPD ACADEMIC DETAILING RESOURCEShttps://medicine.dal.ca/departments/core-units/cpd/programs/academic-detailing-service.html

ANAPHYLAXIS TOOLKIT

https://cdn.dal.ca/content/dam/dalhousie/pdf/faculty/medicine/departments/core-units/cpd/academic-detailing/AntibioticsPediatricPatients.pdf

OTHER CANADIAN ACADEMIC DETAILING PROGRAMS

RXfILES

http://www.rxfiles.ca/rxfiles/

BC PAD

https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/pad-service

CHOOSING WISELY CANADAhttps://www.bing.com/search?q=CHoosing+Wisely+Canada&src=IE-TopResult&FORM=IETR02&conversationid=

13 THINGS PATIENTS AND PHYSICIANS SHOULD QUESTIONLast updated: January 2018

Don’t do imaging for lower-back pain unless red flags are present.

Don’t use antibiotics for upper respiratory infections that are likely viral in origin, such as influenza-like illness, or self-limiting, such as sinus infections of less than seven days of duration.

Don’t order screening chest X-rays and ECGs for asymptomatic or low risk outpatients.

Don’t screen women with Pap smears if under 21 years of age or over 69 years of age.

Don’t do annual screening blood tests unless directly indicated by the risk profile of the patient.

Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in this age group.

Don’t routinely measure Vitamin D in low risk adults.

Don’t do annual physical exams on asymptomatic adults with no significant risk factors.

Don’t order DEXA (Dual-Energy X-ray Absorptiometry) screening for osteoporosis on low risk patients.

Don’t advise non-insulin requiring diabetics to routinely self-monitor blood sugars between office visits.

Don’t order thyroid function tests in asymptomatic patients.

Don’t continue opioid analgesia beyond the immediate postoperative period or other episode of acute, severe pain.

Don’t initiate opioids long-term for chronic pain until there has been a trial of available non-pharmacological treatments and adequate trials of non-opioid medications.

https://choosingwiselycanada.org/wp-content/uploads/2018/02/Family-Medicine.pdf

SWITCH RX

Also see - International Institute for drug withdrawal http://iipdw.com/

https://switchrx.ca/

SLEEP WELL https://mysleepwell.ca/

DEPRESCRIBING.ORG

https://deprescribing.org/

Algorithms for PPIs antihyperglycemics, antipsychotics, benzodiazepines, Cholinesterase Inhibitors

CANADIAN DEPRESCRIBING NETWORK (CADEN)

https://www.deprescribingnetwork.ca/

Researchers from the Bruyère Research Institute and the Ontario Pharmacy Research Collaboration developed evidence-based guidelines for deprescribing.

https://deprescribing.org/wp-content/uploads/2019/03/deprescribing_algorithms2019_BZRA_vf-locked.pdf

http://www.cfp.ca/content/64/5/339 - taper information

TOWARD OPTIMAL PRACTICETOOLS FOR PRACTICE

https://www.acfp.ca/tools-for-practice/

http://www.topalbertadoctors.org/home/

BC THERAPEUTICS INITIATIVEhttps://www.ti.ubc.ca/

https://www.ti.ubc.ca/our-evidence-reviews/

Podcasts – Therapeutics Education Collaborative

https://therapeuticseducation.org/

THERAPEUTIC EDUCATION PODCAST https://therapeuticseducation.org/podcast

BC Therapeutics Education Collaborative

CVD calculator

http://chd.bestsciencemedicine.com/calc2.html

JOURNAL CLUB

ACP journal club

http://annals.org/aim/journal-club

THERE’S A WIKI FOR THAT!WIKI JOURNAL CLUB

HTTP://WWW.WIKIJOURNALCLUB.ORG/WIKI/MAIN_PAGE

Wiki Landmark trials https://www.wikijournalclub.org/wiki/WikiJournalClub:List_of_landmark_papers

SIGN UP FOR UPDATESNICE - UK

https://www.nice.org.uk/news/nice-newsletters-and-alerts

NICE medicine Awareness

Recent publications from major journals

UK focused

Health Canada: Med effect e-notice of drug advisories

https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/stay-informed-medeffect-canada.html

CBC Health News

https://www.cbc.ca/news/multimedia/sign-up-for-second-opinion-our-health-newsletter-1.3853230

Journal table of contents

TRIP DATABASEhttps://www.tripdatabase.com/

TRIP EXAMPLE – PCSK9

PAIN /OPIOID USE DISORDER TOOLS

Centre for Effective Practice -Wellhealth.

https://thewellhealth.ca/

IWK DRUG INFORMATION – MANY USEFUL LINKS

http://www.iwk.nshealth.ca/pharmacy/iwk-drug-information

http://pulse.iwk.nshealth.ca/subsites/page/?id=151

ANTIBIOTIC INFORMATION

IWK

https://app.spectrum.md/clients/7-iwk-health-centre

Pediatric Dosing Guidelines

http://pulse.iwk.nshealth.ca/subsites/page/?id=121

NS HEALTH

http://www.cdha.nshealth.ca/antimicrobial-stewardship-2

NB Horizon Health

http://en.horizonnb.ca/media/951180/antimicrobial_treatment_guidelines_for_common_infections_en.pdf

VACCINES AND IMMUNIZATIONS PUBLIC HEALTH

https://www.canada.ca/en/public-health/topics/immunization-vaccines.html

Links to many resources: e.g., travel vaccinations

Immunize Canada https://immunize.ca/

RX TX – CPS PRODUCT MONOGRAPHS

https://www.e-therapeutics.ca/search

APP

RxTX Mobile – free to CMA members – CPS and more

(https://www.pharmacists.ca/products-services/rxtxmobile/

CADTH

https://www.cadth.ca/

CADTH

Recommendation for

Trelegy Ellipta Inhaler

https://www.cadth.ca/sites/defaul

t/files/cdr/complete/SR0436_co

mplete_Inspiolto-Respimat-

Dec_21-15-e.pdf

PHARMACARE FORMULARIES

Formulary (full benefit and exception status drugs)

NS

https://novascotia.ca/dhw/pharmacare/

https://novascotia.ca/dhw/pharmacare/exception-status-drugs.asp

NB

https://www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescriptionDrugPlan/NBDrugPlan/ForHealthCareProfessionals/NewBrunswickDrugPlansFormulary.html

https://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/NBDrugPlan/SpecialAuthorization/Special_Authorization_Criteria-e.pdf

DRUG INFORMATION CENTRES

NS Regional Drug Information Centre

Halifax Infirmary 902-473-4211

IWK

http://www.iwk.nshealth.ca/pharmacy/iwk-drug-information

NB

Moncton City Hospital

Saint John Regional Hospital

CLINICAL KEYhttps://www.clinicalkey.com/#!/

APPS 2015 INDUSTRY STUDY IDENTIFIED MORE THAN 165,000 HEALTH-RELATED

SMARTPHONE APPS AVAILABLE FROM THE GOOGLE PLAY STORE AND APPLE I TUNES.

IAM Medical Guidelines (McGill) https://play.google.com/store/apps/details?id=com.itpcrg.iam&hl=en_CA

(includes Deprescribing App, Canadian Thoracic Society, Cancer related etc.)

Canadian Cardiovascular Society https://www.ccs.ca/en/resources/mobile-apps

SPAF tool https://itunes.apple.com/ca/app/ccpn-spaf-tool/id913300357?mt=8

(optimize stroke prevention treatment in their patients with nonvalvular atrial fibrillation.)

ADDITIONAL EBM SITES

Acronyms? Cardiology trials http://cardiologytrials.org/

Health Technology assessments

American Department of Health and Human Resources (AHRQ) https://play.google.com/store/apps/details?id=gov.ahrq.epss&hl=en_CA