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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/
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
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 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
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
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
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