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Pharmacoepidemiological concepts and methods are frequently applied in pharmacy practice. Perhaps the most common application of pharmacoepidemiology is the use of information obtained from pharmacoepidemiological studies to make drug therapy decisions. The best clinical decisions are based on solid evidence. This chapter discusses the incorporation of evidence-based medicine into clinical practice.

Other areas to which pharmacists apply pharmacoepidemiological methods include adverse drug reaction surveillance, drug utilization evaluations (DUEs), and pharmacoeconomical analyses. All of these functions provide pharmacists with excellent sources of data to conduct more formalized pharmacoepidemiological research. This chapter also discusses how to apply the pharmacoepidemiological methods discussed throughout this book to the practice of pharmacy. Resources available to pharmacists who wish to practice in the area of pharmacoepidemiology are discussed as well.

The best drug therapy decisions are decisions based on sound evidence. Evidence that a drug is safe and effective is obtained from pharmacoepidemiological studies and disseminated via the medical literature. Medical literature can be classified as primary, secondary, or tertiary.

Primary medical literature provides new information to the field of medicine and consists of descriptive, observational, and interventional studies. All of these study designs are used to provide new information about the use or effect of a particular drug in a specific population. These studies are then published in pharmacy and medical journals.

Hundreds of medical journals are published every week. These journals fall into either general or specialty categories. General medical journals publish information on topics of interest to general practitioners, whereas specialty medical journals publish in specific areas of medical practice (e.g., dermatology, cardiology). To remain current in the field of practice, practitioners typically subscribe to a few medical journals within their scope of practice.

Secondary medical literature consists of indexing systems. It is impractical to search one by one through the thousands of editions of medical journals to find clinical information. The secondary systems allow practitioners to search through the vast array of medical journals to find information about a particular subject. Search terms are entered into a database, and the database then reveals when and where information has been published on the topic of interest. Some databases provide access to complete article(s), and others provide information only on where to locate the article(s). The most commonly used indexing system is the Medline database, which was created in 1966 and indexes more than 1600 medical journals.

Tertiary medical literature consists of literature reviews, which can be in the form of textbooks, reference books, or review articles in medical journals. Before a review is written, a literature search is conducted using the secondary systems to identify all of the articles published on a particular subject. The information is then collated and presented in a manner that is easily used by practitioners. Tertiary resources are quick, efficient resources that are used to answer questions about the most common clinical problems.

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