Although drug information is readily available in books and drug databases accessed via the Internet or personal digital assistants, there are still some situations in which verbal communication with a knowledgeable source is often the quickest strategy for answering clinical questions about medications. A noncommercial, pharmacist-operated drug information service can be a useful information alternative that offers a personalized approach.

The primary goal of a drug information service is to improve patient care by providing objective and unbiased information for drug-related questions. Drug information services are facilities or personnel dedicated to and specializing in the provision of written or oral information about drugs and pharmacotherapy, in response to a request from other health care professionals, organizations, committees, or patients. A drug information expert can estimate how much time may be necessary to perform the research, consider the urgency of the requestor, and prioritize requests. There is no special accreditation or licensing for drug information services; it is the pharmacist who is licensed.

Drug information is often cited as the first clinical pharmacy function to have developed in U.S. hospitals, and the specialized skill set needed for drug information practice is taught in nationally accredited postdoctoral pharmacy residencies across the country. Drug information specialists have the literature evaluation skills necessary for providing evidence-based recommendations, and they are experts at utilizing various sources of information. Drug information services are financially supported by a university, the state, or a hospital.

The benefits of drug information services have been demonstrated in a sample of more than 1,000 hospitals.¹ The presence of a drug information service was associated with statistically significant decreases in medication costs, total costs of care, medication errors, and patient mortality rates. One study that retrospectively examined medical records compared two similar cases of patients who were taking neuroleptic drugs and had amenorrhea and elevated prolactin levels.² A psychiatrist ordered a computed tomography scan for one patient, but consulted a drug information service before it was performed. The service recognized the elevated prolactin levels as a documented adverse drug reaction to the neuroleptic medication, and the scan was cancelled, saving $2,573 in direct costs. In the second patient, for whom the service was not consulted, unnecessary costs for diagnostic investigations and drug treatment totalled $42,892.² In the hospital setting, drug information services are associated with reduced costs of $1,962 per occupied bed per year, or $430,580 to $1.7 million per hospital per year.^3,4

Perhaps the best way to demonstrate the usefulness of drug information services is through examples of questions that have been posed:

• Which medications can be used to treat pain in an injured patient who is on maintenance naltrexone therapy for alcohol abuse?

• Are there any alternative formulations or dosing methods for a patient who has trouble swallowing tamsulosin capsules?

• How long of a washout period is needed between stopping St. John's wort and starting a selective serotonin reuptake inhibitor?

• What is Zerinol, a drug my patient received in Italy, and what is the closest U.S. equivalent?

• What dose of acetylcysteine is recommended to prevent contrast-induced nephropathy?

Table 1 lists locations and contact information for U.S. drug information services that accept questions from health care professionals, regardless of their institutional affiliation. Some services limit their assistance to health care professionals within their state, and some services accept questions internationally. There are a number of Poison Control Centers that also serve as a drug information service for nonemergent questions.