Academic journal article Journal of the Medical Library Association

Pharmacist Perception and Use of UpToDate®*

Academic journal article Journal of the Medical Library Association

Pharmacist Perception and Use of UpToDate®*

Article excerpt

INTRODUCTION

UpToDate® is an important resource for providing evidence-based information at the point of care. It is partnered with Lexicomp® Online, which provides the specific drug monographs for the resource. UpToDate is known for providing specific patient care recommendations, potentially impacting clinical health care professionals' decision making [1], Promotional material for UpToDate suggests its use improves clinical outcomes; however, these claims are based on an observational study that found marginal improvement in hospital length of stay (5.6 vs. 5.7 days, P<0.001) and mortality (9.0% vs. 9.1%, P=0.04) in institutions subscribing to UpToDate, compared to those that do not [2],

Physician opinion of UpToDate has been extensively analyzed. In prior studies, UpToDate was preferred by physicians over other commonly used point-ofcare resources in terms of information layout, confidence in use, and/or satisfaction with content [3-8]. Thiele et al. found that users of UpToDate were significantly more confident in their answers to 4 clinical questions, compared to users of Google, Ovid, and PubMed [6[. Similarly, users were more satisfied with the accuracy of retrieved answers and ease of use with UpToDate over PubMed Clinical Queries, according to Sayyah Ensan et al. [7], Studies have also measured the currency and review procedures of UptoDate. UpToDate claims to update with new information daily but does not follow any specific updating schedule [1]. In 2 studies, UpToDate had substantial lag times in information integration, taking up to 11 months to incorporate new information [9, 10]. Additionally, according to UpToDate's editorial policy, only some articles undergo independent external peer review [1],

With UpToDate's rising popularity, evaluation of its use among health care professionals is essential; however, studies focused on pharmacists are largely unavailable. The objective of this study was to (1) describe pharmacists' use and perception of UpToDate, (2) determine contribution of demographic factors to whether pharmacists choose to use this resource, and (3) describe their perceptions of product updating time and peer-review processes. Because the sample consisted of pharmacist preceptors, questions regarding allowed uses of UpToDate by pharmacy students were also posed.

METHODS

This was a cross-sectional survey of a convenience sample of Purdue University College of Pharmacy Advanced Pharmacy Practice Experience (APPE) preceptors. These individuals could be faculty, adjunct faculty, or pharmacist volunteers. The survey instrument, available on SurveyMonkey®, was distributed to 1,199 potential participants via electronic mail in October 2012. It was communicated that participation was voluntary. Two reminders were sent, and the survey was open for 3 weeks. Survey results were kept anonymous. The study was approved by institutional review boards (IRBs) at each investigator's institution.

The survey consisted of ten research questions and four demographic items that were developed over a series of meetings between authors Wallace and Beckett (Appendix, online only). The basis of questions was a literature review of articles focusing on prescriber use of UpToDate [3-10]. An investigation of similar scope as this project, but focused on Wikipedia, was also reviewed for potential questions [11], The survey instrument was further developed and piloted with a focus group of Manchester University College of Pharmacy faculty, who also serve or have served as APPE preceptors, in October 2012. All research questions had at least two possible responses and were structured to yield nominal data. Unless otherwise stated, participants could only select one answer. Answers were provided alphabetically unless a more logical order existed (e.g., time-order variables). Question and answer items appeared in the same order for each participant.

All initial respondents were included in the calculated response rate. …

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