Drug information services in Nepal: the changing perspectives.

here are a growing number of drugs and vast literature coming through every day. Clinicians are hard pressed to keep up with all the recent advents due to shortage of time, however, for safe and efficacious use of medicines, unbiased, up to date and objective information about the drugs is essential. Medicines are now considered as active substances plus information 1. Information obtained from manufacturers is liable to be biased, and in the present day of therapeutic and information explosion, a quick referral to a pharmacopoeia or formularies is hardly sufficient for adequate information on the vast number of drugs and dosage forms available in the market in all the different brand names. Drug information (DI): DI is defined as the knowledge of facts acquired through reading, study or practical experience, concerning any chemical substance intended for use in diagnosis, prevention or treatment of disease. It covers all types of information provided, including subjective and objective information, as well as information gathered by scientific observation or practical experience 2. Drug Information Services (DIS): DIS encompasses the activities of specially trained individuals to provide accurate, unbiased, and factual information primarily given in response to patient oriented drug problems received from pharmacists, nurses, clinicians and other healthcare professionals 2. Need of DIS in Nepal: Like most other developing countries, Nepal also suffers from lack of adequate drug information due to limited availability of current literature, and poor documentation and dissemination of the little available information 3. According to one study in 1993 4 , unbiased and current drug references were not available in most clinical facilities and to officials and committees developing drug lists and making procurement decisions. Some examples of irrational use of drugs still in evidence in Nepal are: polypharmacy, use of expired drugs, irrational combination of drugs, and overuse of antibiotics, vitamins / herbal remedies, brand prescribing, retail shop prescribing and unethical dispensing. Such irrational practices, combined with lack of patient information on proper handling and use of drugs can lead to wastage of medicine as well as other serious consequences like adverse drug reactions and drug interactions 4. In addition, there are other factors like remote rural population, few hospitals, shortage of pharmacies in most of the existing hospitals, poverty, illiteracy, high demand for drugs not consistent with rational use in rural areas, and no sense of risk in taking drugs which further complicate appropriate use of drugs. …