M. Balen, BSc(Pharm), PharmD
J Inform Pharmacother 2002;9:500.
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The proliferation of the "evidence-based" practice paradigm and the pharmaceutical care practice model requires adeptness at navigating an unprecedented volume of literature. According to the National Library of Medicine, an estimated 10,000 completed references are now added to the MEDLINE database on a weekly basis.(1) In addition to MEDLINE, there are other online databases such as EMBASE, HEALTHSTAR and the International Pharmaceutical Abstracts, as well as the internet in general. This information is available to both the healthcare professional and the general public. An increasingly informed healthcare consumer places yet a further demand for the pharmacist to continue to be up to date with healthcare information.
Keeping current with the health sciences literature is an everyday challenge that many healthcare professionals face. This undertaking, although potentially daunting, is necessary for optimal patient care. Some professionals already have a good surveillance approach to the literature, but most probably have a desire to further improve their skills.
Personally, I can recall many times during my two years as a Doctor of Pharmacy student, where I would encounter a role model pharmacist who always seemed to have relevant citations or articles in their files to support the clinical or educational issue at hand. Often these papers came from a wide assortment of journals, some were recent and some were "classics". What did these elite professionals do to keep their knowledge and their personal reference files so complete and up to date? They must have spent hours reviewing the literature and reading the articles, or so it seemed. What these pharmacists had, in fact, was "a system". The system was comprised of an approach to life-long learning, a case-by-case, patient-oriented method of acquiring resources, and a knowledge of how to make technology work for them.
This article is the first of a multi-part series that will review a number of methods whereby healthcare professionals can use the Internet and email to help them to keep up with professional literature. Part one of the series will outline how journal contents can be delivered to you by email. Subsequent installments will review other technology-based surveillance strategies for keeping aware of professional publications. These strategies include using on-line abstracting services; the PubMed search engine, and on-line journal clubs.
Some basic computer skills are required in order to In order to incorporate the strategies discussed in this review. Users will need to be email literate and know how to use an Internet browser such as Netscape or Internet Explorer. Some basic internet search engine techniques will also be needed.
Experienced pharmacists may already have a core set of journals that they follow in order to keep up to date with developments in their practice area. New clinicians, or pharmacists who are new to a particular clinical practice area, will first need to decide what information sources are available to them. For example, a new graduate responsible for providing pharmaceutical care to patients in a general medicine practice environment has several key publications to be aware. Information that may impact pharmacotherapy may be provided by a core set of professional journals. An example of a core set of journals that may be of relevance to pharmacists practicing in a broad spectrum of practice areas is provided in Table I.
Table I. Example Core Professional Journal Set for Keeping Up with Developments in Pharmacotherapy
American Journal of Health System Pharmacists
Annals of Pharmacotherapy
Annals of Internal Medicine
British Medical Journal
Clinical Infectious Diseases
Journal of the American Medical Association
New England Journal of Medicine
Journal of Informed Pharmacotherapy
Once core resources have been identified, the publishers' internet site can be reviewed to investigate whether or not an automated e-mail table of contents (an "eTOC") delivery service is available. E-mail table of contents is a process whereby the full issue table of contents is delivered from the publisher to the recipient by e-mail. For the Journal of Informed Pharmacotherapy, simply click on the Elert service icon at the top right corner of the opening screen, or in the left border index, for each issue (Figure 1)
Figure 1. Subscribing to the Journal of Informed Pharmacotherapy Email table of contents (Elert) service
For additional journals, the publishers website can be located by typing in the journal name into an Internet search engine such as Google. For example, in order to locate the Internet site for "Annals of Pharmacotherapy", type the journal name into the Google search bar. The appropriate link should appear at or near the top of the search results page (Figure 2). Follow the desired link to the Journal site. Once the publishers web page is in view, look for a link to a table of contents feature as shown in figure 3. Often the link will have a name such as econtents, elert, or customized alerts to suggest that contents are deliverable by email. This process can be repeated for all the journals that you wish to receive the eTOC.
Figure 2. Finding a Professional Journal Website with an Internet Search Engine
Figure: 3 The Annals of Pharmacotherapy E-mail Table of Contents Service. Note the "E-Contents" link in the left side column menu.
Once eTOC subscriptions have been activated, delivery of journal table of contents will begin to arrive by e-mail according to publisher release schedule (e.g. weekly for the New England Journal of Medicine). In order to avoid excessive email inbox clutter, subscribers should consider making a dedicated folder or "mailbox" to store eTOC mailings. These e-mails can then be reviewed when time permits. The help section of most e-mail software can provide instructions as to how to set up mailboxes or mail folders to store messages. Also, mail software filtering rules can be applied to automate the transfer of eTOC messages to specified mail folders. Making a habit of scanning through available eTOC is an efficient way to keep up to date with what is coming out in the health sciences literature. Selective reading of articles that are likely to impact practice will help subscribers remain current with advances in pharmacotherapy.
Keeping up to date with professional literature by paper-based means can be a daunting challenge. Advances in information technology make the surveillance of health science publications convenient and manageable. Subscribing to the eTOC service that some journal publishers provide is one strategy that can help health care professionals keep up to date with new developments in their practice area. The advantages of this literature surveillance technique are that information delivery is automated and available for viewing when the recipient chooses. No additional steps beyond opening an e-mail message are required in order to access the journal contents listings. Pre-requisites for using this strategy are access to an internet connected computer, an e-mail account, and familiarity with how to use an internet browser and e-mail software. Not all journals provide an eTOC option. For example, from within the previously identified “core journals”, neither the American Journal of Health Systems Pharmacists nor Pharmacotherapy offer such a service. The next article in the series will discuss strategies to keep up to date with professional publications that do not have eTOC.
Fact Sheet MEDLINE. Available from National Library of Medine Fact Sheets http://www.nlm.nih.gov/pubs/factsheets/medline.html . Accessed May 6, 2002.
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