History

History

The history and structure of MI services in the UK largely reflect those of the NHS in which it functions, and to which most of its activities are directed. Through the 1960s hospital pharmacy was undergoing a radical change, especially with the development of ward-based, patient-focused activities – clinical pharmacy. The pharmacist’s traditional role of com-pounding and supply was being replaced by the provision of prescribing advice to doctors and nurses, and information provision directly to patients. The hospital pharmacist became the ward-based expert on med-icines and therapeutics. However, this expansion of activity was accompanied by a parallel demand for high-quality and reliable information. Prior to this, information on medicines was acquired from personal knowledge or from standard reference sources. The requirement for information and advisory support to healthcare professionals with a medicines-related role was further stimulated by a number of simulta-neous developments. The so-called therapeutic explosion in the 1960s and 1970s made available a vast array of new and potent medicines with increased efficacy and toxicity. Accompanying this was an ‘information explosion’ in which the availability of published, critically assessed, clinical information and evidence increased dramatically. This literature covered all aspects of medicines, including their pharmacology, pharma-cokinetics, comparative clinical efficacy, toxicity, use in specific circum-stances such as pregnancy, and the pharmaceutics of formulation and drug delivery. It is estimated that there are currently over 18 000 medical and pharmaceutical journals worldwide, the majority of which have the poten-tial to include information on medicines, although many are not peer-reviewed nor of high quality. Of these only about 5400 are cited by Medline and 7000 by Embase (these data sources are discussed later). The establishment of these new roles for hospital pharmacists in the UK, including MI services, was formalised in the Noel Hall report.

The demand for high-quality, evaluated, rapidly available, patient-oriented information, that was not from pharma industry, for all members of the healthcare team led to the development of drug information services, which were renamed MI services in the UK in 2000, to reflect better current terminology and links to medicines management.