A search strategy is the order in which you search information resources. It helps ensure that you use the most appropriate resources to answer the enquiry. Very simple enquiries may only require you to consult one or two resources (e.g. what is the dose of pantoprazole for a gastric ulcer?) whereas more complex enquiries may require the use of many resources (e.g. what is the dose of intrapleural gentamicin for empyema?).
Experience will help you learn which resources are most helpful for each type of enquiry. If you are working in MI, your in-house database is always a good place to start. If the enquiry has been answered recently it could save you a lot of time and energy.
It is usually appropriate to start with general resources, such as the PI, AMH, Therapeutic Guidelines, Martindale and Micromedex first.
You may not need to use MEDLINE or Embase for relatively easy enquiries and doing so may be an unnecessary use of your time.
Search strategies can vary between individuals and workplaces depending on personal preferences and resources available.
Here is an example of a search strategy for an enquiry about enteral administration from a MI centre in an Australian hospital:
- Product information
- Don’t Rush to Crush
- Micromedex
- MEDLINE/Embase
- Compounding pharmacist
-
APF.
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Knowing when to stop searching is an important skill to learn.
Finish when you are absolutely certain that you haven't missed anything that would change your response.
That is, you are confident that your search has been exhaustive within the limits of the time, skills and access to resources available to you.
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There is a comprehensive list of search strategies in Section 5.3 of the Medicines Information Procedure Manual.
Read the following examples and then try the exercise.
Example 1
A junior doctor calls you to ask: “Can sodium-glucose co-transporter 2 inhibitors cause hyperkalaemia?”
Firstly check:
If you don’t find the information to answer your enquiry consider:
- Martindale
- AHFS
-
DRUGDEX (in Micromedex)
If you still haven’t found enough information try:
Recognised adverse effects for established drugs usually only require that you check first-line resources, especially if the enquirer only wants a yes or no answer. If the adverse effect is unusual, the drug is relatively new or if you need more in-depth information (such as incidence or information about management), then you may need to proceed further through your strategy.
Example 2
A paediatric oncology pharmacist calls into your office to ask you about the interaction between posaconazole and ciclosporin. There is a child on the bone marrow transplant unit who is currently on both drugs but has suffered an adverse reaction to the ciclosporin and needs to discontinue it. How will this affect the posaconazole levels, if at all?
Firstly check:
If you don’t find the information to answer your enquiry consider:
If you still haven’t found enough information try:
Exercise
A gastroenterologist telephones you to ask about the safety of infliximab in pregnancy. A patient with Crohn’s disease has received several doses of infliximab over the last month and has just found out she is 10 weeks pregnant.
What resources would you check first?
Show answer
Australian product information, AMH, RWH Pregnancy and Breastfeeding Guide.
If you didn’t find an answer, where would you look next?
Show answer
REPRORISK in Micromedex, Briggs Drugs in Pregnancy and Lactation (Briggs).
And if you still needed more information?
Show answer