Parastou Donyai

Introduction

The current era is characterized by man’s inordinate ability to store, retrieve and transmit large volumes of information using computer technology. Albert Einstein proposed that the secret of success is ‘to know where to find the information and how to use it’. Most pharmacists would probably agree. This chapter aims to provide the reader with a theoretical understanding of how to source health- and medicines-related information in the present information age. While the quality of retrieved information is considered, guidance on the detailed evaluation of what is known broadly as ‘clinical evidence’ is found elsewhere (see Ch. 20).

In the GPhC’s Standards of conduct, ethics and performance, the knowledge and provision of health- and medicines-related information, specifically, is considered in the following manner. In relation to their own knowledge and competence, pharmacists must develop their skills in-line with their area of expertise, keeping up-to-date with relevant progress through CPD (see Ch. 6). In relation to the provision of medicines-related information to those who want or need it, pharmacists are expected to be able to provide accurate, reliable, impartial, relevant and up-to-date information.

Yet with thousands of medicinal products, dressings and appliances on the UK market, pharmacists are highly unlikely to hold in-depth knowledge of all health- and medicines-related issues at all times. Therefore, the ability to retrieve relevant health- and medicines-related information in a timely and efficient manner becomes central to the practice of all pharmacy professionals (Box 16.1).

Where does information exist and how can it be retrieved?

Information retrieval is the tracing and recovery of stored information. Information can range from patient information to drug monographs, to more sophisticated health technology assessments. It can exist in many forms from the archives of a drug company to the worldwide web. Effective information retrieval requires an understanding of the range of relevant information available, where it exists and how it might be sourced.

Pharmacists sourcing information are likely to use the internet at some point during their search. The expanse of information on the Web and its apparent accessibility has integrated the internet into most work routines. While, on the whole, the seemingly endless material may not suit most pharmacists’ information needs, there are specific online resources that pharmacists can browse. These include websites operated by governments, professional, practice, regulatory or academic bodies, as well as websites belonging to patient groups and the pharmaceutical industry. However, the fluid nature of the internet, the vast array of information available, plus the variable nature of each query will probably involve pharmacists in some degree of internet searching. This necessitates an understanding of search engines and search strategies. There are databases on the net and on CD-ROM which act as directories for scientific papers and other publications and, as such, can be used to search for available material.

Before widespread use of the internet, the principal source of health-related information was the printed book. Books still contain a vast array of indispensable information and reputable ones play a vital role in information management. Although individual pharmacies may not keep the full range of essential books, specialist centres will have access to these and to other resources.

Directory of useful websites

Table 16.1 provides a list of some of the established health-related websites, although web addresses or pathnames can change or more useful sites can be created. To help order the directory, similar websites are grouped together. The list is not exhaustive and it should be used as a starting point.

Bookmarking

Once a number of relevant websites have been identified and authenticated for inclusion, these can be stored as a saved text file, using hyperlinks to connect each typed URL address in the document to the address bar on the browser and therefore the desired web destination. Hyperlinks are, usually, in a different colour to the rest of the document or are underlined and can be activated by a mouse click.

Hyperlinks provide a way of finding and bookmarking useful websites. Websites normally have a directory of related websites as ‘links’.

An accepted method of bookmarking relevant pages is to use an internet browser with functions such as ‘Favourites’. A marker points at a website which then enables the user to quickly return to that site without having to remember and type in its URL. Browsers usually offer the facility for organizing the bookmarks into folders and subfolders.

There are also innovations such as the social bookmarking website http://delicious.com/, which provides a means of storing personal bookmarks online instead of within the browser, thus enabling bookmark information to be accessed and shared online.

Searching the internet

Accessing a list of useful websites and following the links therein is one approach to finding information on the internet, but is unlikely to be productive unless the query falls specifically within the remit of a known website. With the web containing over 40 billion pages, at some point it is likely that the website containing the required information is simply unknown to the user and it has not been possible to reach it via ‘browsing’ the internet. For that reason, it is essential to have a good appreciation of internet search options.

Effective use of search engines

Before beginning a new search, the user should take time to consider what they already know, knowledge gaps and information required. It is advisable to have a plan that focuses the search. The user should select a set of keywords that best reflect the information need and narrow the search to a particular subject or topic. Results should be compared to the original information need. If appropriate material is found on the first page of the search then the activity need go no further. It is important to know when to stop searching, especially when there is limited time.

When, however, the results do not match the information need, it is advisable to pause and reflect. The user should consider what they are searching for; can the search be refined by changing keywords, perhaps adding, taking away or replacing them? The keywords must match the information needed. One additional approach is to subtract any redundant words from the search query. These include words such as ‘a’, ‘an’, ‘the’, ‘and’, etc. It might also be helpful to rearrange the search so that the more important search terms are placed first, to give more influence when the results are ranked.

Boolean terms for academic databases are described in more detail later. In Google™, the Boolean terms AND and NOT are not used in the traditional sense. Google™ will automatically link a series of words using the AND operator, instead of NOT, to eliminate a word from the results. A space should be left after the word that is needed and a minus sign (−) should be typed immediately before the word that is to be excluded. The term OR can, however, be used in Google™ by typing OR between the words. Google™ can also be forced to link words by using a plus sign (+), especially where one of the words is a common word that might normally be ignored. The search engine can also be asked to search for a string of words in a particular order, e.g. ‘Community-acquired pneumonia’. The user should examine search engine tools to make the most of any advanced features. Sometimes, the search engine itself may need to be changed or the basis of the search re-examined.

It is important to recognize that search engines do not necessarily index the whole of each document they retrieve. A search engine may upload each page in full, but it may only use the first few thousand characters for indexing and so vital information further down the web page will escape being indexed. Where a search engine does return a link to a site, sometimes it is not possible to access the content if the user is behind their organization’s ‘firewall’. Search engines do not locate everything on the web first-hand. It might be that a general search engine finds another site that is a more appropriate starting point, for example a health services directory. In that way, the search is narrowed automatically.

Some public web pages are protected from search engines through use of a file (robots.txt) that blocks access to the robot. This normally relates to personal, sensitive, interactive, timely or premium (subscription, or paid for) content. Another place that search engines cannot always reach is commercial data collections, or collections of valuable, copyrighted content, such as subscription-based academic journal databases and other specialized databases, information in professional directories, patents and news articles.

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