Accessing data for quality improvement

Clinical pharmacologists are well placed to improve practice both locally and nationally. Locally, many drug and therapeutic committees are led by clinical pharmacologists, using evidence-based medicine to establish local formularies and lead good prescribing practice within organisations. Use of local and national prescribing indicators by clinical pharmacologists has led to the identification of both good and poor prescribing practice. Examples of good practice are promoted more widely and poor practice is addressed through education and training. One example is the materials developed to promote the appropriate use of tramadol for pain management.   

On a national level, clinical pharmacologists are involved in assessing data packages used to obtain marketing authorisations for new medicines, and subsequently in evaluating their clinical and cost effectiveness. This post-marketing assessment results in more effective use of finite NHS resources and an overall benefit for patients.

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Clinical pharmacologists have a role to play in pharmacovigilance, leading regional adverse drug reaction monitoring centres and contributing to the collection of national datasets on drug safety such as the Yellow Card Scheme. Similarly, clinical pharmacologists run TOXBASE, the National Poisons Information Database, which has been successful in identifying clinical effects of xenobiotics in overdose. In addition to assessments directly related to individual medicines, clinical pharmacologists often have a specialist interest, eg in hypertension or stroke medicine, and use large databases to develop new national, evidence-based therapies and guidelines.