The articles in this issue provide an excellent foundation for the application of evidence-based medicine (EBM) by pharmacists. The references and web sites listed help readers understand what EBM is, where to find the
"evidence" and how to apply it to benefit patients.
The inverse of EBM is empiric-based medicine under which most of us have been trained. EBM challenges the concept of physician experts who dictate medication and other orders based on "experience." As evidence is increased, we are likely to see a more systematic approach to medication therapy-one based on science and not simply clinical impression or memory. The development of EBM gives pharmacists the opportunity to espouse rational medication therapy. I could define the pharmacist's role in the application of EBM to pharmacotherapy as evidenced-based pharmacy practice (EBPP).
EBPP challenges pharmacists to:
Pharmacists who develop EBPP will feel enriched because they will take a leadership role in the application of scientific and well-documented pharmacotherapy to the care of their patients.
- Understand how to find and keep abreast of the "evidence" relevant to their area of practice
- Apply evidenced-based practice to their patients and analyze when the evidence might benefit patient care and when it might not
- Individualize the application of evidence to specific patients. This might be complex in a patient with multiple problems for which the evidence is not fully developed.
- Consistently apply EBM in Pharmacy and Therapeutic Committee decision-making
- Assure that drug information centers are an institutional resource in applying EBM to development of the hospital formulary
- Develop a variety of case studies by which new pharmacy staff members and students could be trained in the application of EBM, to encourage them to prepare EBM cases as they develop their practices
- Study (formally or informally) where patient outcomes are enhanced through the application of EBM
- Use EBM in interdisciplinary discussions and case studies
- Apply EBM in the development of practice guidelines, decision-support databases and the use of computerized practitioner order entry systems