Evidence based practice

This series of trials, and many more, has led to the dramatic change in how HRT is currently prescribed and greater understanding of the associated risks. HRT, once thought of as a cure-all for menopausal symptoms, is now a therapy that should be used only to reduce the frequency and severity of vasomotor symptoms associated with menopause in women without risk factors for CHD or breast cancer. The changes that have occurred over the years in the use of HRT further support the importance of evidence-based practice and judicious medication use. 

Dantzer, R. (2006). Cytokine, sickness behavior, and depression. Neurol. Clin., 24(3), 441-60. Dawes, M., Davies, P., Gray, A. et al. (2005). Evidence-Based Practice A Primer for Health Care Professionals. Edinburgh Elsevier Churchill Livingstone, de Leon, J. (2006). AmpliChip CYP450 test personalized medicine has arrived in psychiatry. Expert Rev. Mol. Diagn., 6, 277-86. 

Laura C. Morgan, Janelle A. Shumate, Loraine G. Monroe and Kathleen N. Lohr, Comparative Effectiveness of Second-Generation Antidepressants in the Pharmacologic Treatment of Adult Depression. Comparative Effectiveness Review No. 7. (Prepared by Rti International-University of North Carolina Evidence-Based Practice Center under Contract No. 290-02-0016.) Rockville, Md Agency for Healthcare Research and Quality (2007) www.effective-healthcare.ahrq.gov/reports/final.cfm... 

Mayo-Smith MR Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. American Society of Addiction Medicine Working Group on Pharmacological Management of Alcohol. JAMA 1997 278(2) 144-51. 

McMaster University Evidence-Based Practice Center (1998). The treatment of attention-deficit/hyperactivity disorder an evidence report (contract 290-97-0017). 

Kaminer Y (2002). Adolescent substance abuse treatment evidence-based practice in outpatient services. Current Psychiatry Reports, 4, 397-401... 

McDonagh, M., Peterson, K. (2006, May). Drug class review on pharmacological treatments for ADHD Final report 2006. Portland Oregon Evidence-Based Practice Center, Oregon Health and Science Center. 

Humphreys, K., Wing, S., McCarty, D., Chappel, J., Gallant, L., Habcrie, B., ct al. (2004). Self-help organizations for alcohol and drug problems Toward evidence-based practice and policy. Journal of Substance Abuse Treatment, 26, 151-158. 

McGovern, M. P, 8c Carroll, K. M. (2003). Evidence-based practices for substance use disorders. 

It is hopefully clear from the foregoing discussion that the principles of evidence-based laboratory medicine can underpin the way in which laboratory medicine is practiced, from the discovery of a new diagnostic test through to its application in routine patient care. The principles provide the logic on which aU of the elements of practice are founded. The tools of evidence-based laboratory medicine provide the means of delivering the highest quality of service in meeting the needs of patients and the healthcare professionals who serve them. The application of evidence-based practice is far more complex in the case of laboratory medicine than in the major area in which such principles have previously been applied, namely the pharmaceutical intervention. 

AHRQ has several initiatives that should be of particular interest to the clinical pharmacy community. These include the Centers for Education and Research in Therapeutics (CERTs), the Evidence Based Practice Centers (EPCs), National Guidelines Clearinghouse (NGC), and a coordinated set of activities with the goal of Translating Research Into Practice (TRIP). 

The philosophy of evidence-based practice is widely accepted, although operational and implementation issues represent major barriers. One of the significant barriers is a shortage of evidence reports on topics of critical interest, and the lack of a national infrastructure to prepare such reports. In response to this need, AHRQ has funded 12 Evidence-based Practice Centers to conduct systematic, comprehensive analyses and syntheses of the scientific literature to develop evidence reports and technology assessments on clinical topics that are common, expensive, and present challenges to decision makers. Since December 1998, 11 evidence reports have been released on topics that include sleep apnea, traumatic brain injury, alcohol dependence, cervical cytology, urinary tract infection, depression, dysphasia, sinusitis, stable angina, testosterone suppression, and attention deficit hyperactivity disorder. 

It is important to remember that EBM applies to a range of providers at a variety of levels. Thus, it should be used to support decision making by all healthcare providers, not just medical clinicians. It is for this reason that the term Evidence-Based Practice (EBP) is increasingly used. Pharmacy, nursing, physiotherapy, and all other professions allied to medicine should, where possible, be providing evidence-based treatment at an individual and service level. For example, evidence can support decisions about whether to treat stroke patients in a dedicated stroke unit or as part of a general ward. ... 

Evidence-based practice is increasingly recognized as the best way to maximize the chances of individual... 

Watson, M.C. Bond, C. Grimshaw, J.M. Molli.son, J. Ludbrook, A. Educational Strategies to Promote Evidence-Based Practice A Cluster Randomised Controlled Trial (RCT). In Health Services Research and Pharmacy Practice Conference Proceedings, 2001. 

Hunt, D.L. Jaeschke, R. McKibbon, K.A. For the evidence-based medicine working group. Users guides to the medical literature XXL Using electronic health information resources in evidence-based practice, JAMA, J. Am. Med. Assoc. 2000. 283 (14), 1875-1879. Westberg, E.E. Miller, R.A. The basis for using the Internet to support the information needs of primary care. JAMA, J. Am. Med. Assoc. 1999, 6, 6-25. http //text.nlm.nih.gov/ (accessed Oct. 2000). www.ncbi.nlm.nih.gov/entrez/query.fcgi db=OMIM (accessed Oct. 2000). 

Evidence-based practice. The link between subsidies and outputs creates an opportunity to specify what the outputs will be. This is important for two reasons. First, it enables the subsidies to be used explicidy to address health problems for which a solid justification exists. Second, it allows policymakers to specify interventions that are known to be evidence based and cost effective. Many health care services have litde im-... 

Agency for Healthcare Research and Quality s Evidence-Based Practice Centers (AHRQ EPCs) (http //www.ahcpr.gov/clinic/epcix.htm)... 

AHRQ has established 12 Evidence-Based Practice Centers to analyze and synthesize the scientific literature and develop evidence reports and technology assessments on clinical topics. 

Online materials to support teaching of evidence-based health care, including the Users Guides to Evidence-Based Practice, are now supported through the Centres for Health Evidence at http //www.cche.net. Table 3-4 summarizes the key elements to be... 

Hunt DL, Jaeschke R, McKibbon KA. Users guides to the medical literature XXL Using electronic health information resources in evidence-based practice. Evidence-Based Medicine Working Group. JAMA 2000 283 1875-1879. 

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