Tips, Tricks for Staying Up to Date With Medical Literature, Guidelines as a Busy Pharmacist

Pharmacy Times® interviewed Jessica W. Merrey, PharmD, MBA, BCPS, BCACP, BCGP, clinical pharmacy specialist at the Johns Hopkins Hospital, and Stephanie Sibicky, PharmD, MEd, BCGP, BCPS, FASCP, director of Undergraduate and Professional Programs at Northeastern University, discusses their presentation at the American Society of Consultant Pharmacists (ASCP) 2022 Annual Meeting titled The Busy Clinician of Oz: Staying Up to Date with Literature, Guidelines, Oh My. The session offers tips to help clinicians identify and implement strategies and tools to remain up to date with medical literature, guidelines, and media.

The ASCP 2022 Annual Meeting will be held at the JW Marriott San Antonio Hill Country Resort & Spa in San Antonio, Texas.

Pharmacy Times®: What was the impetus for this session topic?

Stephanie Sibicky: So, every year, the Pharmacy Education and Research Committee, as a part of ASCP, comes up with some hot topics or issues that we think the membership would really like to hear about. One of the focus of PERC, which is what we call our group, is on new practitioners as well as students, and sort of engaging them in what it's like to be a pharmacist, but also a consultant pharmacist.

Over the course of several years, we've had group members mention that it's difficult to keep up with literature, and it's difficult to stay current and what are some techniques that we can give to new practitioners and students to start thinking about as they make these plans for professional development, and kind of staying up to date with all of the new information that comes out.

We know medicine is everchanging and fluid and things change rapidly, so it's really important that we instill some of these skills upfront. So that was really where this came from, and from suggestions from our group, and that's usually how we create sessions every year is we just sort of poll the group and see what their interests are. So that's where this came from.

Pharmacy Times®: What are some of the challenges you’ve heard colleagues discuss regarding staying up to date with medical literature?

Jessica W. Merrey: So I think the challenge can be a wide array. Everything from how do I—I've been in school where the information is being kind of shared with me or what I need to look into—so how do I transition to owning that information, but also, how do I keep on top of the flood of information that's coming. As Stephanie mentioned, there's just a lot of everchanging information that could change your practice, what you were doing last week is now different based on new information. So how do you keep on top of it, how do you apply that new information, and even as you get further into your specialty, how do you stay a well-rounded pharmacist outside of just your specialty that you're in.

Pharmacy Times®: What are some of the “old school” strategies for remaining up to date with literature and guidelines?

Stephanie Sibicky: So I think that there's—I mean, there's a lot of different ways. To be honest, a lot of the old school stuff is still things that people do. I think one of the classic, like old school methods that we think about is actually just like pulling journal articles and going through the tables of contents and reading through what the new articles that have come out are. Definitely with—I mean, a lot of people aren't getting subscriptions to the actual paper versions of these anymore, and they can come to your inbox, which is actually really helpful, and it's easy to scan through them and then acquire the digital copies if you'd like. But that still can be really tedious.

So I think that there's several new strategies, and we'll talk about that a little bit later. But I think like that was the old school way to do things, or when you're in practice to just like, hear people talk about some of the new studies that came out and kind of word of mouth. Then it can be really slow to do that.

The other thing you can think about is some faculty members, we have to update our slides every year. So we're pulling guidelines, and we're trying to look at textbooks and trying to go through the information. It's kind of a lot of information and drilling it down into some smaller bits of information. But textbooks aren't always updated as often, guidelines aren't always updated as often. So it can be really challenging to use some of those new or those older techniques, which is why some of the newer ones are a little more accessible and easier for not only practitioners but students as well.

Jessica, I don't know just if you have any other ones that you think of like the old school methods.

Jessica W. Merrey: I think the only old school one that I can think of as still being just as viable now would be using our students and our learners that are on rotation. So I precept clinical rotations usually 11 to 12 months out of the year. So having topic discussions with them forces me to either refresh on the information or they bring up new articles that I'm not familiar with.

Pharmacy Times®: What are the “new school” strategies, and are they better?

Jessica W. Merrey: So some of the newer strategies that I can think of right off would be social media. So whether it's Facebook, Twitter, LinkedIn—all of these kind of social conversation networks allow quick posts of a new article and say, ‘Oh, I didn't see that. Let me go look further.’

Someone will include some commentary obviously, things like Twitter will be a very short commentary on it. So there are podcasts available to listen to—that might be more of a subscription that you would join to be able to listen to important information.

Previously, we would have the journal mailed to your house. Now you can receive a table of contents monthly for what's in that journal that then helps you decide if it's worth going further into the journal to read specific articles.

Stephanie Sibicky: Yeah, and I'll jump in with a with a few more. I mean, in our talk, we go through several of the things that are on our plans. So some other things you can set up like Google alerts for things that are of particular interest to you. I know, I was very interested in the factor Xa inhibitors anticoagulants. So I have a Google Alert setup for the drug names specifically. So if there's new articles that come out, I can be notified right away about them.

There's also a lot of curated lists that you can get through like Medscape or Journal Watch. Some are pharmacy specific; some aren't. So, depending on what your interest is, you can get those emailed to you, and they'll just do like a list of different links that you can click on to their articles.

I think staying abreast with things happening locally as well—so state organizations, state boards of pharmacy, certainly being involved in pharmacy organizations—is going to be another really great way to stay up to date and coming to the different meetings like the annual meetings that occur, going to CE sessions, those types of interactions with people who are either leaders in the field or who have done some of that research for you is going to be really beneficial and is something that you have to do anyway as a pharmacist to keep your license or your certification.

So the information is out there, and there's lots of ways that you can gather it. I think that in the pandemic even, things being more virtually available, we really have lots of information at our fingertips. So I can understand sometimes it might be a little bit overload with all of these newfangled ways that you can get this experience and all this information, but kind of picking out what works best for you, I think is going to be really helpful.

Jessica W. Merrey: To go back to the question of are the newer strategies better, I would say they’re certainly more accessible than having to wait for the print journal to come in the mail or wait for students to come on rotation to have information. So I would say that they're better in terms of real time, right after the information is out and available. I would say we have to take the information with a grain of salt depending on the source. So certainly, if you have to link to the article, you're reading the article from the authors, then that would be a higher level of reliability than reading the commentary from someone who is on some social media account, if you're not familiar with who that person is. So there's a little bit more work involved in ensuring reliable information.

Pharmacy Times®: What are some practical and trustworthy resources for literature and guideline summaries?

Jessica W. Merrey: In our talk, we start with the hierarchy of literature that a randomized control trial compared to a meta-analysis etc. So we try to equate that in terms of these resources as well that a journal article will always be more reliable than the voice of someone else who is summarizing it.

So certainly the journal article coming from the author or the journal itself, but there are also organizations and societies that you can trust as being reliable sources. So your pharmacy societies ASAP, ASHP, APHA—won't try to name all of them or else I’ll leave someone out. So your pharmacy societies, your medical societies, even if it's a medical society, then the American Heart Association, American Diabetes Association, clot.com, or thromboses.org, for the anti-factor tinnitus that Stephanie was talking about. So the medical societies, the actual research foundations, the journal articles themselves would be the most reliable resources to use. And if something is coming from those sites, even on LinkedIn or Twitter, then you can trust that information.

Stephanie Sibicky: Yeah, I would add to that—we really have to go back to those drug info skills that you learn as a student. Anything that's been peer reviewed, as Jessica mentioned, from those organizations, or that's been endorsed by someone nationally who has a presence—they have a vested interest in the information being accurate and valid. So that information is going to be in our top tiers.

But I mean, there are people who are posting things on social media that do have good credentials. It's important that you have a critical eye and that you question things—so if something seems fishy, it actually might be. But there are lots of people out there who are curating really great information and disseminating really important articles and sources of information.

Or even just like crowdsourcing different information can be helpful—if you have a clinical question that's maybe not answered through an article, it's something very complex or it's something that there's not a lot published on. Number one, you could have a have an interest in publishing it yourself. If you have like a case report or something which happens on geriatrics to be honest, there could be some really interesting conversations that are going on in your gathering that expert opinion. But knowing that expert opinion falls lower down on that list of that hierarchy that Jessica is talking about. Really doing your due diligence to be sure that the sources are nonprofit or not for profit, sometimes they're for profit, if there's ads sprinkled throughout a post—maybe just have a critical eye with it. It doesn't mean the information is bad, necessarily, but you just need to verify that it is in fact information that you think is going to be valuable for your patients. So question everything. If it seems fishy, it might be. Those are some of the advice that I would give people who are diving into this for the first time and really trying to think about what is valid or what isn't.

Pharmacy Times®: What are some advantages of using social media to stay up to date with medical literature and guidelines, and what are some disadvantages?

Stephanie Sibicky: Yeah, I'll jump in on this as part of the section that I'll be speaking on. I think that there's there are a ton of benefits for social media, but we do have to be careful about it as well.

Some of the advantages are definite opportunities for networking with other people who are like minded or even not like minded. Sometimes, that discourse can be really helpful for you in trying to figure out and solve problems for your patients. But I think that you have access to this wide array of people from across the world, and they may not be publishing their research, but they could be talking about it. So I think that that's really helpful.

I think that there's definitely an ability to have interdisciplinary discussions with physicians, nurses, different, again, different professionals in the field, different experts in the field. It definitely can be a lot of fun, too. So social media can be helpful from not only a professional side, but if you're looking for practical jokes, or some other fun type of entertainment, there's an entertainment value there.

So those are some of the advantages, I would say, as well as the information being fairly up to date. I mean, a lot of the medical organizations and journals will post when they have interesting articles, or they have events that are going on journal clubs, etc. So there's a lot of information there that you can use from a social media side.

Then the alternative to that on the disadvantage side is that most of your feeds are going to be dictated by the algorithm. So if you like certain things, you're going to start seeing more of that, if you're interacting with certain types of posts, you're going to be interacting more with like a like-minded or a like-idea. So just be mindful that you may be seeing things more often because the algorithm is selecting it for you.

Then, of course, we have to talk about privacy. So not everybody wants to have everything on blast on social media, and some people don't want to post, and they don't want to interact, maybe they just sort of lurk around and read some of the information that's there. That's totally your choice. Some people have like, fake accounts—or not fake accounts—but they have a protected account, it's private, or they don't show their pictures and things like that. That's totally fine. It's really up to your comfort level.

I mentioned earlier that it's important that you don't get overwhelmed. There's a lot of information out there just like in the news, and really trusting different information is going to be where you're going to spend most of your time is this valid, is this a reputable person? So trying not to get overwhelmed. If you're trying to start out and using social media, I would say start small, use one platform and see how you like it. And then you can start learning more about it to be more effective for what you need it to be used for.

Pharmacy Times®: How do you recommend pharmacists vet sources on social media to assess legitimacy or trustworthiness?

Jessica W. Merrey: Yeah, I think if your information is not coming from a society or foundation with which you're familiar, then again, we can use social media to our benefit—Google, the author, Google, the people that are involved in the article to see what they have written about before. What have they provided before just to get an idea of are they an expert in the field. And if it's someone who's giving commentary or reading a summary, then, honestly, I recommend at least read the abstract to make sure that the summary matches or similar with the abstract and not biased in one way or the other.

Stephanie Sibicky: And you can always ask questions, right? So one thing that I've seen a lot of people do is if there's something controversial or if they're presenting kind of a different opinion, to just ask like, well, what resources are you going to get this information if they're not citing them themselves. I think that if people aren't citing resources, and you ask them that question, if they tell you they're not citing their resources, then you can definitely tell that maybe there's something going on there. Or if they can give you a reason, ‘Oh, there's not much published on this. This is my experience.’ That's going to help you gauge whether you trust the information or you how much you utilize that information in your practice. So you can always ask, I always encourage people, if I taught something, or my students have a question for me that like maybe they think it's just my opinion or not always ask if there's a resource that can support that information.

Jessica W. Merrey: And then take that information to your team. So you're not the only pharmacist in your setting, even if you feel like you are. So fined other pharmacists and say, ‘Hey, I found this article. Isn't this interesting,’ and then use that to spark interest in conversation.

Pharmacy Times®: What are your recommendations for how pharmacists can create their own individualized plan for staying up to date with medical literature and guidelines?

Jessica W. Merrey: I think my initial recommendation is to know yourself and know what works for you. If you are not a person who has your phone with you all the time, and it's not on social media, then probably the strategies of using Twitter, LinkedIn, and these podcasts may not work for you. So know the way you learn best. I, for instance, am a printer and highlight and write it down so that I can take notes. So an electronic record or electronic information is not always the best for me, I need to download it. So recognizing how you learn and retain information best—but also, as Stephanie mentioned, the social media aspects can be fun, and so know what you enjoy how you enjoy learning as well, because that will make you more engaged in being able to identify what works for you.

I do think having a well-rounded [approach with] some old school and some new school techniques to make sure that you're capturing information in lots of different ways to be helpful.

Stephanie Sibicky: Yeah, I agree. I think that thinking back to how you curate information does you use like a Dropbox or a folder that you put those digital copies in, and you organize it in a certain way, versus being more searchable, and like I rely on searching through Google or searching through PubMed for each source is going to be up to you.

So I agree with Jessica, take some time to reflect on what has worked for you in the past, what maybe hasn't worked as well in the past, and then trying to reach outside your comfort zone as well and starting small with that. So like if you think, ‘You know what, I do like listening to books on tape, maybe I'll do a podcast that's about geriatric medicine, or that's about internal medicine or something like that.’ See, if you like it, if you don't like it, then you say, ‘You know what, this didn't work for me. And now I'm going to try something else.’

One thing about being a pharmacist and being a health care professional, in general, is this continuous professional development. So you’re learning doesn't stop when you take your licensing exam, it doesn't stop when your residency ends. It's something that continues throughout your career lifespan. So part of that is just reflecting on where you are, what information you need, and what works best for you. I encourage people to try different things, and figure out what works; we're always learning. It's not just about content that we're learning, it's about process that we're learning. So starting small and in trying new things, I think is going to be the way to go.

I definitely would encourage people—students, as Jessica mentioned before, are a great resource. Because they can teach you things as much as you can teach them. So if you have an opportunity to precept or engage with students in a journal club or something else of that nature, I think that's a really great way to start off with some of the new information, as well as learn what they're doing. I mean, students nowadays are super resourceful way more than I ever was, as somebody who's a millennial, they're just very resourceful, and figuring out what works for them. And like, ‘Oh, I never really thought of using that website or using that resource. Can you teach me more about that?’ I think there's lots of different avenues that you can go down in trying to figure out what's going to work best for you. But really having that open mind I think is going to be key. That's something that I've tried to do, as I've gone through my professional career, and sometimes things work and sometimes they don't, and sometimes I'm like in a Twitter, I want to be on Twitter all the time, and then I take months off, because sometimes it's just too overwhelming for me or I just don't have any interest in doing it, but then I start to come back again.

So there's nothing that says you have to stick to one plan and do it forever. I think it's important that, again, find out what's important to you, what works well for you, and reach out of your comfort zone if you really feel like you can.