On-call scenario 4: Sources
Here are some places that you might have looked for information about converting a patient on oral medicines for Parkinson's disease to a rotigotine patch:- BNF
- SmPC via emc or MHRA
- Martindale and/or AHFS Drug Information (if you have access)
- Micromedex or UpToDate (if you have access)
- Trip Pro Database (this is free on NHS computers and so if you are on-call at home you'll need to log-in to your work's network to access it)
- Your local guidelines
- Expert national and international groups (e.g. neurology, medicine)
- Google Scholar and/or Google
Is this list similar to the one that you constructed?
However, when you work through the BNF, SmPC, Martindale and AHFS and other sources, you are surprised to find no guidance on how to switch between oral Parkinson’s medicines and a rotigotine patch. You have no local guidelines and you struggle to find a term in Embase for dose conversion.
Finally, you attempt to search Google and bring up more hits than you can possibly handle. A quick scan of the first few pages reveal some guidelines from other acute NHS Trusts, advice from expert groups such as Parkinson’s UK, opinions given in various online forums, and some protocols from hospitals outside the UK. You are now faced with too much information.
What will you do now?