Dear HIFA colleagues,
I'm preparing a presentation and I'd like to say a little about the challenge of meeting the information needs of prescribers and users of medicines in LMICs. [HIFA did a systematic review with the LSHTM and Nagasaki University on this topic in 2020: https://gh.bmj.com/content/5/4/e002094 ]
I shall note that it is easy for anyone with an internet connection to get reliable information on a single medicine. But it is much more challenging to get good guidance on how to select the right medicine that is appropriate to a specific clinical encounter.
I have long been an advocate of the British National Formulary. In my travels to several countries in Africa and South Asia I have noted that many primary health workers use old print copies of the BNF to guide their prescribing. Is this still the case?
The BNF describes itself as: ‘the first choice for concise medicines information. Trusted by health professionals across the world to support confident decision-making at the point of care’.
The BNF used to be freely available to anyone on the internet, but this is no longer the case. Now it is only available to NHS staff in the UK and those who pay (the print copy costs £80; I was unable to find out the cost of subscribing to it online, but it is almost certainly prohibitive to most prescribers in LMICs). The BNF is available to eligible institutions through Research4Life (WHO's collaboration with publishers) and I would be interested to hear more about its use.
My question is: if the BNF could be made freely available online to everyone (and also free to reproduce and adapt to national and facility needs) could this have a significant impact on access to reliable information on medicines and help save lives?
If it could make a significant difference, then perhaps we can start thinking about whether and how we can make happen.
There may be other ways to support the information needs of prescribers (and there are many other factors apart from information that drive prescribing behaviour, as Massimo Serventi and others have said). For example, it seems likely that artificial intelligence tools such as ChatGPT could be used for this purpose.
What do you think?
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org