The Pharmaceutical Journal
Vol 270 No 7235 p203
8 February 2003

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Well-written but lacking critique of how NICE guidance fits in

'Evidence-based pharmacy', by Phil Wiffen. Pp iv+182. Price £19.95. London: Radcliffe Medical Press Ltd; 2001. ISBN 1 85775 384 4

This is a clear and well-written book which addresses the important concept of evidence-based care and practice. It is written by a pharmacist with expertise and considerable experience in this area through his work within the Cochrane collaboration framework. The book is divided into 10 chapters which take the reader through a logical sequence, starting with the relevance of evidence-based care to contemporary pharmacy practice. For practitioners and students new to this area, there is a clear and informative section on using both established databases (such as Medline) and a chapter largely devoted to the effective use of the Internet to access evidence.

Following on from an explanation of the techniques used in systematic reviews and meta-analyses there is an invaluable chapter that explains the concepts and types of statistical analyses used within these techniques (including number needed to treat, odds ratios and quality adjusted life years). In the chapter on "appraising the evidence", there is clear guidance on how to assess the quality of the evidence and critically appraise the literature. These are skills which are essential for all pharmacists who, in this era of evidence-based medicine, must be research users if they are to be credible practitioners. A later chapter also addresses the imperative to strengthen pharmacy practice research and for pharmacists to become generators of evidence, as well as users.

The only real omission of note in this book is a critique of how practitioners should assimilate the guidance emanating from the National Institute for Clinical Excellence and the National Service Frameworks into this evidence-based paradigm. This is a real-life dilemma faced by all those in clinical practice. It is to be hoped that there will be further, updated editions of this book as this is a rapidly evolving area in this era of guidelines, targets and quality indicators.

Judith Cantrill