Rotation 6 - Refigerator Malfunctions, Life on Hold, and Other Stories

Posted by E. Caliman at Sunday, December 20, 2015

I spent Rotation 6 at the University of Michigan's Drug Information Service. This mainly consisted of working on a couple of assigned projects while fielding calls from various U of M practitioners. Some were quick fixes that merely required reading a medication's package insert, while others required consulting multiple resources to discover the answer. Unfortunately, there is not a lot of data out there for some questions and the best answer you can give is "We couldn't find any data on your question. Use clinical judgment".

One of the more frequent types of calls we received were storage conditions of medications requiring refrigeration. In a few instances, we had some malfunctions that allowed the medications to go on excursions outside their specified temperature. This required calling the manufacturer for information on what the stability is outside of the recommended range. This meant spending a lot of time on hold. We learned to dread calling one particular manufacturer because in order to get the information, we need the expiration date and lot number of the affected products, whereas other manufacturers could provide blanket data.

Calling manufacturers for other reasons resulted in substantial hold times. I got used to listening to hold music, which was mostly smooth jazz or classical music, but one manufacturer in particular played country music, which surprised me. One manufacturer I had to call a couple of times had no hold music, so I sat at my computer, listening to silence. The best you can hope for in these instances is that you navigated the menu tree correctly so you wouldn't be transferred all over the place to someone else who would tell you that this was the wrong department and transfer you again.

There were some interesting stories we encountered in the call center. One was involved a patient's medication by a certain manufacturer no longer being approved by his mail-order pharmacy, so we looked into other generic manufacturers, guided by the site of manufacture. Another involved calling a manufacturer for information on an adverse event that limited the functional capabilities of a patient. Finally, another medication had a temperature excursion, but it was in a patient's home. It was a very expensive medication, but thankfully could remain stable for long enough that the patient could finish it.

Our longitudinal projects included filling out Medwatch reports, where you report adverse events to the FDA. We thankfully only had a few to fill out this rotation. It involves going into the patient's electronic medical record and gathering the necessary data for the form. The other project was a drug monograph, a summarizing report on a particular drug. The ones we were assigned were newly approved by the FDA, but were waiting approval to the U of M formulary. This project involved reading the package insert, looking at prices, and reading clinical trials.

This rotation was a bit more laid back, which is nice when you're trying to prepare for the next stages in your career, including job, residency, and fellowship interviews, attending ASHP Midyear, and finalizing your research paper.