A database model of drug usage in pregnancy and lactation according to user information requirements

The information needs of a population of gynaecologists and obstetricians concerning drug administration in pregnancy and lactation, were investigated, employing the triangulation approach. This involves the application of three analytical tools; content analysis, focus group interviews and a structured questionnaire. Content analysis was performed on queries submitted to two representative Drug Information Centres (DICs); the focus group interviews (FGIs) of gynaecologists and obstetricians were conducted in hospital departments; and the questionnaire was distributed among the majority of Israeli gynaecologists and obstetricians. The combination of complementary methods used constitutes a powerful tool for data assembly and for validation of conclusions. Statistical analysis of the results reveals a relation between information usage and background variables, such as country of study, place of work and teaching position. In addition, a relation was found between information usage and attitude towards drug administration. Based on this analysis, a typology of users' profile was drawn and their information needs defined. A scheme of the pattern of drug information usage was delineated, leading to the designing of a database model to meet the information requirements. Several drugs were selected to be included in the model, representing various pharmaceutical groups, different degrees of risk for the fetus and different amounts of available information about potential teratogenicity and toxicity. AskSam+ hypertext software was chosen to create the database due to its flexibility, ease of updating and enhanced text retrieval capability. Data are stored in a network of nodes connected through links. Each structured node contains all the information on a single drug; its names, risk factor, teratogenicity, fetal toxicity, mutagenicity and oncogenicity, all based upon and followed by a bibliographic list. These attributes are each assigned to a structural node and related hierarchically to body systems, organs and related pathology. The database is user friendly, allows rapid retrieval of information and is easily installed on a PC in the gynaecologists and obstetricians' office. This model can also be readily adapted to other medical disciplines, according to their specific needs