We have evaluated and provided links for some of the high quality information available on the internet, which is freely accessible. This information should be used to supplement your learning and clinical decision making.
Evidence and Guidelines Search
Cochrane Reviews are systematic reviews of research in healthcare. Cochrane Reviews base their findings on the results of studies that meet certain quality criteria and are therefore valuable sources of information for those providing care and researchers. Cochrane reviews have the standard format of abstract, plain language summary followed by the full systematic review.
Finds evidence on health, drugs, public health, social care and commissioning in one place. The results include guidance, systematic reviews, evidence summaries and patient information. Sources include the British National Formulary (BNF), Clinical Knowledge Summaries, NICE, SIGN, the Cochrane Library and Royal Colleges, Social Care Online and GOV.UK. Search results can be filtered and full text can be freely obtained in most cases.
Medicines Q&As are produced by the Specialist Pharmacy Service (SPS) and include high quality, evidence-based, and quality controlled answers to specific questions. These Q&As may provide either a complete answer or a starting point for additional tailoring to a specific related enquiry. Go to Medicines, Medicines Articles and filter by Q&A, or do a specific search. Some examples of Q&As include: What is the antidepressant of choice in coronary heart disease (CHD)? What is the evidence for verapamil for prevention of cluster headache? What is the risk of developing Serotonin Syndrome following concomitant use of tramadol with selective serotonin reuptake inhibitors (SSRIs)? How do we assess and manage bleeding risks in patients requiring oral anticoagulation for atrial fibrillation?
BETs were developed in the Emergency Department of Manchester Royal Infirmary to provide evidence based answers to real-life clinical questions with a clinical bottom line. Authors of a BET can comment on issues that influence real clinical decisions such as cost, resources and training. Each BET has a colour symbol to show whether it is complete and checked. Note that some of the BETs may not have had a recent update.
CKS is aimed at primary care practitioners and provides a summary of the current evidence base and practical guidance on best practice in over 330 common primary care presentations. CKS is regularly updated as and when significant new evidence emerges. You can search by topic (e.g. angina, headache, hypertension in pregnancy) or by speciality (e.g. cardiovascular, kidney disease and urology)
The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care in England and Wales.
The Scottish Intercollegiate Guidelines Network (SIGN) develops evidence based clinical practice guidelines for the National Health Service (NHS) in Scotland.
Medscape is an American resource and is part of WebMD Health Professional Network and contains a vast amount of information. The Disease & Conditions section allows you to browse various topics by specialty and each topic is referenced. There is a section on Anatomy and a Drug Interaction Checker. As this is an American resource guidelines and drug dosing may differ. You will need to register (free) for Cases and Quizes.
The official website of the NHS in England with over 48 million visitors per month and chances are that your patients use this to gather health information. NHS Choices is a health information service with thousands of articles, videos and tools for patients. There is a service directory to find and compare healthcare in England.
The Renal Association is the UK professional body for nephrologists and has a role in disseminating research, education and clinical services. Guidelines can be found here and the Information & Resources section includes topics such as CKD, anaemia, proteinuria and more about the use of eGFR and its limitations for e.g. in extremes of body weight, age under 18 years and pregnancy.
The National Kidney Foundation is the leading organisation in the United States with information on prevention and treatment of kidney disease for healthcare professionals and patients. They produce clinical practice guidelines through the NKF Kidney Disease Outcomes Quality Initiative (NKF KDOQI). Guidelines and Clinician Tools (factsheets, clinical updates and bulletins) can be found in the Professional section.
ACC has been established since 1949 with the aim to improve cardiovascular health through education, research and quality care. The Clinical Topics section has the latest articles, guidelines and images and education. The education section contains comprehensive MCQs with detailed and referenced answers.
The Resuscitation Council (UK) develop and publish evidence based resuscitation guidelines, which are intended for all healthcare professionals, first-aid organisations and lay people.
The British Association of Dermatologists (BAD) works with the Department of Health, patient bodies and commissioners across the UK. BAD produce clinical guidelines and these can be found in the healthcare professional section. There is also information on careers and research.
DermNet New Zealand presents authoritative facts about the skin for patients and health professionals in New Zealand and throughout the world. Topics are illustrated with information on conditions, dermatopathology, treatments and procedures. There is a large section on continuing medical education and quizzes.
The American Academy of Neurology guidelines can be found here.
The Guidelines & Research Services section provides access to RCOG guidelines, journals and library services. The RCOG has partners in the UK and globally to improve the standard of care delivered to women and the practice of O&G. The Faculty of Sexual & Reproductive Healthcare (FSRH) and other specialist societies can be found at: https://www.rcog.org.uk/en/about-us/specialist-societies/
UKTIS provide evidence based data and advice for the safety of drugs in pregnancy and the management of some conditions in pregnancy e.g. migraine, allergic rhinitis and constipation . The summary is available for free but a subscription fee is required to access the full drug monographs. The monographs are in alphabetical order or you can use the search box.
UKTIS has produced freely available bumps information leaflets to provide women and their partners with the facts that they need to make informed decisions, in conjunction with their healthcare provider, about use of a medicines in pregnancy. This information should be discussed with the patient.
Specific Drug Search
The eMC contains up to date, approved and regulated prescribing information for licensed medicines in the UK. There are two types of documents-Summaries of Product Characteristics (SPCs or SmPCs) or Patient Information Leaflets (PILs). An SPC tells healthcare professionals how to prescribe and use a medicine correctly and is based on clinical trials that a pharmaceutical company has carried out. Information includes dose, adjustment in renal, hepatic or elderly patients, adverse effects, interactions, overdose, pharmacokinetics and excipients.
MedlinePlus is produced by the National Library of Medicine (NLM) and is written to be patient friendly. There is a comprehensive section on Herbs and Supplements, which are listed in order of A-Z. Each herbal monograph includes information on use, evidence, adverse effects and interactions. Examples include St. John’s Wort, Evening Primrose Oil and Glucosamine.
ClinicalTrials.gov is a database of over 10,000 publicly and privately supported clinical studies of human participants conducted around the world. The Website is maintained by the National Library of Medicine (NLM) at the National Institutes of Health (NIH). You can do a basic search by topic or location or do an advanced search.
Safety of drugs in Acute Porphyrias
The BNF section 9.8.2 on Acute Porphyrias has a list of unsafe drugs and unsafe drug groups.
This service is based at University Hospitals of Wales and provides detailed advice on the safe use of drugs in porphyria for patients and healthcare professionals. A list of drugs considered safe in acute porphyrias is available here.
Epnet is a network of specialist porphyria centres throughout the EU. It contains information for patients and healthcare professionals.
Drugs that cause QT prolongation
CredibleMeds is produced by the Arizona Center for Education and Research on Therapeutics (AZCERT). They maintain the QTDrugs Lists- a list of drugs categorised by their potential to cause QT prolongation and/or torsades de pointes (TdP). Free registration is required to access the QTDrugs Lists.
Yellow Card Reports
Yellow Card reports can be submitted here. The Yellow Card Scheme helps the Medicines and Healthcare products Regulatory Agency (MHRA) monitor the safety of all healthcare products in the UK. For established medicines and vaccines you should report all serious suspected Adverse Drug Reactions (ADRs).
New medicines and vaccines that are under additional monitoring have an inverted black triangle symbol (▼) displayed in their package leaflet and summary of product characteristic. You should report all suspected ADRs for these products. Further details can be found at: https://www.gov.uk/guidance/the-yellow-card-scheme-guidance-for-healthcare-professionals
Free MRCP Revision
MRCP (UK) develops and delivers membership and specialty examinations. There are 100 MRCP 1 and 151 MRCP 2 sample questions. Select MRCP (UK) examinations, select Part 1 or Part 2 and then sample questions.
There are over 5000 questions in the same format as the MRCP exam. You can choose to revise with random questions, test yourself on a specific subject or generate a practice MRCP to test yourself with. Registration is free to track progress and identify your strengths and weaknesses.
MRCP study contains thousands of free MRCP part 1 and part 2 questions in the form of a quiz, which is arranged by topic and exam type; registration is required. There is also a section on MRCP notes on over 700 topics with images; a subscription is required for this but you can select Test Free (bottom) to view the freely available topics. The topics are in note form and unreferenced.