by Terry Brenner

Imagine you’re a health and physical education teacher at a high school in western Montana. One day you overhear a clutch of student athletes talking about taking something you’ve never heard of to improve their performance in sports. You’re worried. What is the stuff? Is it harmful? Who would know the answer?

Or imagine you’re a physician, an internist with a large and varied practice in the Missoula area. Keeping up on new and better drugs to treat the illnesses you see has become almost impossible because of the pace at which they’re developed and come on the market. You have no one on your staff with the time to research new drugs for you. Who does?

The University of Montana. In fact, for either situation and thousands of others, UM has a service that can answer your questions and those of educators and health professionals near and far: its little-publicized Drug Information Service.

At the helm is Cathy Bartels, an associate professor of pharmacy practice and full-time DIS director since 1995. Amy Gruel, a 1998 UM graduate in pharmacy, works with Bartels as a drug information specialist.

Their job, Bartels says, is to provide “accurate, complete, up-to-date, unbiased information” about prescription and nonprescription medications and dietary supplements to health professionals in Montana and elsewhere in the country. Their clients include doctors, nurses, nurse practitioners, pharmacists, school administrators and counselors.
Can Bartels and Gruel answer queries off the top of their heads? No, Bartels says. They are not walking encyclopedias. They are researchers.

“We search various computer databases, Medline, journals, the Web, books and pharmaceutical manufacturers to find the information needed to answer the questions,” she says.

What kind of questions? Here’s a sampling.
If a patient has an allergy to sulfa drugs, is it safe for him to be given generic propofol, which contains sulfites? Or should he receive only the brand-name product, which does not contain sulfites?

What treatment options are there for a woman suffering from menopausal hot flashes who has a history of breast cancer?

Why are over-the-counter products containing phenyl propanolamine being pulled off the market?
Is there an interaction between amiodarone and grapefruit juice? If so, how should it be managed?
What information in the clinical literature discusses the use of mycophenylate mofetil (CellCept) in the treat- ment of myasthenia gravis?

Once they find the answer, they “phone, write, fax or e-mail the information to the requestor,” Bartels says. It’s usually technical, which is one reason the DIS cannot take requests from the general public.

“I try to keep our service ‘hidden’ from the lay public to avoid getting calls directly from them,” she says. “This is because we don’t have access to their medical records and might not know the whole story before trying to answer their questions. Plus, we don’t want to risk the chance of being misinterpreted by someone without the technical expertise needed to understand our responses.”

Surprising as it may seem in retrospect, the idea of starting a drug information service was not a winner. Several proposals submitted for outside money were rejected, says Professor Gayle Cochran, chair of the pharmacy practice department and a member of the first grant-writing team in 1977.

Finally, she says, “it became obvious that if the School of Pharmacy was ever going to have such a service, it would have to be funded from within the school.”

During the 1980s the school limped along with nothing more than a pharmacy reference room to serve faculty members and students. And as a low priority in a facility cramped for space, it was displaced several times. Not until fall semester 1991 was the pharmacy school able to announce a bona fide Drug Information Service, created to serve not only pharmacy students and faculty but also professionals in the fields of health care and health education. Its director was John Peterson, a part-time pharmacy practice faculty member.

Reference materials and journals were scrounged here and there — from pharmacy school accumulations, the Mansfield Library and pharmacy faculty members. Students, heavy users of the resources, pitched in their time as monitors to keep the service open for use in the evenings and on weekends. During fall semester 1992, the first semester in which records were kept, the service received 33 calls from outside.

By the time Bartels took over as director in 1995, outside calls for help averaged 31 per month, she says. Today that number has tripled to an average 98 per month.

Providing information is but one part of the DIS, however. From the outset, its proponents envisioned an equally important function, and Peterson put it in gear in 1994. That spring semester he offered a four-week clerkship experience for pharmacy students, giving them specialized experience in researching drug literature and providing drug information to others. That program has grown, too — more than tenfold.

“We now have students year-round and quite often have two students at a time,” Bartels says. “Our eventual goal is to provide this experience to all students in the professional program.”

For pharmacy Dean David Forbes, that goal dovetails nicely with the school’s role as part of an institution of higher education.

“We’re here to provide our pharmacy students with the very best experiences we can so they can go out and do a good job,” he says. “One of the problems is, we’re not the real world. We provide classroom experiences for our students. The Drug Information Center receives normal, everyday questions from the state’s health professionals, and our students get a chance to participate in that. So we kill two birds with one stone. We provide the service and give the students the opportunity to learn while we provide the service.

“I’m from Wisconsin,” Forbes says, “where they say ‘the borders of the university are the borders of the state.’ I’ve always believed that’s true for us as well.”

For more information, call the School of Pharmacy and Allied Health Sciences at (406) 243- 4621.