542269
research-article2014
AOPXXX10.1177/1060028014542269Annals of PharmacotherapyNess et al
Letter to the Editor
Pharmacists’ Use of Electronic Handheld Drug Information Applications
Handheld electronic devices (HEDs) assist health care practitioners in obtaining current drug information (DI) to prevent medication errors and decrease adverse events at the point of care.1-3 Published literature has focused on the use of personal digital assistants (PDAs); however, in recent years, there has been a shift to smartphones, which provide additional functions and features.4 Studies assessing pharmacists’ use of DI applications on HEDs on a national scale have not been conducted. Therefore, the objectives of this study were to describe pharmacists’ use patterns of HEDs, determine which DI applications pharmacists use most often, and identify pharmacists’ preferences regarding DI applications. Pharmacists licensed as of May 2012 through October 2012 from states that collect and release e-mail addresses were included in the study. In all, 13 state pharmacy boards provided e-mail addresses. A previously published survey instrument was modified to assess pharmacists’ DI application preferences.5 The final survey consisted of 15 questions (13 multiple choice, 2 open ended) and was open from November 1 to November 30, 2012. The project received institutional review board approval, with exempt status for human subjects research, and confidentiality among responders was maintained using the Qualtrics Research Suite software. A total of 5973 pharmacists completed the survey, resulting in a 12% response rate (5973/48848). The majority of the participants were female (2754/5284, 52%). Ages were evenly distributed from 25 years to >55 years. Most pharmacists practiced in a community pharmacy setting (2314/5295, 44%). Among the pharmacists, 48% (2622/5485) reported using a HED support tool in their practice. The most common reason for not using a HED support tool was access to computer-based DI databases at their practice site (2176/2834, 77%). The most popular HED used was the smartphone (2092), with the iPhone/iPad (1774) being the most popular type of operating system. The majority of pharmacists used their personal HED (2122/2555, 83%), and only 37% (940/2530) used these devices while in pharmacy school. The majority of pharmacists accessed DI resources from their HED daily (1337/2528, 53%). The most popular DI application used by pharmacists was ePOCRATES, followed by Lexi-Comp and mobileMicromedex (Figure 1).
Annals of Pharmacotherapy 2014, Vol. 48(10) 1392–1393 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1060028014542269 aop.sagepub.com
Also, 352 pharmacists reported using “other” applications, including Pharmacist’s Letter, Google, Pocket Rx, Facts & Comparisons eAnswers, Sanford Guide, and Johns Hopkins ABX Guide. When the pharmacists were asked about their reasons for using a particular DI application, most userfriendly (1243), most accurate and complete (1230), and low or no cost (1212) were the most frequently chosen responses (n = 2500). Most pharmacists preferred using applications (1343/2486, 54%) on their HED compared with mobile optimized Web sites (292/2486, 12%). The pharmacists were asked to provide recommendations for future DI applications. Pharmacists suggested including a pill identification feature that incorporates the use of a smartphone camera to scan the pill for identification and mentioned additional clinical features to be incorporated including: clinical practice guidelines, drug shortage information, drug class conversions, package insert links, law information, pediatric dosing information, herbal/natural supplement product information, medication cost, third-party formulary information, nuclear medicine information, links to primary resources, intravenous and oral product conversions, National Drug Code (NDC) numbers, compounding information, disease state overviews with treatment options, and information on international drug products. Pharmacists also listed technical features, including voice recognition software, ability to sync with online databases, easy/quick access, free access, and quick updates. It is important to note that some of these features can already be found in DI resources. In conclusion, 48% of pharmacist respondents reported using a HED support tool in their practice. ePOCRATES, Lexi-Comp, and mobileMicromedex were the most-used DI applications, and the recommended features of DI applications could assist in creation of the ideal application. Genevieve Lynn Ness, PharmD Belmont University College of Pharmacy, Nashville, TN, USA Jennifer Riggins, PharmD Eli Lilly and Company, Indianapolis, IN, USA Amy Heck Sheehan, PharmD Purdue University College of Pharmacy, Indianapolis, IN, USA [email protected]
Downloaded from aop.sagepub.com at Purdue University on August 28, 2014
1393
Ness et al
Epocrates
1299
Lexicomp
1245
mobileMicromedex
1098
Medscape
691
WebMD
491
Clinical Pharmacology
414
Other
352
UpToDate
319
Natural Medicines Comprehensive Database
167
Skyscape Medical Resources
150
Tarascon Pharmacopoeia
47
Natural Standard
38
Do not Use a Drug Information Application
35
Mosby’s Drug Reference for Health Professions
33
Davis’s Drug Guide
11
Figure 1. Type of handheld drug information application used in practicea (n = 2516). a
Check all that apply question: multiple choices were accepted
Declaration of Conflicting Interests
References
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
1. Siracuse MV, Sowell JG. Doctor of pharmacy students’ use of personal digital assistants. Am J Pharm Educ. 2008;72:07. 2. Galt KA, Rule AM, Houghton B, et al. Personal digital assistant-based drug information sources: potential to improve medication safety. J Med Libr Assoc. 2005;93:229-236. 3. Enders SJ, Enders JM, Holstad SG. Drug-information software for Palm operating system personal digital assistants: breadth, clinical dependability, and ease of use. Pharmacotherapy. 2002;22:1036-1040. 4. Bit Rebels. The evolution of smartphones [Infographic]. http://www.bitrebels.com/technology/the-evolution-of-smartphones-infographic/. Accessed June 5, 2014. 5. Kostka-Rokosz MD, McCloskey WW. Survey of pharmacy preceptors’ use of hand-held electronic devices. J Am Pharm Assoc. 2009;49:69-72.
Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Eli Lilly and Company funded the state boards of pharmacy fees for the lists of pharmacists’ e-mail addresses.
Authors’ Note Preliminary results of this study were presented as a poster at the Drug Information Association: Medical and Scientific Communications 2013 Annual Forum in Chandler, AZ, and won first place in the resident/fellow poster session. The full results of this study have been presented as a podium presentation at the American Society of Health-System Pharmacy (ASHP) Midyear Clinical Meeting; December 10, 2013; Orlando, FL.
Downloaded from aop.sagepub.com at Purdue University on August 28, 2014
research-article2014
AOPXXX10.1177/1060028014542269Annals of PharmacotherapyNess et al
Letter to the Editor
Pharmacists’ Use of Electronic Handheld Drug Information Applications
Handheld electronic devices (HEDs) assist health care practitioners in obtaining current drug information (DI) to prevent medication errors and decrease adverse events at the point of care.1-3 Published literature has focused on the use of personal digital assistants (PDAs); however, in recent years, there has been a shift to smartphones, which provide additional functions and features.4 Studies assessing pharmacists’ use of DI applications on HEDs on a national scale have not been conducted. Therefore, the objectives of this study were to describe pharmacists’ use patterns of HEDs, determine which DI applications pharmacists use most often, and identify pharmacists’ preferences regarding DI applications. Pharmacists licensed as of May 2012 through October 2012 from states that collect and release e-mail addresses were included in the study. In all, 13 state pharmacy boards provided e-mail addresses. A previously published survey instrument was modified to assess pharmacists’ DI application preferences.5 The final survey consisted of 15 questions (13 multiple choice, 2 open ended) and was open from November 1 to November 30, 2012. The project received institutional review board approval, with exempt status for human subjects research, and confidentiality among responders was maintained using the Qualtrics Research Suite software. A total of 5973 pharmacists completed the survey, resulting in a 12% response rate (5973/48848). The majority of the participants were female (2754/5284, 52%). Ages were evenly distributed from 25 years to >55 years. Most pharmacists practiced in a community pharmacy setting (2314/5295, 44%). Among the pharmacists, 48% (2622/5485) reported using a HED support tool in their practice. The most common reason for not using a HED support tool was access to computer-based DI databases at their practice site (2176/2834, 77%). The most popular HED used was the smartphone (2092), with the iPhone/iPad (1774) being the most popular type of operating system. The majority of pharmacists used their personal HED (2122/2555, 83%), and only 37% (940/2530) used these devices while in pharmacy school. The majority of pharmacists accessed DI resources from their HED daily (1337/2528, 53%). The most popular DI application used by pharmacists was ePOCRATES, followed by Lexi-Comp and mobileMicromedex (Figure 1).
Annals of Pharmacotherapy 2014, Vol. 48(10) 1392–1393 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1060028014542269 aop.sagepub.com
Also, 352 pharmacists reported using “other” applications, including Pharmacist’s Letter, Google, Pocket Rx, Facts & Comparisons eAnswers, Sanford Guide, and Johns Hopkins ABX Guide. When the pharmacists were asked about their reasons for using a particular DI application, most userfriendly (1243), most accurate and complete (1230), and low or no cost (1212) were the most frequently chosen responses (n = 2500). Most pharmacists preferred using applications (1343/2486, 54%) on their HED compared with mobile optimized Web sites (292/2486, 12%). The pharmacists were asked to provide recommendations for future DI applications. Pharmacists suggested including a pill identification feature that incorporates the use of a smartphone camera to scan the pill for identification and mentioned additional clinical features to be incorporated including: clinical practice guidelines, drug shortage information, drug class conversions, package insert links, law information, pediatric dosing information, herbal/natural supplement product information, medication cost, third-party formulary information, nuclear medicine information, links to primary resources, intravenous and oral product conversions, National Drug Code (NDC) numbers, compounding information, disease state overviews with treatment options, and information on international drug products. Pharmacists also listed technical features, including voice recognition software, ability to sync with online databases, easy/quick access, free access, and quick updates. It is important to note that some of these features can already be found in DI resources. In conclusion, 48% of pharmacist respondents reported using a HED support tool in their practice. ePOCRATES, Lexi-Comp, and mobileMicromedex were the most-used DI applications, and the recommended features of DI applications could assist in creation of the ideal application. Genevieve Lynn Ness, PharmD Belmont University College of Pharmacy, Nashville, TN, USA Jennifer Riggins, PharmD Eli Lilly and Company, Indianapolis, IN, USA Amy Heck Sheehan, PharmD Purdue University College of Pharmacy, Indianapolis, IN, USA [email protected]
Downloaded from aop.sagepub.com at Purdue University on August 28, 2014
1393
Ness et al
Epocrates
1299
Lexicomp
1245
mobileMicromedex
1098
Medscape
691
WebMD
491
Clinical Pharmacology
414
Other
352
UpToDate
319
Natural Medicines Comprehensive Database
167
Skyscape Medical Resources
150
Tarascon Pharmacopoeia
47
Natural Standard
38
Do not Use a Drug Information Application
35
Mosby’s Drug Reference for Health Professions
33
Davis’s Drug Guide
11
Figure 1. Type of handheld drug information application used in practicea (n = 2516). a
Check all that apply question: multiple choices were accepted
Declaration of Conflicting Interests
References
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
1. Siracuse MV, Sowell JG. Doctor of pharmacy students’ use of personal digital assistants. Am J Pharm Educ. 2008;72:07. 2. Galt KA, Rule AM, Houghton B, et al. Personal digital assistant-based drug information sources: potential to improve medication safety. J Med Libr Assoc. 2005;93:229-236. 3. Enders SJ, Enders JM, Holstad SG. Drug-information software for Palm operating system personal digital assistants: breadth, clinical dependability, and ease of use. Pharmacotherapy. 2002;22:1036-1040. 4. Bit Rebels. The evolution of smartphones [Infographic]. http://www.bitrebels.com/technology/the-evolution-of-smartphones-infographic/. Accessed June 5, 2014. 5. Kostka-Rokosz MD, McCloskey WW. Survey of pharmacy preceptors’ use of hand-held electronic devices. J Am Pharm Assoc. 2009;49:69-72.
Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Eli Lilly and Company funded the state boards of pharmacy fees for the lists of pharmacists’ e-mail addresses.
Authors’ Note Preliminary results of this study were presented as a poster at the Drug Information Association: Medical and Scientific Communications 2013 Annual Forum in Chandler, AZ, and won first place in the resident/fellow poster session. The full results of this study have been presented as a podium presentation at the American Society of Health-System Pharmacy (ASHP) Midyear Clinical Meeting; December 10, 2013; Orlando, FL.
Downloaded from aop.sagepub.com at Purdue University on August 28, 2014
