Guide to Palm® and Pocket PC® OS Medical Applications
A Pharmacist's
Guide to Palm® and Pocket PC® OS
Medical Applications
Emanuel Pop, PharmD
Candidate
CONTENTS
- Introduction
- Advantages for using a PDA
- Criteria for evaluating PDA medical application
- Comparative Tables
- Table 1. General Drug Information References
- Table 2. Specialized Drug References
- Table 3. Medicine Texts and Clinical Assessment Tools
- References
Introduction
Handheld computers, also known as Personal Digital Assistants (PDAs) are rapidly becoming an integral part of the healthcare providers' daily activities. A key challenge faced by pharmacists and students has been the retrieval of drug information that is timely, accurate, and easily obtained. The handheld computer has revolutionized how healthcare providers obtain drug information, offering data at the point of care. 1 One of the biggest challenges for use of the PDA may be the overwhelming number of medical applications from which the healthcare provider may choose. Software that offers patient-tracking applications allowing easy monitoring of patients, as well as applications for formulary access, is also now available. There is no official governing body of the various PDA applications, so it becomes a "buyer-beware" type marketplace. This page provides an overview of some of the important medical applications for the pharmacist's handheld computer. 2
Advantages for using a PDA 3,4
- Size : PDAs are small and lightweight
- Breadth of information : Large drug information references that would require hundred of pages in print can easily fit into the PDA.
- Current information : Many drug information applications are updated daily, weekly, or monthly; paper references are often only updated on an annual basis.
- Cost : Some medical applications are free, especially with the Palm OS PDA. The paper-based and electronic version of a drug information book are often the same price. Special pricing can be found occasionally with PDA applications that are not free
- Queries : Many drug information applications offer different ways of searching for data. For instance, one can search by drug name, drug class, or indication, as well as in a table in many applications
- Retrieval time : The PDA offers faster retrieval of information -- usually less than 30 seconds
Criteria for evaluating PDA medical application 3,5
- User friendly : Determine whether the software is easy to use and understand. Only minimal training for the user should be required. It should be easy to install and receive updates.
- Comprehensiveness : Make sure that all categories of medications are covered, including ophthalmic, herbal or over-the-counter agents. The program should include drug interactions, adverse effects, indications index, off-label use, pregnancy category, pediatric dosing, pharmacology, kinetics and primary literature notes.
- Accuracy : Verify that the drug information is correct. Look to see if some of the information provided is ambiguous or if important information has been omitted (e.g. Black box warning, allergy information, renal, hepatic, blood, laboratory test requirements).
- Time intervals of updates : Note how often the drug information software is updated with new drugs and new information. Some applications are updated monthly while others are quarterly or longer.
- Free-hand writing available : Determine whether there is an area in which notes can be added for a particular drug. Also, check to see if a new drug can be added that may have not been updated into the existing medical information software.
- Memory requirements : Note the amount of memory required. Some programs may be too large for PDAs with limited memory, other allow for expandable memory for a nominal fee.
- Cost : Check the cost of use. Some applications, such as ePocrates are free. Other may charge a one time annual or an annual fee.
Comparative Tables
Table 1. General Drug Information References 3,4, 6-14
|
Program & Publisher Description |
Size PalmOS (P) |
Expansion Card Compatibility (A*) |
Updates |
Download Site and Cost |
|
A to Z Drug Facts by Facts and Comparisons Features > 2800 Rx, OTC, investigational, and orphan drugs Uses, dosages, administration, interactions, adverse reactions, warnings, precautions (pregnancy, lactation, children, elderly, special risk) lab test interference |
(P) 3.6 MB (W) 7.3 MB |
Palm M5xx, Clie, Visor, HandEra expansion memory cards |
Unlimited |
$49.95 |
|
AHFS Drug Information 2003 Multimedia Card by ASHP Features >1000 drug monographs Indications, dosage, administration, interactions, adverse effects, precautions, monitoring parameters; evaluative analysis MUST HAVE PDA WITH HANDERA 330 EXPANSION SLOT |
(P) 32 MB (W) 32 MB |
HandEra ONLY |
Unlimited |
$100 |
|
Dr Drugs by Davis's Drug Guide for Physicians Features >1500 drug monographs Indications, dosing, interactions, adverse reactions, pregnancy risk factors; natural products drug monographs, main and personal index |
(P) 2.5 MB (W) 5.8 MB |
Palm M5xx, Clie, Visor, HandEra expansion memory cards |
Quarterly |
$49.95 |
|
ePocrates by ePocrates Inc. Features >2800 monographs Indications, adult and pediatric dosing, interactions, adverse effects, precautions, mechanism of action, pricing/packaging, pregnancy categories, notes section, tables, formulary information DocAlerts provides notices on safety, recall, and product announcements and news from selected medical organizations MultiCheck drug interactions program for up to 30 drugs at a time |
(P) 2.5 MB Not available for WinCE |
Not compatible with any card |
Unlimited Daily |
Free |
|
ePocrates Pro by ePocrates Inc. Features >2700 monographs >400 alternative medicine ePocrates ID - 300 diagnoses, and 350 bugs and 250 drugs monographs Indications, adult and pediatric dosing, interactions, adverse effects, precautions, mechanism of action, pricing/packaging, pregnancy categories, notes section, tables, formulary information, DocAlerts provides notices on safety, recall, and product announcements and news from selected medical organizations MultiCheck checks interactions among up to 30 drugs and/or alternative medicines at once Med Math Rapidly calculate over 30 of the most commonly used medical equations Note: Med Math can be downloaded as a separate program FOR FREE , from medcalc |
(P) 3.0 MB (W) 4.0 MB |
Not compatible with any card |
Unlimited Daily ePocrates ID - yearly |
$49.99
|
|
LexiComp Platinum by LexiComp Drug Information Handbook Features >1600 drug monographs covering >3900 drugs Indications, adult and pediatric dosing, interactions, adverse reactions, warnings, contraindications, MOA, pricing/ packaging, pregnancy categories, monitoring parameters, notes selection, geriatric and anesthesiology information Additional compatible software available for $40/each (i.e. diagnostic medicine, natural products, geriatrics, nursing, pediatrics, plus others from Lexi-Comp) |
(P) 2.7Mb - 5.8MB (W) 3.4-5.8Mb |
Handspring, Sony Memory Stick, Palm M5xx SD cards |
Unlimited for 1 yr Weekly |
$75
$71.25 |
|
MobileMicromedex by Micromedex Features >3,200 Drugs 256 alternative medicines Indications, dosing, interactions, adverse reactions, warnings, contraindications, pregnancy/ lactation issues, drug monitoring Includes drug information data - AltMedDex Points, toxicology data -- Tox Points acute care data -- Clinical Points |
(P) 4.8 MB (W) 6.4 MB |
Compatible with memory expansion cards |
Quarterly |
Free if your hospital or facility has a subscription to MICROMEDEX Healthcare Series Handango $74.95 |
|
MosbyDrugs by Mosby's Drug Consult and Drug Interaction analyzer Features Clinical pharmacology, interactions, adverse reactions, warnings, contraindications, pregnancy/ lactation issues, special considerations; international brands included organized via table of contents, main index, chemistry index, therapeutic index, indications index |
(P) 5.6 MB (W) 13.6 |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
Quarterly |
$64.95
|
|
PDRDrugs by Physicians' Desk Reference Features Indications, dosing, drug interactions, adverse reactions, black box warning, contraindications pregnancy/ lactation issues, special considerations |
(P) 2.1 MB (W) 5.6 MB |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
Yearly |
Free $49.95 |
|
Tarascon's Pharmacopoeia by Tarascon Publishing Features 47
reference tables from the print edition |
(P) 3.3 MB (W) 4.4 MB |
Compatible with most extended memory cards |
Unlimited |
Free |
A* -- Compatibility evaluated for Palm OS system only
Table 2. Specialized Drug References 3,4,5,6,15,16,17
|
Program & Publisher Description |
Size PalmOS (P) |
Expansion Card Compatibility (A*) |
Updates |
Download Site and Cost |
|
Drug Interactions |
||||
|
Drug Ix by Medical Letter's 2002 Handbook of Adverse Drug Interactions Features Drug interaction analyzer containing >3,000 brand names with generic equivalents Describes the interaction itself and its probable mechanism Allows listing of each of the drugs the patient is taking and then view the possible interactions on the screen. Presents reference citations pertinent to the interaction. Published references, comments and recommendations for clinical management are also featured. |
(P) 2.5 (W) 4.5 |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
No updates |
$49.95 |
|
Infectious Diseases Drugs |
||||
|
ABXGuide by Johns Hopkins of ID Features Hopkins antibiotic software adaptation of the online ABX Guide Optimized for use at the point of care |
(P) 1.4 MB (W) 4.9 MB |
Compatible with most extended memory cards |
Updates |
Free |
|
BartlettID by John G. Barlett Features A practical reference covering all relevant aspects of antibiotics Dosage, trade names, price, indications, interactions, use in pregnancy, and renal failure. Management guidelines given by organ system and disease category provide you with rapid access to the best available therapies. Tabular material will contain newly approved antibiotics and new recommendations for management. |
(P) 1.6 MB (W) 2.6 MB |
M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$29.95 |
|
IDNotes by PDA Med Solutions Features Sections on microorganisms, infectious diseases by
anatomical location, prophylactic therapy for infections
and for surgical procedures,
index of the antimicrobial spectra, index of the normal flora
by anatomical sites and an exhaustive section of the pharmacology
of antimicrobial agents |
(P) 640 KB
Not available in WinCE format |
M5xx, Clie, Visor, Handera expansion memory cards |
Updated Quarterly for 2 years |
$39.99
|
|
Sanford Guide by Antimicrobial Therapy Inc. Features 23 tables and information on >140 antimicrobials Mirrors the paper version, with the same familiar sections and tables Extensive reference to the primary literature and practice guidelines Table that provides Web site addresses and telephone numbers that can be used to obtain more info on topics of interest (i.e. bioterrorism, vaccinations and occupational exposure) |
(P) 1.5 MB (W) 3.0 MB |
M5xx, Clie, Visor, Handera expansion memory cards |
Annual Updates |
$25.00 |
|
Pediatrics |
||||
|
HarrietLane by The Harriet Lane Handbook, 15 th ed. Features diagnostic guidelines, recommended tests, therapeutics, and dosage schedules |
(P) 3.7 MB (W) 5.2 MB |
M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$49.95 |
|
5 Minute Pediatric Consult by T he 5-Minute Pediatric Consult Features Covers >500 topic to aid diagnosis and treatment Provides information on problems seen in infants, children, adolescents Coverage includes a database, differential diagnosis, data gathering, physical examination, laboratory aids, therapy, follow-up, commonly asked questions, and emergency care |
(P) 3.6 MB (W) 9.5 MB
|
M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$69.95 |
|
PktPeds by Pocket Pediatrics Features Covers >200 topics including critical care/emergency medicine, wellness neonatology, ID, dermatology |
(P) 0.9 MB (W) 1.3 MB |
M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$37.95 |
A* -- Compatibility evaluated for Palm OS system only
Table 3. Medicine Texts and Clinical Assessment Tools 3,6,12
|
Program & Publisher Description |
Size PalmOS (P) |
Expansion Card Compatibility (A*) |
Updates |
Download Site and Cost |
|
Harrison's Manual of Medicine by Harrison's Manual of Medicine Covers hundreds of diseases and conditions; provides treatment summaries, signs/symptoms, differential diagnosis, pathophysiology, laboratory findings and practice guidelines |
(P) 1.3 MB Not available for WinCE |
Memory Cards Are Not Supported |
No Updates |
$65.95 |
|
Griffith's 5-Min. Clinical Consult by Griffith's 5-Minute Clinical Consult Basics
Genetics, incidence/prevalence, signs & symptoms,
causes, risk factors |
(P) 4.3 MB (W) 9.5 MB |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
No updates |
$69.95 |
|
Washington Manual by Washington Manual of Therapeutics, Lippincott Williams & Wilkins Features Provides management of common medical disorders via an electronic table of contents, main index, medication index; provides treatment summaries, signs Latest drug information along with accurate dosages, evidence-based guidelines for patient management, extensive coverage of inpatient therapeutics, updated oncology information including bone marrow transplantation and expanded coverage of fluid and electrolyte and ischemic heart disease management |
(P) 2.4 MB (W) 3.4 MB |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$59.95 |
|
Dorland's Medical Dictionary by Dorland's Pocket Medical Dictionary, 26th Edition Features Provides extensive coverage on over 33,000 medical terms Also includes anatomy terms that reflect the new Terminologia Anatomica and key drug terms -- including 500 of the newest drugs Very helpful medical reference |
(P) 6.1 (W) 10.4 MB |
Palm M5xx, Clie, Visor, Handera expansion memory cards |
No Updates |
$39.95 |
A* -- Compatibility evaluated for Palm OS system Only
References
- Topps D, Thomas R, Crutcher R. Introducing PDAs to Family Physician Teachers. Fam Med 2003; 35(1): 55-9.
- McCreadie SR, Stevenson JG, Sweet BV, Kramer M. Using personal digital assistants to access drug information. Am J Health-Syst Pharm 2002; 59 (Jul 15): 1340-1343.
- Keplar KE, Urbanski CJ. Personal Digital Assistant Applications for the Healthcare Provider. Annals Pharmaco 2003; 37: 287- 296.
- Enders SJ, Ender JM, Hostad SG. Drug-Information Software for Palm Operating System Personal Breath, Clinical Dependability and Ease of Use. Pharmacotherapy 2002; 22(8):1036-1040.
- Miller SM, Beattie MM, Butt AA. Personal Digital Assistant Infectious Diseases Applications for Healthcare Professionals. Clinical Infectious Diseases 2003; 36 (15 April):1018-1029.
- Skyscape.com, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.skyscape.com .
- American Society of Health-System Pharmacists home pate [cited 2003 May 20]. Available from: URL: http://www.ashp.org .
- ePocrates, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.epocrates.com .
- Hogan R. New Media. JAMA 2001; 286(2): 229-233.
- Lexi-Comp, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.lexi.com.
- Thompson Micromedex, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.micromedex.com/mobilemicromedex .
- Handango, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.handango.com .
- PalmMD.com, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.pdamd.com .
- Tarascon Publishing, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.tarascon.com .
- Johns Hopkins University's Division of Infectious Diseases home page [cited 2003 May 20]. Available from: URL: http://www.hopkins-abxguide.org .
- PDA Medical Solutions, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.pdamedsolutions.com .
- Antimicrobial Therapy, Inc. home page [cited 2003 May 20]. Available from: URL: http://www.sanfordguide.com .
