Apothecarium and 5-Minute Clinical Consult for the Palm Pilot - Software Review - Evaluation

Journal of Family Practice, March, 2001 by Allan J. Wilke

Apothecarium and 5-Minute Clinical Consult for the Palm Pilot SKYSCAPE.COM, INC, 131 COOLIDGE STREET, SUITE 222, HUDSON, MA 01749. PHONE: (978) 562-5555. WEBSITE: WWW.SKYSCAPE.COM.

PRICE: Apothecarium, $104.95 LexiDrugs 2000, $64.95; 5-Minute Clinical Consult, $64.95. All prices are from Palm Gear HQ.

HOW SUPPLIED: Direct download from Handango (www.handango.com), Palm Gear HQ (www.palmgear.com), or CollectiveMed.com (www.colletivemed.com).

DOCUMENTATION: Available as an HTML file that is included in the download.

HARDWARE AND SOFTWARE REQUIREMENTS: Palm OS 2.0 or higher with 8 MB of memory. The databases are large: LexiDrugs 2000, 1.3-2.4 MB; 5-Minute Clinical Consult, 2.8 MB; and Interact, 1.1 MB.

CUSTOMER SUPPORT: (888)-SKYSCAPE; support@skyscape.com.

MONEY BACK GUARANTEE: Must be approved by developer.

RATING: Good to excellent.

Skyscape produces these programs and bundles LexiDrugs 2000 and Interact as Apothecarium. LexiDrugs, 5-Minute Clinical Consult, and Interact are independent programs that link to each other. These programs can be downloaded from several Internet sites.

LexiDrugs is based on Lexi-Comp's Drug Information Handbook. LexiDrugs' database contains monographs on approximately 6200 prescription and over-the-counter drugs, including drugs dispensed in Canada and Mexico. Users can search by trade or genetic name, and in some instances by therapeutic class (eg, "cough and cold combination" or "macrolide [antibiotic]"). Once a drug of interest is located, LexiDrugs presents a number of sections of information. The most commonly used sections, US Brand Names, Use, Usual Dose, Drug Interactions, Warnings/Precautions, Contraindications, Pregnancy Risk Factor, and Dosage Forms are represented by individual buttons. Other sections include Therapeutic Category, Adverse Reactions, Mechanism of Action, Overdosage/ Toxicology, Administration, Restrictions, Test Interactions (influence of the drug on laboratory tests), Canadian Brand Names, Dietary Considerations, Pharmacodynamics/Kinetic, and Monitoring Parameters.

The Usual Dosage section is the one I use the most. It separates dosing information into children, adults, and elderly, and, where appropriate, into oral, intramuscular, intravenous, and topical. One limitation is that the drugs are grouped by their generic names. The section my patients like the most is Adverse Reactions. They are amazed and appreciative when I take out my Palm Pilot to answer their questions about how this new drug I am recommending is going to mess up their lives. The Dosage Forms section indicates whether the drug is available as a capsule, tablet, chewable tablet, film-coated tablet, powder, suspension, syrup, patch, inhalation solution, metered-dose inhaler, and so forth. It does not, however, contain physical descriptions, such as the color or the shape of the tablet or whether it is scored. Additionally, because the drugs are listed by their generic names, when multiple dosage forms are available it does not indicate which trade name is associated with which dosage form.

Screen navigation is intuitive. To look up a specific drug, the user begins to spell it. Usually, after the first 3 or 4 letters the drug name appears in the scrolling list of drugs, along with those that are similarly spelled (Figure 1). Users can also scroll up or down through the alphabetical list to find the drug. Once the drug's name is found the monographs are accessed by tapping the drug's name on the screen using the Palm's stylus. There is another icon that takes users to a note page where they can annotate the monograph. There is even a New icon that allows users to. add a new drug. (I prefer to wait for the periodic updates).

[Figure 1 ILLUSTRATION OMITTED]

The 5-Minute Clinical Consult based on Griffith's 5-Minute Clinical Consult is probably familiar to most physicians from its other incarnations as a book or a computer program (Figure 2). It is a compendium of more than 1000 disease monographs in alphabetical order. Its format is similar to LexiDrugs. To access a disease, users select the first few letters and choose from the scrolling list. Once the disease is selected button icons appear for Basics, Diagnosis, Treatment, Medications, Follow-up, and Miscellaneous. I have found this software to be most useful when I am making rounds and a resident asks for details about a particular disease.

[Figure 2 ILLUSTRATION OMITTED]

Interact is based on Lexi-Comp's Drug Interaction Database. When users open the program they are presented with an alphabetical list of name brand and generic prescription and over-the-counter drugs. When users click on a drug, they see a list of possible interaction pairings. The obvious limitation is that the user needs to know the generic names of the drugs. In this program there are buttons for Significance Level, Mechanism of Action, Clinical Effects, Predisposing Factors, Patient Management, Discussion, and References. As with LexiDrugs and 5-Minute Clinical Consult, users can annotate each pairing of interactions. If a patient is taking more than 2 drugs that need to be checked against each other, it is easier to click on the List icon. This produces the same alphabetized list of drugs, but each drug has a check box in front of it. The user `simply checks off each drug for the interactions' check and then taps the OK button. What appears next is a list of drug interaction pairs and the significance levels. There is a Monograph button if more information is desired. The only shortcoming I can see is that there are no food-drug interactions listed.