Shabbir M.H. Alibhai, MD, MSc, FRCP(C) Senior Editor, Geriatrics & Aging.
We do not normally review software for Geriatrics & Aging. However, this particular piece of software, ePocrates, is very relevant to physicians in general and to our readers in particular. ePocrates is a drug reference program designed to meet the needs of clinicians in an increasingly complex pharmacotherapeutic environment. Over 2,600 drugs and related tables are included in this software for your handheld device (e.g., Palm). Best of all, it's free to download and updates itself automatically every time one synchronizes with a desktop that is connected to the Internet.
This is not my first encounter with ePocrates. I have been using it regularly for almost a year. In fact, I obtained it shortly after purchasing my first handheld device last summer. ePocrates is incredibly compact--it takes up only 1.5 Mb on the average handheld--yet it contains an incredible amount of useful information for today's busy clinician.
To begin with, ePocrates contains information about hundreds of unique drugs--almost anything you might prescribe to patients in North America. It contains the usual dosages and indications for each drug. For example, indications for ACE inhibitors include hypertension, CHF, post-MI and for reduction of cardiovascular events. Pretty current. Colchicine was indicated for gout attacks, prevention of gout, and for Familial Mediterranean Fever (I'm not making this up). The material in ePocrates is apparently peer-reviewed, although the details of which information is reviewed, and by whom, are unclear. Information for each drug includes:
- adult and pediatric dosing information, along with common and serious adverse reactions;
- drug interactions (simple lists which can be clicked to provide a small paragraph describing the interaction);
- safety information (use in pregnancy, lactation and chronic renal failure);
- cost (U.S. prices);
- mechanism of action, where known (e.g., levofloxacin inhibits DNA gyrase and topoisomerase IV--quite impressive).
Information is easily found because drugs are listed alphabetically under their generic and trade names. Alternatively, one can search by drug class (e.g., oncologic agents).
ePocrates is easy to install and has come in handy for me on dozens of occasions. While it does not replace comprehensive tomes such as the CPS, I found myself using them far less often after I obtained ePocrates. Moreover, these days I find myself looking up drug information in ePocrates instead of relying on my memory. My knowledge of pharmacological agents has definitely improved as a result. Using ePocrates while in clinic or on the wards has saved me time on numerous occasions. I have never had a patient or family member complain when I used it in front of them; in fact, I was more surprised by their lack of reaction than they were by my use of ePocrates.
I have only a few criticisms of ePocrates, and these are mentioned only because I want someone to take notice and improve this program further. First, non-prescription drugs are not well covered. The other day, my patient bought some Aleve and I couldn't find it; I had to resort to another source to find out that Aleve contains naproxen. Second, Canadian prices and formulary information would be most welcomed, especially given some of the wildly different prices we pay for drugs compared to our American counterparts. Third, frequencies for common and serious side effects would be great (e.g., 7% nausea, 0.01% anaphylaxis). These minor criticisms aside, given the convenience and versatility of this program, combined with its automatic update features and price (free), I have no hesitation in recommending ePocrates to anyone with a handheld. In fact, one might go so far as to say this is a good reason to consider buying a handheld in the near future.
By the way, I started using ePocrates on my Palm Vx. This review, however, was done using ePocrates on my new Sony Clié PEG-NR70V handheld. What a beautiful device! 16 Mb RAM, built in keyboard, swivel high-resolution colour screen, fully Palm-software compatible, with a slot for memory expansion using MemoryStick technology. Bundled software allows one to read and edit Word and Excel files. It can play MP3 and ATRAC3 audio files (and comes with a cute earplug and miniaturized set of controls), view digital photos and small movie clips, and the NR70V even comes with its own built-in 320x240 pixel digital camera. All of this comes in a sleek, sturdy carrying case. The only catch is the price--the NR70V sells for $1,000. Price aside, it is no wonder that many critics have credited Sony with the greatest advance of handheld technology since the introduction of the Palm. I'm certainly impressed.
ePocrates software is compatible with most Palm OS® handheld devices including Palm, Handspring, TRG, Sony, Samsung and Kyocera Smartphone brands.