Pharmacy Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
JMIR Mhealth Uhealth. 2022 Apr 20;10(4):e29985. doi: 10.2196/29985.
Drug-referencing apps are among the most frequently used by emergency health professionals. To date, no study has analyzed the quantity and quality of apps that provide information on emergency drugs.
This study aimed to identify apps designed to assist emergency professionals in managing drugs and to describe and analyze their characteristics.
We performed an observational, cross-sectional, descriptive study of apps that provide information on drugs for adult emergency care. The iOS and Android platforms were searched in February 2021. The apps were independently evaluated by 2 hospital clinical pharmacists. We analyzed developer affiliation, cost, updates, user ratings, and number of downloads. We also evaluated the main topic (emergency drugs or emergency medicine), the number of drugs described, the inclusion of bibliographic references, and the presence of the following drug information: commercial presentations, usual dosage, dose adjustment for renal failure, mechanism of action, therapeutic indications, contraindications, interactions with other medicinal products, use in pregnancy and breastfeeding, adverse reactions, method of preparation and administration, stability data, incompatibilities, identification of high-alert medications, positioning in treatment algorithms, information about medication reconciliation, and cost.
Overall, 49 apps were identified. Of these 49 apps, 32 (65%) were found on both digital platforms; 11 (22%) were available only for Android, and 6 (12%) were available only for iOS. In total, 41% (20/49) of the apps required payment (ranging from €0.59 [US $0.64] to €179.99 [US $196.10]) and 22% (11/49) of the apps were developed by non-health care professionals. The mean weighted user rating was 4.023 of 5 (SD 0.71). Overall, 45% (22/49) of the apps focused on emergency drugs, and 55% (27/49) focused on emergency medicine. More than half (29/47, 62%) did not include bibliographic references or had not been updated for more than a year (29/49, 59%). The median number of drugs was 66 (range 4 to >5000). Contraindications (26/47, 55%) and adverse reactions (24/47, 51%) were found in only half of the apps. Less than half of the apps addressed dose adjustment for renal failure (15/47, 32%), interactions (10/47, 21%), and use during pregnancy and breastfeeding (15/47, 32%). Only 6% (3/47) identified high-alert medications, and 2% (1/47) included information about medication reconciliation. Health-related developer, main topic, and greater amount of drug information were not statistically associated with higher user ratings (P=.99, P=.09, and P=.31, respectively).
We provide a comprehensive review of apps with information on emergency drugs for adults. Information on authorship, drug characteristics, and bibliographic references is frequently scarce; therefore, we propose recommendations to consider when developing an app of these characteristics. Future efforts should be made to increase the regulation of drug-referencing apps and to conduct a more frequent and documented review of their clinical content.
药物参考应用程序是急诊卫生专业人员最常使用的应用程序之一。迄今为止，尚无研究分析提供紧急药物信息的应用程序的数量和质量。
本研究旨在确定旨在协助急诊专业人员管理药物的应用程序，并描述和分析其特征。
我们对提供成人急救药物信息的应用程序进行了一项观察性、横断面、描述性研究。2021 年 2 月在 iOS 和 Android 平台上进行了搜索。由 2 名医院临床药剂师独立评估应用程序。我们分析了开发者隶属关系、成本、更新、用户评分和下载次数。我们还评估了主要主题（急救药物或急诊医学）、描述的药物数量、是否包含参考文献以及是否存在以下药物信息：商业制剂、常用剂量、肾功能衰竭时的剂量调整、作用机制、治疗适应症、禁忌症、与其他药物的相互作用、在妊娠和哺乳期的使用、不良反应、制备和给药方法、稳定性数据、不相容性、高警示药物的识别、在治疗算法中的定位、药物重整信息和成本。
总共确定了 49 个应用程序。其中 32 个（65%）在两个数字平台上都有发现；11 个（22%）仅适用于 Android，6 个（12%）仅适用于 iOS。总的来说，41%（20/49）的应用程序需要付费（从 0.59 欧元[0.64 美元]到 179.99 欧元[196.10 美元]），22%（11/49）的应用程序由非医疗保健专业人员开发。加权平均用户评分 4.023（标准差 0.71）。总的来说，45%（22/49）的应用程序侧重于急救药物，55%（27/49）的应用程序侧重于急诊医学。超过一半（29/47，62%）的应用程序没有参考文献或已经超过一年没有更新（29/49，59%）。药物中位数为 66 种（范围为 4 种至>5000 种）。只有一半（26/47，55%）的应用程序包含禁忌症和不良反应（24/47，51%）。不到一半的应用程序解决了肾功能衰竭时的剂量调整（15/47，32%）、相互作用（10/47，21%）和妊娠及哺乳期使用（15/47，32%）。只有 6%（3/47）识别了高警示药物，2%（1/47）包含药物重整信息。与用户评分较高相关的因素分别为：与健康相关的开发者、主要主题和更多的药物信息（P=.99、P=.09 和 P=.31）。
我们对提供成人急救药物信息的应用程序进行了全面回顾。关于作者、药物特征和参考文献的信息经常很缺乏；因此，我们提出了一些建议，在开发这些特性的应用程序时应考虑这些建议。未来应努力加强对药物参考应用程序的监管，并更频繁和有文件记录地审查其临床内容。
