Evaluation of adverse drug reaction formatting in drug information mobile phone applications.

OBJECTIVE: To evaluate the differences in presentation (formatting) of adverse drug reaction (ADR) information within drug monographs in commonly used drug information (DI) mobile device applications. METHODS: A cross-sectional analysis of ADR formatting of twenty commonly prescribed oral medications within seven DI mobile applications was performed. Databases were assessed for ADR information, including presence of placebo comparisons, severity of ADR, onset of ADR, formatting of ADRs in percentile (quantitative) format or qualitative format, whether references were used to cite information, and whether ADRs are grouped by organ system. Data was collected by two study investigators and discrepancies were resolved via consensus. RESULTS: The seven DI mobile applications varied significantly on every analyzed ADR variable with the exception of ADR onset, which was absent in all databases. Significant differences were found for variables known to impact clinical judgment such as placebo comparisons and qualitative versus quantitative formatting. Placebo comparisons were most common among monographs in Lexicomp (30%) but were absent among monographs within other applications. Quantitative information was commonly used in most databases but was absent in Epocrates. Qualitative formatting was present in all Epocrates and Micromedex applications but absent in the majority of other applications. Substantial variations were also found in severity and grouping information. CONCLUSION: Substantial variation in ADR formatting exists among the most common DI mobile applications. These differences may translate into alternative interpretations of medical information and thus impact clinical judgment. Health care librarians and clinicians should consider ADR formatting when choosing between DI applications.

Pharmacists and opioid use disorder care during COVID-19: Call for action.

Opioid use disorder (OUD) is a chronic relapsing condition characterized by problematic opioid use causing significant impairment in daily life. Medication for opioid use disorder using buprenorphine, methadone, and naltrexone with behavioral therapy reduces illicit opioid use and risk of overdose death. Despite evidence and decades of experience, barriers limit access to treatment and care for individuals with OUD. Barriers include a lack of treatment centers particularly in rural areas, regulations on buprenorphine prescribing, and stigma from the community and health care professionals. While many barriers are longstanding, the coronavirus disease 2019 (COVID-19) pandemic-forced isolation and associated stress has exacerbated challenges for individuals with mental health conditions such as OUD. Pharmacists are well-positioned to bridge existing gaps in OUD care, particularly during the COVID-19 pandemic. Roles for pharmacists include OUD risk identification and screening, referral of patients to treatment and support programs, ensuring medication access, expanding naloxone access, and advocacy initiatives. This review article identifies barriers to care for patients with OUD during the COVID-19 pandemic and explores opportunities and resources for pharmacists to improve OUD care during the pandemic and beyond.