FP Watch

The Rx Files

Drug comparison charts

Detailed, objective, comparative drug information

Loren Regier, BSP  Brent Jensen, BSP  Tessa Laubscher, MB CHB, CCFP

There is no shortage of drug information, but where can you find detailed, objective, comparative, up-to-date Canadian drug information? The RxFiles–Drug Comparison Chart Updates book contains charts summarizing practical information on the optimal selection and use of medications.

Putting charts together

Several clinicians and resources provide information for the comparison charts. At the outset, physicians provide information and identify current questions and controversies. In a review of therapy, program staff sort through original clinical trials, evidence-based reviews, recent overviews, and clinical guidelines and sift through information from drug databases (Micromedex, Hansten’s Drug Interactions, the American Hospital Formulary System, Briggs’ Drugs in Pregnancy and Lactation, Natural Products Database, and Canadian product monographs). This initial compilation is used to draft outlines that are then revised to incorporate both outcome evidence and expert opinion. Family physicians, specialists, pharmacists, and other health professionals peer review the material before publication.

What is in a chart?

Charts contain a variety of drug information specific to a therapeutic area. This often includes generic names, trade names, dosage forms, dosage strengths (which tablets are scored), drug classification, contraindications, renal cautions, side effects, pregnancy categories, important drug interactions, comparative information, initial and maximum doses, usual doses, and comparative cost. Charts provide tips to individualize therapy and avoid drug-related problems. The resulting information is detailed and summarized on one page, a format that results in some small print but sets each chart apart from the others.

Standard book and pocket edition

The standard book of RxFiles–Drug Comparison Chart Updates (September 2004) contains 68 pages of colour-tabbed, indexed, coil-bound summaries of more than 40 drug therapy areas (Table 1). A pocket edition is also available for those who wish to carry the book in their laboratory coats and do not mind small print. Cost for each book is $45, with substantial discounts for students, residents, and those ordering many copies (order forms are on the website www.RxFiles.ca).

Are charts available for hand-held computers?

Many drug comparison charts are available for Palm-compatible hand-held computers. Charts are offered in either Mobile DB or HanDBase formats. Both formats are searchable and require less than 400 to 800 KB of memory, respectively. In addition to drug comparison charts, a summary of important trials on antihypertensive medications is also available in Palm format.

Website and e-mail support

Drug comparison charts and newsletters can be freely accessed in PDF format at www.RxFiles.ca. An e-mail update service is also available for those wishing to be notified of new or updated postings.

About the program

RxFiles is an academic detailing program with headquarters at Saskatoon City Hospital. The program was pilot-tested in Saskatoon in 1997 and expanded to serve the province of Saskatchewan in 2000. The program’s goal is to provide objective and unbiased drug information for promoting optimal drug therapy. The RxFiles Newsletter is published three or four times yearly and sent to all Saskatchewan physicians. Additional question-and-answer summaries and comparison charts are published periodically.

The hallmark of the program is brief visits to physicians’ offices to highlight information and discuss questions arising from the most recent newsletter and chart materials. This interaction enhances the value of the materials and ensures that the information uncovered gets into practice. The program has been well received, as documented by its growth and feedback from physicians. The RxFiles is also involved in other drug information and education initiatives, such as continuing medical education, student and resident teaching rounds, prescribing orientation for new physicians, and collaborative research projects. The RxFiles employs a program coordinator, six part-time program pharmacists, and several physician consultants. Although funding is provided by Saskatchewan Health, an independent program advisory committee that includes several family physicians directs program development.

Sorting through the outcome evidence

Physicians are looking for outcome evidence to make drug therapy decisions; results can be spun different ways, however, especially in product marketing. Several additional materials have been designed to help sort through evidence in potentially controversial areas. These materials contain interesting observations and summaries of trials related to antihypertensives, antihyperlipidemics, antithrombotics, and hormone replacement therapy. These summaries emphasize key findings, limitations, clinical considerations, and absolute differences in both beneficial and harmful effects. To quantify the risk versus benefit of therapy, results are often described as number needed to treat or number needed to harm.

Check it out!

For more information, visit the website www.RxFiles.ca; phone (306) 655-8506; or write RxFiles, Saskatoon City Hospital, 701 Queen St, Saskatoon, SK S7K 0M7.

Mr Regier is a pharmacist at Saskatoon City Hospital and Program Coordinator for the RxFiles Academic Detailing Program in Saskatchewan. Mr Jensen is a pharmacist at Saskatoon City Hospital and Information Specialist with the RxFiles Academic Detailing Program in Saskatchewan. Ms Laubscher is a Saskatoon family physician and Assistant Medical Director of Northern Medical Services, University of Saskatchewan. She serves as physician advisor to the RxFiles.