Epocrates or Medscape mobile health apps, which one is best for healthcare professionals?

Epocarates

Epocrates is an American based company located in California. The company developed mobile products and online clinical resources for healthcare practitioners for quick access to medical information. Their products and services offer a diverse range of easy to use, trusted and reliable information. Applications that are free for download on Epocrates' website are RX drug reference, Atlas of Anatomy, Echocardiography, and many more.

Epocrates RX mobile app is available for iPad, iPhone, Android, and Blackberry. It offers:

DocAlert: Notifications of updated recommendations

Interaction check: Check for potential interaction between two or more drugs

Calculator

Pill identification: Imprint, shape, color, score, coating, clarity

Tables: Quick disease states categories

Drug reference

o Adult and pediatric dosing for FDA-approved and off-label indications

o Black box warnings, adverse reactions, drug interactions, alternatives

o Insurance formularies

o Approximate retail drug pricing for patients

o Pregnancy risk categories

o Metabolism, excretion, drug class, and mechanism of action

Medscape

Medscape is part of WebMD Health Professional Network since 2001. It is a resource for health professionals, featuring peer-review original articles, medical news, drug information, and interaction checker. Medscape is free of charge for all consumers, but registration is required.

Key features of Medscape includes:

Online drug information

Review articles

Patient education

Book reviews

Conference presentation and medical meetings summary

Primary medical journals

Medical news Reuters, Medscape Medical News, and medical news journal publishers

Medline: abstracts and literatures

Medscape RX App for iPad, iPhone, Android, and Kindle Fire. It offers:

News: Guidelines, new drugs, expert interview

Reference

o Drugs: Drugs, OTC, herbals

o Conditions: e.g. Cardiology, critical care, gastroenterology

o Procedures: e.g. ACLS & BLS, Critical care, Eye

o Interactions check for drug, OTC, or herbal

o Calculators

o Directory: Physician search, pharmacy search, hospital search

Head to head comparison

Medscape mobile health app is completely free with free online registration. To take full advantage of Epocrates mobile health app, a fee of about $199/year is required in order to view the medical dictionary, guide to lab testing and data interpretation, and lists of treatment. Medscape mobile health application incorporates all of Epocrates features with the addition of a daily newsletter in over thirty areas of expertise. Epocrates pill recognition is slightly better than Medscape; a feature that will improve patient safety especially if a patient forgets what pill they have taken. Even though Epocrates has been out in the market longer, many people favor Medscape. Medscape earned 4 out of 5 stars on iTunes store compared to Epocrates with 3 out of 5 stars.

Reliability

Reliability between Epocrates (free version) and Medscape mobile health applications was determined by random selection of medications and comparing the accuracy of information in each app to the FDA approved prescribing information. Factors that determine accuracy include new drug updates, pharmacology, pill description, recommended dose, and dosage forms. The medications used in this study were Eliquis, Vicodin, amitriptyline, Singulair, and Pradaxa.

1) Eliquis: Eliquis was approved in 2012. Epocrates app does not provide information on Eliquis, while Medscape app provides complete information.

2) Vicodin: Epocrates mentioned the discontinuation of the 5/500 mg formulation and updated the app with the 5/300 mg formulation. The pill identification, however, still has the 5/500 mg picture. Medscape added the 5/300 formulation to their database, but also kept the 5/500 mg.

3) Amitriptyline: Package insert recommended starting dosage is 50–75 mg/day, preferably taken at bedtime. The dosage is increased by 25–50 mg weekly, depending on tolerability, to 150–200 mg/day with a max of 300 mg/day.

o Epocrates: Dosage forms: 10, 25, 50, 75, 100, 125, 175 mg

25-75 mg at bedtime, increase by 25 to 50 mg/day every 2 to 3 days. Max 300 mg/day

o Medscape: 10, 25, 50, 75, 100, 175 mg

25 mg at bedtime, increase by 25 mg every 5 to 7 days to 100-200 mg/day; up to 300 mg/day if needed

Epocrates added to their database the 125 mg tablet, which does not exist. Medscape has the correct dosage forms.

4) Singulair: Package insert recommendation for allergic rhinitis is for pediatric patients 6 to 23 months of age: one packet of 4-mg oral granules. Epocrates provides the correct pediatric dose. Medscape listed an age range of 6 to 24 months.

5) Pradaxa: Epocrates and Medscape information were correct

Conclusion

Medscape appears to be more accurate and updated compared to Epocrates (free version), but Epocrates does have an edge in the pill description category. When comparing to the package inserts, Epocrates has errors in available dosage forms and complete drug dose description. Medscape was overall more accurate; one mistake found was the age range for the Singulair pediatric dose. It was difficult to view the pill description using Medscape, but very easy with Epocrates.

This study is limited by the number of types of comparisons and the number of drugs that were included. In this limited study Medscape was more reliable. It is best to use both mobile health apps because they are both free, and having two or more sources offers more accurate and reliable information. It is always best to also refer to the approved prescribing information for accurate dosing information.

Reference

Appmanimal. Medscape versus Epocrates. Nov 11, 2011. Web February 7, 2013.

Medscape online. 2013.

Epocrates online. 2013.

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