This article is more than 5 years old. Information may no longer be current.
Available drug information on the Internet: A focus on vetted sites
Click Here to Manage Email Alerts
The Internet is a popular and frequently used source of medical information for patients and health care professionals. However, using online resources for drug information can be risky.
Online resources, although convenient, interactive, timely and usually free, also can be unregulated, commercialized and lacking in privacy policies. Because most information on the Internet is not reviewed by independent experts, information may be incomplete, inaccurate and misleading for patients and health care providers. According to a survey by the Health On the Net Foundation (HON) Code of Conduct, 68.3% of health care professionals said patients discuss information found on the Internet.
Sally A. Arif
Although it may be argued that this improves communication and helps patients become more knowledgeable about their disease state(s) and medication(s), it also suggests that health care practitioners must be proactive about directing patients to reputable sources of information, especially drug information, on the Internet. Familiarization with the wide array of available drug information sources is important to guide patients to high-quality, accurate Internet drug information sources.
Some tools, such as JAMA benchmarks and HON criteria, have been used to determine the quality of information on the Internet and have been described in the literature (see Table 1).
Websites must register to be certified by the Europe-based HON and/or other certifying agencies, such as the US-based Utilization Review Accreditation Commission (URAC), which deems a site to have a higher level of trustworthiness and credibility regarding drug information. Users can ascertain whether a website is credentialed by looking for a seal of approval or logo from the certifying body on the website homepage.
Related Links: MedlinePlus, Mayo Clinic, Pharmacist Letter, GlobalRPh Inc, Drugs.com, Epocrates Rx, Lexi Drugs Online, Micromedex Online, Medscape, WebMD, ArizonaCERT, Indiana University School of Medicine, ClotCare Online Resource, The Warfarin Dose Refinement Collaboration
However, critics of the certification process say there are no uniformly consistent guidelines for credentialing. Therefore, health care providers should critically judge the quality of drug information on any website for themselves, when evaluating reliability and validity utilized by large accrediting bodies. This should help to steer use of these websites to those that are the most reliable and accurate. Based on a 2010 survey by HON, 72% of health care professionals said it would be helpful to guide patients to a trustworthy (online) source, which is a significant increase from 2005 (59%). Another available resource is a short tutorial related to evaluating Internet health content developed by the NIH.
Navigating the Internet for drug information resources can be daunting, but awareness of reliable open-access sites is essential (see Table 2). Utilization of websites such as Wikipedia to answer drug information questions can be limited and should be discouraged due to incomplete information and lack of adequate drug-dosing specifics.
The FDA website (fda.gov) also provides general information on drugs and biologics, as well as bioequivalence information through the Orange Book. Drug manufacturer websites are typically viewed as bias-prone; however, they provide useful information for clinicians, including directions for drug reimbursements, the latest product labeling and company contacts for product-specific information. Several drug information references, such as ePocrates, Lexi-Drugs and Micromedex, are available online. Lexi-Drugs and Micromedex provide detailed drug monographs, which include FDA and non-FDA indications, mechanisms of action, pharmacodynamics/kinetics, and renal and hepatic dosing considerations, but they require a paid subscription, which can provide additional features such as drug calculators. Although the information on epocrates is not as thorough or as extensively peer-reviewed as the information available from Lexi-Drugs or Micromedex, access can be free and has quick dosing information and drug interaction screens.
All health care providers should be proficient users of reputable online drug information resources. These online sources, many available at no cost, can also provide useful information for patients and can be utilized when other resource strategies fail to provide the most current information available. Additionally, it is important to fully understand the criterion utilized in certifying reliable drug information websites to establish comfort with the online source and the information provided.
Disclosure: Arif reports no relevant financial disclosures.