The Physicians’ Desk Reference (PDR) appeared in its 69th edition in 2015, but research shows that most doctors just use their smartphone. With free drug reference databases like Epocrates, it’s becoming increasingly easy to ditch the five-pound paper publication, which has been listing FDA-approved prescription drugs since 1947.
This follows the general trend for physician smartphone use. According to a 2014 study by Kantar Media, 51 percent of doctors use drug coding or reference apps. Epocrates has led the market, with over half of US physicians using their mobile health applications.
Transitioning to a digital PDR has its obvious benefits: you can quickly query a huge database and you don’t have to carry around a textbook. Apps like Epocrates also provide more than simple drug information, with functions for drug interactions, an insurance provider database, and a pill ID. To top it off, this information is free – but thats where the story gets more complicated.
Epocrates, like many free reference tools, makes most of its revenue from advertising. For doctors this means wading through marketing messages catered to their search history, which try to sway their decisions about which drugs to prescribe. These “DocAlerts” are effective (Epocrates says drug makers get $3 in increased sales from every dollar spent on DocAlerts), which has raised ethical concerns since patients bear the financial and health risk of their doctor’s decision.
These concerns aren’t new or unique to smartphone apps, however, since the PDR has always been partially funded by the pharmaceutical companies that make the drugs listed in the volume. So far, the ads haven’t turned off the 1 million active members of the Epocrates network.
Its easy to assume that apps like Epocrates will quickly make the physical PDR obsolete, but it might not be happening as quickly as you would expect. According to Epocrates’ 2014 Mobile Trends report, physician use of smartphones actually didn’t change from 2013 to 2014, contrary to predictions. The report’s tagline: “amidst historic change in health care, devise adoption achieves temporary equilibrium.”
The reality is that paper medical references remain ubiquitous; you will find a printed PDR in most doctor offices and clinics, and more than half of doctors still read medical journals on paper. But with 95 percent of doctors under the age of 35 using smartphones for professional purposes, it seems only a matter of time before drug reference is completely app-based.