Off-label use information in electronic drug information resources

Objective: To compare electronic drug information resources for scope, completeness, and consistency of off-label uses information. Methods: An evaluation study of six electronic drug information resources (Clinical Pharmacology, Lexi-Drugs, American Hospital Formulary Service Drug Information (AHFS DI), Facts and Comparisons Off-Label, Micromedex Quick Answers and In-Depth Answers) was conducted. All off-label uses for the Top 50 prescribed medications were extracted from all six resources and used to determine scope (i.e., whether the resource listed the use). A random sample of 50 uses were then used to evaluate completeness (i.e., whether the entry cited clinical practice guidelines, cited clinical studies, provided a dose, described statistical significance, and described clinical significance) and consistency (i.e., whether the resource provided the same dose as the majority of resources). Results: A sample of 584 uses was generated. The largest number of listed uses was in Micromedex In-Depth Answers (67%), followed by Micromedex Quick Answers (43%), Clinical Pharmacology (34%), and Lexi-Drugs (32%). The highest scoring resource for completeness was Facts and Comparisons Off-Label (median score 4/5), followed by Micromedex In-Depth Answers (median score 3.5/5), and Lexi-Drugs (median score 3/5). Consistency with the majority was highest for Lexi-Drugs (82%), followed by Clinical Pharmacology (62%), Micromedex In-Depth Answers (58%), and Facts and Comparisons Off-Label (50%). Conclusions: The strongest resources for off-label use content varied. The top resources for scope were Micromedex In-Depth and Quick Answers. For completeness, the highest scoring resources were Facts and Comparisons Off-Label and Micromedex In-Depth Answers. Lexi-Drugs and Clinical Pharmacology were the most consistent.