Here we review the premium Lexi-Complete application for the iPhone & iPod Touch, which its developers have been generous enough to offer us for a review. In April 2010, we reviewed Lexi-Comp for the iPad when it first debuted ahead of many of its competitors. A major issue then was whether Lexi-Comp’s considerable resources were worth its hefty price—still a very salient concern. Moreover, keep your eyes open for our upcoming comparison of the free Medscape app against the paid versions of Lexi-Complete and Epocrates.
Ohio-based Lexi, a long-standing (celebrated their 30th anniversary in 2008) and sizeable (>130 employees) reputable provider of tools to enhance clinical care, prides itself on being a “industry-leading provider of drug information and clinical content for the healthcare industry” that strives to “improve patient safety, ensure compliance, and elevate the quality of care patients receive.”
Long story short, we trust Lexi and their products, and commend them on their commitment to community outreach in the Ohio area. As for their extensive portfolio of databases and apps, we’ll take a closer look at them in this review.
In this review, we will focus in on the widely touted Lexi-Drugs database, as well as the Lexi-Drug ID database, and also take a look at Lexi-Patient Education. We plan to take a closer look at Lexi-Interact (Lexi’s medication interaction checker) and Lexi-CALC (Lexi’s medical calculator) in upcoming comparison articles (also featuring MedScape and Epocrates), and will not go further in depth into Harrison’s Practice or 5-Minute Clinical Consult since our prior reviews of fairly similar resources afford considerable insight into how exceptionally useful they can be in the clinical setting. And at the end of this review, you can find a complete list of Lexi’s databases and apps, including brief descriptions.
For the flagship Lexi-Drugs database, the start screen features various functions, of which the first –and, by far, the most useful for this database—is “Drugs.” The other functions of the Lexi-Drugs database have their roles, especially “Pharmacologic Category” when comparing drugs in a particular class, but are otherwise not nearly as useful as “Drugs.”
From the “Drugs” screen, the Lexi-Drugs library can be quickly searched for the medication of interest (here, Plavix):
The buttons at the top of the monograph are quick links to print information, Lexi’s drug interaction checker, Lexi’s Drug ID function, and patient (adult and pediatric) education. Each drug’s section then features “Special Alerts.” Here, for Plavix, we see statements concerning the widely-publicized Plavix-PPI interaction as well as the decreased effectiveness of Plavix in patients with defective CYP2C19 activity (poor metabolizers). Next, the reference includes brand names, pharmacologic categories, and dosing by indication with specific references on which these recommendations were based, as well as dosing adjustments (for geriatric patients, renal or hepatic impairment, etc.).
The drug monograph continues with clinical practice guidelines that include active links to the appropriate articles/consensus statements that open with WiFi or 3G connection. For example, as shown below, the Plavix monograph links to the ACC/AHA 2007 Guidelines for the Management of Unstable Angina and Non-ST Elevation Myocardial Infarction.
The monograph proceeds with contraindications, alerts, warnings, safety issues, strengths/dosage forms, monitoring parameters, drug interactions, storage, mechanism of action, pharmacodynamics/kinetics, adverse reactions, dietary considerations, patient information, pregnancy risk factor and considerations, lactation, allergy and idiosyncratic reactions, various considerations (especially cardiovascular, anesthesia, dental, mental health, etc.), and references (linked to PubMed). Now, as you might expect, this lengthy list of wonders makes for an extensive drug monograph, but the “Jump” button in the top-right corner of each drug monograph allows for quick navigation if you know what you are looking for (for example, checking renal dosing in an ESRD patient, safety of the medication in a pregnant or lactating patient, mechanism of action, or the price of the medication).