Purpose of App Review

  • to review the breadth of calculations available
  • to review the applicability of the app

Introduction

Every patient is a bit different in terms of how medicines affect him/her and how his/her body affects the availability and function of a given medicine.

These interactions are particularly important for certain antibiotics.

The DoseAdjust medical app from Duffek, LLC, seeks to help you electronically calculate dosing regimens for patients receiving vancomycin and aminoglycosides.

User Interface

On first and subsequent uses, the app opens up the default screen of the app. The default is the New Patient screen.

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The toolbar at the bottom of the app gives you access to saved patient data for any past patients you have entered into the app as well as to the Help section.

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On the New Patient screen, the app guides you to enter information about the patient and the drug in order to make the calculation. Information to enter includes: the drug, volume of distribution, gender, age, height, weight, serum creatinine, and desired peak, trough, and infusion time for the selected drug. If you want to save the patient, the app provides an option to enter the Patient ID at the top of the screen.

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With this information entered, you then select next on the iPhone version. This takes you to a screen with calculated patient information such as ideal body weight, creatinine clearance, and half-life.

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After selecting next again, the app takes you to the final screen. This screen lists calculated parameters (some similar to the screen before), volume of distribution (complete with slide bar to adjust the volume if desired), and the recommended dose and dosing interval.

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If desired, you can also calculate new regimens from this screen by entering a new dose and dosing interval. The regimen peak and trough are then listed below (but are not labeled as to the dose and dosing interval used to calculate them).

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For patients that you might make several changes on, the app allows you to save their information in the app by selecting the Save radio button from the results screen.

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To access saved data, navigate to the Past Patients screen and select the patient of interest. You are then brought to the results screen for that patient. You can calculate new regimens for the patient by entering the dose and dosing interval, but cannot change the parameters you initially entered on the patient, such as serum creatinine.

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The Help screen provides information on the formulas used to make calculations within the app.

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Evidence to support use

  • NOT provided

Price

  • $2.99

Likes

  • graphical representation of dose decay
  • explanation of most formulas used
  • ability to save patient information for review and further calculation

Dislikes

  • reference ranges and usual infusion times not provided or adjusted for the drug being calculated
  • guide for choosing parameters not available
  • units not specified for peak and trough
  • lacks PIN-lock function

Healthcare providers that would benefit from the app

  • I don’t see how this would be helpful to a health care professional who is deciding to use vancomycin or aminoglycosides; it is important to get these doses correct and most providers have access to more advanced calculators and/or pharmacy specialists.

Conclusion

  • The DoseAdjust medical app provides an electronic calculator for adjusting dosing regimens of vancomycin and aminoglycosides.  The app is limited in its scope to just four drugs and in its applicability to only providers very familiar with all the parameters needed to make the calculations – but, if you are familiar with these parameters, you likely already have a mechanism to make these calculations.

iTunes Link

Availability on Android:

  • As of publish, not currently available

iMedicalApps recommended?

  • No.  Getting the dose of these drugs wrong can have profound impact on the patient.  Dose calculations should be done under supervision of your local pharmacy/pharmacist.

Rating: 3/5
1. User Interface – 4.  Straightforward interface, easy to enter data
2. Multimedia usage – 3.  Utilizes split-screen and graphics, as well as slider bar functions
3. Price – 3.  Relatively inexpensive at $2.99
4. Real world applicability – 2.  Use depends on patient population, prevalence of vancomycin or aminoglycoside use, and need to adjust doses

App version: 1.2
Compatibility: iPhone 3GS, iPhone 4, iPhone 4S, iPhone 5, iPod touch (3rd, 4th, 5th generations), iPad.  optimized for iPhone 5
Requires: iOS 6.0 or later
Tested on: iPhone 4S and iPad 4

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your healthcare provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or healthcare provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your healthcare provider.