The Rx Files
Drug comparison charts
Detailed, objective, comparative drug information
Loren Regier, BSP Brent Jensen, BSP Tessa Laubscher, MB CHB, CCFP
T here is no shortage of drug information, but
where can you ﬁnd detailed, objective, compara-
tive, up-to-date Canadian drug information? The
What is in a chart?
Charts contain a variety of drug information speciﬁc to
a therapeutic area. This often includes generic names,
RxFiles–Drug Comparison Chart Updates book con- trade names, dosage forms, dosage strengths (which
tains charts summarizing practical information on tablets are scored), drug classiﬁcation, contraindications,
the optimal selection and use of medications. renal cautions, side effects, pregnancy categories,
important drug interactions, comparative information,
initial and maximum doses, usual doses, and compara-
Putting charts together tive cost. Charts provide tips to individualize therapy
Several clinicians and resources provide informa- and avoid drug-related problems. The resulting infor-
tion for the comparison charts. At the outset, phy- mation is detailed and summarized on one page, a for-
sicians provide information and identify current mat that results in some small print but sets each chart
questions and controversies. In a review of ther- apart from the others.
apy, program staff sort through original clinical
trials, evidence-based reviews, recent overviews,
and clinical guidelines and sift through information Standard book and pocket edition
from drug databases (Micromedex, Hansten’s Drug The standard book of RxFiles–Drug Comparison
Interactions, the American Hospital Formulary Chart Updates (September 2004) contains 68 pages
System, Briggs’ Drugs in Pregnancy and Lactation, of colour-tabbed, indexed, coil-bound summaries
Natural Products Database, and Canadian prod- of more than 40 drug therapy areas (Table 1). A
uct monographs). This initial compilation is used pocket edition is also available for those who wish
to draft outlines that are then revised to incorpo- to carry the book in their laboratory coats and do
rate both outcome evidence and expert opinion. not mind small print. Cost for each book is $45,
Family physicians, specialists, pharmacists, and with substantial discounts for students, residents,
other health professionals peer review the material and those ordering many copies (order forms are
before publication. on the website www.RxFiles.ca).
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FP Watch Surveillance médicale
Table 1. RxFiles comparison chart topics Are charts available for
Asthma hand-held computers?
Cardiovascular conditions Many drug comparison charts are available for
• Antihypertensive guideline and summary Palm-compatible hand-held computers. Charts are
• Angiotensin-converting enzyme inhibitors and angiotensin oﬀered in either Mobile DB or HanDBase formats.
receptor blockers Both formats are searchable and require less than
• β-Blockers 400 to 800 KB of memory, respectively. In addition
• Calcium channel blockers to drug comparison charts, a summary of impor-
• Diuretics and various antihypertensives tant trials on antihypertensive medications is also
• Lipid-lowering agents and landmark trials
available in Palm format.
• Oral antiplatelet and antithrombotic agents
• Insulins Website and e-mail support
Gastrointestinal conditions Drug comparison charts and newsletters can be
• Acid suppression freely accessed in PDF format at www.RxFiles.ca.
• Helicobacter pylori eradication An e-mail update service is also available for those
Hormonal conditions wishing to be notiﬁed of new or updated postings.
• Oral contraceptives
• Postmenopausal herbal therapy
• Postmenopausal medical therapy About the program
• Hypersexuality treatment RxFiles is an academic detailing program with
• Androgens headquarters at Saskatoon City Hospital. The pro-
gram was pilot-tested in Saskatoon in 1997 and
• Oral anti-infectives
expanded to serve the province of Saskatchewan
• Inﬂuenza drugs
in 2000. The program’s goal is to provide objec-
• Community-acquired pneumonia
• Urinary tract infections (among adults) tive and unbiased drug information for promot-
Pain ing optimal drug therapy. The RxFiles Newsletter is
• Back pain published three or four times yearly and sent to all
• Migraine (acute and prophylaxis) Saskatchewan physicians. Additional question-and-
• Nonsteroidal anti-inﬂammatory drugs and other analgesics answer summaries and comparison charts are pub-
• Opioids lished periodically.
• Rheumatoid arthritis: disease-modifying antirheumatic drugs The hallmark of the program is brief visits to phy-
Psychotropics sicians’ oﬃces to highlight information and discuss
• Antidepressants questions arising from the most recent newsletter
• Antipsychotics and chart materials. This interaction enhances the
• Antianxiety agents
value of the materials and ensures that the informa-
tion uncovered gets into practice. The program has
• Mood stabilizers
been well received, as documented by its growth
Extras and feedback from physicians. The RxFiles is also
• Anticonvulsants involved in other drug information and education
• Topical corticosteroids initiatives, such as continuing medical education,
• Topical treatment for glaucoma student and resident teaching rounds, prescribing
• Drug interactions with herbal products orientation for new physicians, and collaborative
• Dementia research projects. The RxFiles employs a program
• Intranasal corticosteroids coordinator, six part-time program pharmacists, and
• Over-the-counter medications several physician consultants. Although funding is
1688 Canadian Family Physician • Le Médecin de famille canadien d VOL 50: DECEMBER • DÉCEMBRE 2004
Surveillance médicale FP Watch
provided by Saskatchewan Health, an independent results are often described as number needed to
program advisory committee that includes several treat or number needed to harm.
family physicians directs program development.
Check it out!
Sorting through For more information, visit the website www.
the outcome evidence RxFiles.ca; phone (306) 655-8506; or write RxFiles,
Physicians are looking for outcome evidence to Saskatoon City Hospital, 701 Queen St, Saskatoon,
make drug therapy decisions; results can be spun SK S7K 0M7.
diﬀerent ways, however, especially in product mar-
keting. Several additional materials have been
designed to help sort through evidence in poten- Mr Regier is a pharmacist at Saskatoon City Hospital
tially controversial areas. These materials contain and Program Coordinator for the RxFiles Academic
interesting observations and summaries of trials Detailing Program in Saskatchewan. Mr Jensen is a
related to antihypertensives, antihyperlipidemics, pharmacist at Saskatoon City Hospital and Information
antithrombotics, and hormone replacement ther- Specialist with the RxFiles Academic Detailing Program
apy. These summaries emphasize key findings, in Saskatchewan. Ms Laubscher is a Saskatoon family
limitations, clinical considerations, and absolute physician and Assistant Medical Director of Northern
diﬀerences in both beneﬁcial and harmful eﬀects. Medical Services, University of Saskatchewan. She serves
To quantify the risk versus benefit of therapy, as physician advisor to the RxFiles.
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