US Pharm. 2013;38(9):49-60.
ABSTRACT: Mobile applications offer a convenient way to access information. Knowing how health care professionals (HCPs) view and use these tools will enhance existing applications and create new ways of making medical/drug information accessible. HCPs’ willingness to use general mobile applications, as well as those available from pharmaceutical companies, was assessed via an electronic survey. Many HCPs use general mobile applications to obtain medical/drug information, and some would use a mobile application offered by a pharmaceutical company.
One of the main responsibilities of a pharmaceutical company is to supply health care professionals (HCPs) with the best available information relevant to appropriate product use.1 As the drug manufacturer, the pharmaceutical company has an obligation to provide accurate information that is in the patient’s best interest. Drug information centers/departments within pharmaceutical companies are considered a resource for rapid, accurate, and concise information about drugs.2 Given the extensive information available today via a wide variety of sources and platforms, tools for accessing these data quickly and efficiently can be a valuable service for a pharmaceutical company to offer.3
Mobile applications can potentially revolutionize how information is managed in the health care industry and allow HCPs to rapidly obtain the information they need. Although the data in a pharmaceutical medical/drug information mobile application (PM/DIMA) may be similar to that available on a pharmaceutical company’s Web site, accessing data in real time through mobile devices and other new channels has emerged as a source of medical information. Wireless technologies such as handheld messaging devices, smartphones, and electronic organizers and tablets have become increasingly popular. About 850 million people own at least one mobile phone.4 Currently, there is little published research on the utilization and preferred functionality of mobile applications for delivery of medical information.5
The purpose of this study was to evaluate utilization patterns of mobile applications and HCPs’ willingness to use mobile applications to obtain medical information from pharmaceutical companies. The results of this study will enable pharmaceutical companies to benchmark their practices of supplying medical information to HCPs. The information revealed in this study could enhance the role of technology in medical information and create novel methods of providing information to HCPs.
Study Design and Population: This study was a prospective, observational, cross-sectional, electronic survey. A branched survey was developed and loaded into Inquisite Survey, a standard feedback-management platform. The target population was HCPs who contacted a pharmaceutical company with a medical information inquiry and received a medical information response (MIR) via e-mail during the 30-day period from December 14, 2011, to January 13, 2012. The study was reviewed and exempted by the University of the Sciences Institutional Review Board.
Survey Design: Survey questions were developed and reviewed by medical information professionals and HCPs for content validity, and HCPs tested each question to ensure comprehension and appropriate time commitment. Mobile application was defined as software that runs on multiple devices such as smartphones, tablets, and other mobile devices (e.g., iPhone, iPad, Droid). The survey explained that although many different types of mobile applications exist, the focus here was on applications used to educate HCPs on medical/drug information. PM/DIMA was defined as an application used to provide medical/drug information from a pharmaceutical company.
A link to the survey was provided in an e-mail template that HCPs received along with the MIR. Receipt of the link allowed the recipient to voluntarily click and record his or her answers. The e-mail template also informed the recipient of the survey topic and explained that the entire process would take less than 5 minutes. The survey could be taken any time during the 30-day period. The survey link was sent only once, with no reminder e-mails.
Some questions incorporated multiple branching. Depending upon the HCP’s answer to one of these questions, the question that followed was generated based on a predetermined flow diagram. Questions examined the HCP’s current utilization of mobile applications, the HCP’s willingness to use a mobile application from a pharmaceutical company, and key features the HCP would find beneficial. Key features were broken down into general versus specific functions. General functions encompassed the pharmaceutical company as a whole, and specific functions pertained to medical information in particular. See APPENDIX 1 for the full survey.
If “other” (when applicable) was selected as a response, the participant had the option to type in free text to clarify his or her answer and provide more detail. Thus, participants were not forced to select a response that did not apply to them. Text entry boxes were included in order to collect as much information as possible and to enhance the depth of reported responses.
If a question was not answered, a message reminding the participant to go back and finish any unanswered questions appeared at the end of the survey. If at any point a participant no longer wished to participate, he or she had the ability to opt out of the survey.
Study Endpoints: This study examined which health care mobile applications HCPs currently utilize; HCPs’ interest in obtaining medical/drug information via a mobile application offered by a pharmaceutical company; and key features HCPs would find beneficial in a PM/DIMA. The primary endpoint was to assess HCPs’ interest in and likelihood of obtaining medical/drug information from a pharmaceutical company via a mobile application (on a scale of 1 to 5, with 1 being “least likely” and 5 being “most likely”). Secondary endpoints included HCPs’ existing usage of medical/drug mobile applications across the health care industry; key features HCPs would find useful in a medical/drug mobile application offered by a pharmaceutical company; and reasons that an HCP would be hesitant to use a mobile application to access medical/drug information from a pharmaceutical company.
Statistics: Descriptive statistics and graphs were used to analyze the data. Results were reported as frequencies and percentages.
Baseline Demographics: The opportunity to participate in the survey was offered to 1,693 HCPs who contacted the medical information center over the noted 30-day time frame. Sixty-three HCPs completed the survey, yielding a response rate of 3.7%. Twelve additional HCPs who partially completed the survey were not included in the analysis because it was impossible to determine at which point an individual abandoned the survey. The age range of the majority of HCPs was 30 to 39 years (25.4%), followed by 20 to 29 years (22.2%) and ≥60 years (19.0%). Most HCPs were pharmacists (66.7%); the rest were physicians (14.3%), “other” (9.5%), physician assistants (4.8%), nurse practitioners (3.2%), and nurses (1.6%). “Other” comprised a pharmacy student, social worker, research assistant, and pharmacy intern (all, n = 1). Four of six HCPs who answered “other” specified their profession in the comment field.
Current Use of Mobile Applications: When asked about their current use of mobile applications, 66.7% of HCPs indicated that they currently access medical/drug information via a general mobile application, such as Micromedex or Epocrates (FIGURE 1). Of the 42 HCPs who stated that they use a mobile application to access medical/drug information, 90.5% currently do not use a PM/DIMA (FIGURE 2).
Frequency of Mobile Applications Use: Of the 42 HCPs who said that they currently use general medical/drug mobile applications, “greater than seven times a week” was the most common response (54.8%) for frequency of accessing medical/drug information via a general mobile application. This was followed by “five to seven times a week” (26.2%), “two to four times a week” (11.9%), and “once a week” (7.1%). The largest proportion of HCPs (40.5%) identified Lexicomp as the general medical/drug application most frequently used to access information. This was followed by Epocrates (26.2%), Micromedex (19.0%), Medscape (7.1%), and “other” (7.1%). WebMD, another possible option, was not chosen. Responses for “other” included Clinical Pharmacology (n = 1), Google (n = 1), and UpToDate (n = 1). For the four HCPs currently using a PM/DIMA, responses were evenly distributed among “once a week,” “two to four times a week,” “five to seven times a week,” and “greater than seven times a week” (all, 25%).
Interest in PM/DIMAs: Among the 59 HCPs not currently using a PM/DIMA, 27.1% were interested in using a mobile application from a pharmaceutical company, 44.1% “may be interested,” and 28.8% were not interested (FIGURE 3). The highest percentage of HCPs rated their likelihood of accessing medical/drug information via a PM/DIMA (on a scale of 1 to 5, with “1” being least likely and “5” being most likely) as “3” or “4” (31.0% each) (FIGURE 4). When likelihood levels were collapsed, 45.2% of HCPs were likely (“4” and “5”) to use a PM/DIMA, whereas 23.8% were unlikely (“1” and “2”) to use a PM/DIMA.
General and Specific Functions Desired: To elicit HCPs’ opinions about beneficial functions in a PM/DIMA, questions on general versus specific functions desired were included. The ability to contact a therapeutic/drug specialist (85.7%) was the most beneficial general function when using a mobile application from a pharmaceutical company, followed by the ability to contact a patient assistance program (61.9%) (FIGURE 5). All four HCPs currently using a PM/DIMA felt that the ability to contact a therapeutic/drug specialist and to report adverse event/product quality complaints would be beneficial. Access to clinical data/drug information (88.1%) was the most important specific function when using a PM/DIMA, followed by access to prescribing information (PI) (73.8%) (FIGURE 6). All four HCPs currently using a PM/DIMA desired access to clinical data/drug information, and three (75%) felt that access to PI and directly submitting medical/drug information requests would be beneficial.
Display Features Desired: When HCPs were asked about display features in PM/DIMAs, the most desired option was “PI” (61.9%). Other desirable features were “submit a question” (59.5%), “professional resources” (57.1%), “patient resources” (47.6%), “contact us” (38.1%), and “search bar” (14.3%). The options “saved searches” and “other” were not chosen by any participant. Three of the four HCPs (75%) currently using a PM/DIMA wanted “PI” and “professional resources” to be displayed, and the remaining HCP wanted “saved searches,” “patient resources,” “contact us,” and “submit a question.”
Reasons to Not Use a PM/DIMA: Seventeen HCPs said that they would not use a mobile application from a pharmaceutical company. The top reasons for not using a PM/DIMA were perception of biased information and unavailability of a smartphone or mobile device (both, 47.1%).
The use of smartphones in the health care industry has been rapidly expanding and offers convenience and efficiency that may not necessarily be achieved with traditional desktop computers. In 2004, about 25% of practicing U.S. physicians used a personal digital assistant (PDA) or smartphone; by 2008, the number had increased to about 35% to 40%. By 2010, more than 50% of physicians were utilizing PDAs or smartphones on a regular basis for everyday treatment activity.6 This survey shows a similar trend, with more than half of participants using a general medical/drug mobile application; however, only a small proportion also used a PM/DIMA. This may be due to a lack of awareness about this method of obtaining medical/drug information, since only a few PM/DIMAs are currently available.
More than half of participants stated that, given the opportunity, they would be or may be interested in using a mobile application from a pharmaceutical company. Current literature describes the benefits of mobile technology in revolutionizing the way physicians practice medicine. The smartphone is considered a new tool that will allow physicians to become efficient in their daily activities while providing their patients with clinically up-to-date care.7 With increased awareness and a greater availability of PM/DIMAs, this could be another potential approach HCPs use to efficiently obtain the information they need.
The ability to contact a therapeutic/drug specialist appears to be the most important general function desired in a PM/DIMA. This emphasizes the importance of the specialist’s availability to engage in a scientific discussion with the HCP. A PM/DIMA could enable greater convenience in contacting a specialist. For example, HCPs could schedule an appointment with a specialist at their convenience or could employ novel methods of communication, such as instant messaging or video chat.
Access to clinical data/drug information appears to be the most important specific function desired when using a mobile application, followed by access to PI. HCPs are often busy, with limited time for calling pharmaceutical companies. The ability to access clinical information from a drug manufacturer directly from a mobile device could save HCPs valuable time. Another timesaver would be the ability to save previously viewed inquiries for future reference. This could be particularly useful for frequently asked questions or topics that HCPs often access.
One of the top reasons participants gave for not using a PM/DIMA was the perception of biased information. Considering that these participants had initially called a pharmaceutical company for medical information, an explanation for why they believe the information is biased is worth seeking.
Currently, to the best of the authors’ knowledge, no other published studies have evaluated HCPs’ utilization of mobile applications to access medical information from pharmaceutical companies. This is the first survey of its kind to examine the use of PM/DIMAs. Given that literature investigating the functionality and utilization of mobile applications is limited, larger studies are needed to obtain additional insights into the use of novel methods for disseminating medical information.
A major limitation of this study was the low response rate. It was difficult to anticipate an accurate response rate, since to the best of the authors’ knowledge, this was the first survey of its kind. Potential reasons for a low response rate could be the inability to send survey reminders or to recontact participants (because of health care compliance issues and company policy). Additionally, dissemination of the survey at a time other than the holiday season could have generated more responses. Compensation could have been provided to increase the response rate; however, this was not pursued owing to company policy. Because of the low response rate, the results may not be representative of the general population of HCPs, and this may have introduced nonresponse bias.
The survey indicates that, overall, HCPs are utilizing general mobile applications to obtain medical/drug information. Additionally, there appears to be some interest in using a medical/drug mobile application offered by a pharmaceutical company. A multifaceted mobile application with a variety of functions for the end user would appear to increase its value and provide added benefit for HCPs. Many HCPs question which mobile applications are valid sources of medical/drug information. For a user to commit to one application, the information must be accurate and from a dependable source. A trustworthy and reliable manufacturer could be a useful source of information.
Potential outcomes of this research include the identification of opportunities to improve upon existing technological platforms and the creation of future applications. As medical information platforms continue to evolve, an understanding of customers’ expectations is essential for adapting to transforming technologies.
Future research could assess compliance processes and the regulatory landscape involved in using novel channels for medical information. As new social media initiatives move forward, an understanding of how to best provide medical information is critical and could impact patient care through the safe use of medications. Pharmaceutical companies should continue to investigate unique and innovative ways to provide accurate and timely medical/drug information to HCPs.
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DECLARATIONS: Poster presented at the Drug Information Association Medical Communications Workshop, Orlando, FL, March 4–7, 2012. The authors received no financial support for the research, authorship, and/or publication of this article. Steve Ascher is an employee of Janssen Research & Development, LLC, and is a Johnson & Johnson stockholder. Purnima J. Topiwala is an employee of Janssen Scientific Affairs, LLC, and is a Johnson & Johnson stockholder.
NOTE: The authors acknowledge the following people for their assistance in this study: Jennifer Kern Sliwa, PharmD, BCPP, Director, CNS Medical Information, Janssen Scientific Affairs, LLC; Michael Cuozzo, PharmD, Director, Crisis Management, McNeil Consumer Healthcare; Sarah Spinler, PharmD, FCCP, FCPP, FAHA, FASHP, AACC, BCPS (AQ Cardiology), Professor of Clinical Pharmacy, Residency Programs Coordinator, Philadelphia College of Pharmacy, University of the Sciences; and Samit Shah, PharmD, Manager, Digital Content Strategy, Janssen Scientific Affairs, LLC.
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