s Reviewing the top medical iPhone apps … what’s the diagnosis? | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Reviewing the top medical iPhone apps … what’s the diagnosis?

Staff Writer

articles by this author...

Editing and Researching news and stories about global and local Pharmacy Issues

Editor's Note: This article was first published in "The Conversation" and each component of the article was written by a different person. Their names appear under the title for each written component as well as professional and personal data at the end of the article.
There is a a bewildering range of medical apps available for use with an iPhone.
Given pharmacists may soon be increasing the depth and scope of their consultations, serious thought should be given to the selection and use of these apps (and others) as a means of adding content to your consultation and the creation of a patient network that may function as a social support system.
Your thoughts are encouraged in the panels at the foot of the article.

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You can use all kinds of iPhone apps to track and improve your health. 

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Want to quit smoking, lose weight, manage your diabetes or get a good night’s sleep? No worries. There’s an app for all of that.

But it’s not always clear which medical apps are based on solid evidence and which aren’t.

We asked the experts to review eight prominent medical apps. They considered whether the apps were useful and medically accurate, and whether they would recommend using them.

Instant Heart Rate by Modula d.o.o – free*

By Merlin Thomas

 

iTunes

 

It’s easy to estimate your heart rate. The hard part is doing it instantaneously, accurately, and the same way every time, while comparing it with previous readings. To be good at it, medical professionals and athletes do practice all the time. But now your iPhone can do it for you.

Place your finger gently over the camera lens on your iPhone. Instant Heart Rate uses the camera’s sensors to detect subtle changes in colour, which occur as each new pulse of oxygenated blood reaches the finger tip. The frequency of these changes over 10 to 15 seconds gives an accurate estimation of your heart rate.

While it can be used for tracking medical conditions, the most common reason for monitoring your heart rate is to gain maximum efficiency from aerobic exercise. Achieving your target heart rate will ensure you’re doing good, taxing (but not overtaxing) exercise. Your recovery heart rate can also give an indication of your progressing fitness.

Most modern aerobic exercise machines have heart rate measures built in and many committed fitness fanatics already have a gadget to measure their pulse, which doesn’t require them to stop and put their finger to their phone.

If your resolution is to start a fitness kick next year, you’ll need to do sufficient work to get your heart beating between 65% and 75% of its maximum rate. This is one free way to know you’re on track.

Calorie and Diet Tracker by MyFitnessPal – free

By Gary Sacks

 

iTunes

 

This is an excellent app for keeping track of what you’re eating. It provides easy-to-use tools to enter the foods you eat (and their associated calories) and the exercise you do. It also allows you to set weight goals. This is helpful because studies show that tracking the food you eat and your weight is a good way to reduce your overall calorie intake.

The app’s database of foods is comprehensive and, overall, it provides a number of helpful tools. For example, there are tools for calculating your Body Mass Index and basal metabolic rate (the amount of energy your body needs at rest).

But the way it estimates daily calories needed to reach your weight-loss goal is not totally accurate. If you follow the app’s guidance strictly, you might not lose exactly as much weight as it says, but you should get pretty close.

One minor complaint is that it only shows energy intake in calories. Hopefully, future updates will allow us to see things in kilojoules too.

Depressioncheck by M-3 Information, LLC – free

 

iTunes

 

By Daniel Quintana

Depressioncheck assesses the risk of depression and other common mood and anxiety symptoms through a 27-item questionnaire (also available online).

This questionnaire, called the “M-3” checklist, has been validated for use in adults against the commonly used Mini-International Neuropsychiatric Interview. As highlighted by the app itself, it’s not a diagnostic tool but, rather, a way to screen for risk of the most common mood and anxiety disorders.

It outlines your risk for four specific conditions: depression, anxiety, post-traumatic stress disorder and bipolar disorder in less than five minutes with an acceptable degree of accuracy. But any questionnaire, whether on paper or in an iPhone app, can’t replace an assessment by a GP. And it’s important to note that circumstances such as physical illness or bereavement can inflate your score.

If you indicate any thoughts of suicide, the app asks if you’re in a crisis and provides a phone number to the United States National Suicide Prevention Lifeline (or tells you to proceed to your nearest emergency department). It would be ideal if this feature was localised for each country.

Milk Monitor by Milo Creative – $2.99

 

iTunes

 

By Karen Simmer

Milk Monitor allows you to record the times of your baby’s feeds, sleeps, medications and wet and dirty nappies. Details of feeds include breast (right and left) and bottle (volume). Information can be shared by email and Twitter.

Recording this information may be useful for parents, especially those with unwell babies and for mothers who are expressing breast milk for their baby to receive at a later feed.

Mothers are often encouraged to feed their babies on demand and follow their maternal instincts, so using an app to assist in parenting a healthy baby may seem unnatural. But the reality is that for many young parents, apps are part of many activities in their daily life. For them, Milk Monitor may help with building confidence and routine. Deviation from their baby’s normal feeding pattern may signal a problem requiring medical assessment and treatment.

Milk Monitor would help those parents who want assistance with building a routine in caring for their baby. But caution is needed if entering information and worrying about details causes extra pressure and reduces the joy of motherhood or parenting.

Sleep Cycle Alarm Clock By Maciek Drejak Labs – $0.99

 

iTunes

 

By Sally Ferguson

In general, we feel more refreshed more quickly if we wake from light sleep, as opposed to deep sleep. And this app aims to wake you from the light stage of sleep.

The app uses movement as an indicator of the stage of sleep. Over a 30-minute period, it gradually wakes you at the optimum time. 7am is my get-up time, so my window began at 6.30. The app mostly woke me at the start of the window, leaving me 30 minutes short each night. Over the course of the workweek I lost 2½ hours of sleep.

There is plenty of research that demonstrates the problems of cumulative sleep debt. And sleeping 30 minutes less each night is likely to be worse over time that being woken from deep sleep.

Having said that, anything that gets people thinking about their sleep, and making it a priority, is a good thing. When it was first released, friends and family members told me about their sleep patterns and how much deep sleep they were getting each night, backing it up with cool graphics produced by the app. They were genuinely interested in the biology and excited to access so much information about a process they otherwise knew very little about.

Livestrong MyQuit Coach by Demand Media, Inc. – free

 

iTunes

 

By Nasser Dhim

This app tries to assist smokers to quit by helping them modify their behaviour through tracking, setting a quit date and disrupting cravings. Almost all of the instructions provided in the app are based on accurate medical information.

There are dozens of smoking cessation apps available, many of which make exaggerated claims of effectiveness. A recent study found that the majority of smoking cessation apps were not built using evidence-based information. Livestrong MyQuit Coach seems to be based on validated smoking cessation self-help methods.

The app has the potential to be effective and has no erroneous content. Even so, it lacks information on the consequences of smoking and smoking cessation, and available treatments. Neither does it provide advice during the quitting process, especially with respect to withdrawal symptoms and how to deal with them.

Diabetes Buddy Lite by BHI Technologies, Inc. – free

 

iTunes

 

By Neale Cohen

The Diabetes Buddy Lite app has some nice features. It’s designed to help people with diabetes record and analyse their data to ensure their insulin doses are accurately adjusted, which is key to managing their condition.

With the app, manual recording of information such as blood-glucose levels, medication timing and doses is relatively user-friendly but time consuming. In an ideal world, automatic downloads from a glucose meter would be a preferred option although, so far, this has proved to be remarkably difficult to develop. This is important because testing blood glucose levels is one of the key aspects to achieving good control of diabetes. This is best done in association with dietary records (carbohydrate counting) and noting the amount and timing of exercise.

Carbohydrate counting is always a challenge and the listings here are helpful but designed for American users. A bit puzzling is the water measurement, which has very little application in this setting. The app falls a little short for health-care professionals as there’s a large amount of information available but it’s not arranged into a manageable format of times and trends.

Vision Test by 3 Sided Cube – free

 

iTunes

By Harrison Weisinger

 

The test begins with visual acuity. This assesses each eye in turn, so the app is already ahead of the game when compared with other self-tests on the web. It’s simple to use – it flashes up letters of progressively decreasing size – and makes reasonable assumptions using the test distance of “arm’s length”. 

Unfortunately, if you make a mistake on a big letter, you “fail” regardless of how you do on the remaining letters. I also loaded the app onto my iPhone and had a go at the cool distance vision function. This works by allowing you to use your iPhone as the remote control for your iPad, which you position in the distance.

It doesn’t give you your acuity (tell you whether you have 20/20 vision). Rather, it recommends you get your eyes tested at the optician (a British term, and quite out of place in Australia or the United States). The “find an optician” function doesn’t work in Australia.

The remainder of the tests in the app follow suit, applying a very basic pass or fail paradigm across a couple of visual functions (colour vision, for instance) and some screening history questions. While these are all reasonable, I was disappointed that I couldn’t get any actual results.

Vision Test is a well-presented, simple app that can performs a quick “screen” of your visual acuity, colour vision and risk of eye disease and then makes the recommendation to see an optician (optometrist). Like all tests of this nature, it is no substitute for a comprehensive eye exam.

*Editor’s note: This story was originally published with an incorrect reference to Heart Rate Monitor by Cocoon $1.99. The actual application reviewed by Professor Merlin Thomas was Heart Rate Monitor by Modula d.o.o. and this has now been corrected.

Have you used these medical apps? Or can you recommend any others? Share your comments below.

This article was originally published at The Conversation. Read the original article.

9 January 2012, 6.30am AEST

Reviewing the top medical iPhone apps … what’s the diagnosis?

Want to quit smoking, lose weight, manage your diabetes or get a good night’s sleep? No worries. There’s an app for all of that. But it’s not always clear which medical apps are based on solid evidence and which aren’t. We asked the experts to review eight prominent medical apps. They considered whether…

Authors

  1. Merlin Thomas

    Merlin Thomas

    Adjunct Professor of Preventive Medicine at Baker IDI Heart & Diabetes Institute

  2. Daniel Quintana

    Daniel Quintana

    PhD candidate and researcher at University of Sydney

  3. Gary Sacks

    Gary Sacks

    Research Fellow, Deakin Population Health at Deakin University

  4. Harrison Weisinger

    Harrison Weisinger

    Foundation Director of Optometry Studies at Deakin University

  5. Karen Simmer

    Karen Simmer

    Professor of Newborn Medicine at University of Western Australia

  6. Nasser Dhim

    Nasser Dhim

    PhD Candidate, School of Public Health, Sydney Medical School at University of Sydney

  7. Neale Cohen

    Neale Cohen

    General Manager Diabetes Services, BakerIDI Heart and Diabetes Institute at Baker IDI Heart & Diabetes Institute

  8. Sally Ferguson

    Sally Ferguson

    Associate Research Professor at University of South Australia

Disclosure Statement

Daniel Quintana receives funding from an Australian Rotary Health/Hooton Family PhD scholarship.

Harrison Weisinger does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.

Karen Simmer receives funding from the NHMRC.

Gary Sacks, Merlin Thomas, Nasser Dhim, Neale Cohen, and Sally Ferguson do not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article. They also have no relevant affiliations.

Deakin University is a Member of The Conversation. The University of Western Australia is a Founding Partner of The Conversation. The University of South Australia is a Member of The Conversation.

Our goal is to ensure the content is not compromised in any way. We therefore ask all authors to disclose any potential conflicts of interest before publication.

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