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Introduction

This comparison provides an overview of the similarities and differences between commonly used tertiary and point-of-care resources. It is intended to help Medicines Information and Advice services:

  • Assess which resources may be useful for different types of enquiry
  • Compare the coverage, features, strengths and limitations of each resource
  • Inform local purchasing decisions.

The comparison is not exhaustive and does not constitute an endorsement of any resource. Services should consider requesting trial access and completing a local assessment before purchasing or subscribing to a resource.

Resource content, ownership, access arrangements and functionality may change. Details should therefore be checked with the relevant publisher or supplier before making purchasing decisions.

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Resources included

This comparison covers the following tertiary and point-of-care resources:

  • AHFS Drug Information
  • BMJ Best Practice
  • ClinicalKey
  • DynaMed
  • Lexicomp
  • Martindale: The Complete Drug Reference
  • Micromedex
  • UpToDate

Some products combine content from more than one of these resources. Where relevant, this overlap is identified within the comparison.

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Access and geographical coverage

The table below summarises the access route and geographical focus recorded for each resource. Access arrangements may change and should be confirmed before making purchasing decisions.

Resource Available via Geographical focus
AHFS Drug Information MedicinesComplete or as an additional resource through Micromedex. A print edition is also published. United States
BMJ Best Practice BMJ Best Practice International focus, although dosing information may reflect United States practice
ClinicalKey ClinicalKey United States, Canada and UK
DynaMed DynaMed Primarily United States, with some Canadian and European guidance
Lexicomp Lexicomp Online United States and Canada
Martindale: The Complete Drug Reference MedicinesComplete or as an additional resource through Micromedex. A print edition is also published. UK-focused, with information about some international medicines
Micromedex Micromedex Primarily United States, with some Canadian and European licensed information
UpToDate UpToDate United States

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Updating and currency

The frequency of updates and visibility of review dates vary between resources. The information below can help users assess how easily the currency of individual topics or monographs can be established.

Resource Frequency of update Visibility of update date
AHFS Drug Information Updated monthly, although only a small number of monographs may be updated each time. The date shown at the top of a monograph relates to the publication as a whole rather than the individual monograph.
BMJ Best Practice Evidence is evaluated daily and content is updated at least every three months. Recent changes are displayed under “Recent updates”. The update date is clearly visible.
ClinicalKey Continuously updated. Monthly content changes are displayed under “News and updates”. The update date is clearly visible.
DynaMed Updated daily. The update date is included at the bottom of each topic.
Lexicomp No specific update frequency is stated. The last-updated date is included at the bottom of each monograph.
Martindale: The Complete Drug Reference Updated every three months, although only a small number of monographs may be updated each time. The monograph update date is displayed at the top. Individual sections also indicate when they were last modified.
Micromedex Checked weekly for new information. The monograph date changes when new information is added. The update date is included at the bottom of each monograph.
UpToDate Updated as new information is published, with no specific update schedule stated. Clinical topics display an update date and a “Literature review current through” date. Drug monographs display a version number but not a date.

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Referencing and evidence

The resources vary in how they reference information, incorporate expert opinion and include guidelines or other grey literature.

Resource Referencing Expert opinion Guidelines and other grey literature
AHFS Drug Information Fully referenced. Does not include expert opinion. Information is taken from referenced sources. Most information is taken from United States manufacturers’ product information. Other sources include academic literature and regulatory alerts.
BMJ Best Practice Fully referenced. Contains a mixture of referenced evidence-based statements and non-referenced content. Includes academic literature and guidelines. Many summaries grade the strength of recommendations.
ClinicalKey Clearly identifies the source being accessed. Referencing is included within the individual sources. Clinical overviews are available and are fully referenced. Includes book chapters, full-text journal articles, guidelines, clinical overviews, MEDLINE abstracts, drug monographs, images, media clips and patient information.
DynaMed Referenced, although some general statements may not include a reference. Contains evidence-based information and expert opinion. Includes academic literature and guidelines. Many summaries grade the strength of recommendations.
Lexicomp Information is not always individually referenced and may be presented in a bibliography-style format. Presents evidence-based information. Includes information from academic literature and guidelines.
Martindale: The Complete Drug Reference Individual sections within each monograph are referenced. Information is taken from referenced sources rather than expert opinion. Primarily uses academic literature, with selected information from other sources. Treatment reviews may refer to clinical guidelines and regulatory warnings.
Micromedex Generally fully referenced, although Drug Consults are not always referenced. Some listed references may not be used in the associated content. Contains evidence-based information and expert opinion. Includes information from United States, Canadian and European licensing agencies, but does not generally include guidelines. The strength of evidence is graded.
UpToDate References are provided at the end of each clinical topic and professional drug monograph. Clinical topics include some expert opinion. Includes clinical consensus as well as academic literature.

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Content and presentation

The resources differ in their content, organisation and presentation. Some are primarily monograph-based, while others focus on clinical topics, disease management or access to a wider collection of information sources.

Resource Content and presentation
AHFS Drug Information Information is presented through drug monographs and topic-based paragraphs.
BMJ Best Practice Content is organised by clinical condition. Dosing guidance generally reflects United States practice. A separate guideline section is organised by geographical region, including Europe.
ClinicalKey A clinical search engine provides access to clinical resources published by Elsevier. The Smart Content search can be used to search across all resources available within ClinicalKey.
DynaMed Information is presented as topic overviews with subheadings. Links to related subjects are included within the content.
Lexicomp Content is primarily monograph-based. The search screen provides access to clinical tools covering areas such as intravenous compatibility, interactions, drug identification, patient education and calculators. An advanced search allows users to search for keywords within monographs.
Martindale: The Complete Drug Reference Information is presented through drug monographs and topic-based paragraphs.
Micromedex

Content is primarily monograph-based. The search screen provides access to clinical tools covering areas such as intravenous compatibility, interactions, drug identification, patient education and calculators.

Two main monograph formats are available:

• DrugPoints summaries: concise information that includes medication counselling and limited toxicology information.
• DrugDex evaluations: more detailed drug information.

Drug Consults provide comparative documents and answers to selected clinical questions.
UpToDate Information is presented through referenced clinical topic summaries.

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Overlap with other resources

Some products include content from other resources or provide access to overlapping information. This should be considered when reviewing existing subscriptions or assessing the need for additional resources.

Resource Overlap with other resources
AHFS Drug Information AHFS Drug Information Essentials is also available through Lexicomp.
BMJ Best Practice No specific overlap with other resources was identified.
ClinicalKey

ClinicalKey includes content from a range of other sources, including:

• drug monographs from sources such as Gold Standard and the British National Formulary;
• journals published by Elsevier;
• electronic books, including Meyler’s Side Effects of Drugs and Schaefer’s Drugs During Pregnancy and Lactation; and
• UK clinical guidelines, including guidance from NICE, BASHH and the British Society for Rheumatology.
DynaMed Drug information is provided by Micromedex.
Lexicomp

Lexicomp includes or draws on content from several other resources:

• Lexicomp Clinical Insights contains content from UpToDate;
• information from Briggs’ Drugs in Pregnancy and Lactation is available;
• AHFS content is available; and
• intravenous compatibility information is powered by Trissel’s 2 Clinical Pharmaceutics Database.
Martindale: The Complete Drug Reference No specific overlap with other resources was identified.
Micromedex
• Provides drug information used within DynaMed.
• Includes individual Martindale monographs.
• Intravenous compatibility information is powered by Trissel’s 2 Clinical Pharmaceutics Database.
UpToDate Drug monographs are powered by Lexicomp.

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Focus and useful enquiry types

The resources have different areas of focus and may be more useful for particular types of enquiry.

Resource Focus of the resource Enquiry types it is valuable for
AHFS Drug Information General drug-focused resource. Pharmacokinetics.
BMJ Best Practice Point-of-care, evidence-based medicine resource focusing on disease management.
• Treatment pathways and management of conditions.
• Establishing whether international guidance is available for a particular condition.
ClinicalKey General reference and repository providing access to other information sources.
• Some specialist enquiries, such as adverse drug reactions and pregnancy.
• Literature searching.
DynaMed Point-of-care, evidence-based resource focusing on a wide range of diseases, including some not always covered elsewhere. Choice of therapy for a particular disease state and evidence to support therapy.
Lexicomp Designed as an all-in-one resource for prescribing and administering medicines. Information is mainly drug-focused.
• Unlicensed indications and dosing.
• Alternative and herbal medicines.
• Drug identification.
• Paediatric Lexi-Drugs and Geriatric Lexi-Drugs provide information tailored to these age groups.
Martindale: The Complete Drug Reference Mostly drug-focused, with some disease-focused monographs known as treatment reviews.
• Pharmacokinetics, although DrugDex contains more information.
• Identification of foreign medicines.
• Chemical structures and molecular formulae.
• Pharmacopoeial information, including storage instructions and solubility.
Micromedex Designed as an all-in-one resource for prescribing and administering medicines. Covers United States-approved prescription and non-prescription medicines.
• Information on unlicensed and niche uses that is often not found elsewhere.
• Pharmacokinetic data.
• Alternative and herbal medicines.
• Drug identification.
• Additional pregnancy databases, available at extra cost, provide information not found elsewhere.
UpToDate Information is disease-focused, although some general drug information is included.
• Disease-focused enquiries.
• The drug interactions tool provides referenced detail about interactions.

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Limitations and distinctive features

The table below summarises the enquiry types for which each resource may be less useful, together with its distinctive features and further comments.

Resource Enquiry types it is not very useful for Distinctive features Further comments
AHFS Drug Information Limited information for non-US licensed medicines. Small section on chemistry and stability. Little additional material in AHFS that is not available elsewhere.
BMJ Best Practice Drug-focused data such as pharmacokinetics, adverse effects and interactions.
• Available as an app for point-of-care use.
• Links to available guidelines are particularly useful.
No further comments were recorded.
ClinicalKey Drug-focused data such as pharmacokinetics, adverse effects and interactions. Access to electronic books and journals. Large information repository.
DynaMed
• Limited information on medicines not licensed in the US.
• In-depth pharmacokinetic and pharmacodynamic drug information is not provided.
Available as an app for point-of-care use. Useful resource, particularly regarding medical conditions and their treatment.
Lexicomp
• Lacks depth in some specialist areas.
• Not useful for new medicines.
• App available.
• “Administration and Storage Issues” has some useful advice.
• Patient information leaflets are available in 20 languages.
A taster site and training site are available.
Martindale: The Complete Drug Reference “Niche” uses of medicines, for which DrugDex may provide more information.
• Foreign brand names.
• Chemical structures.
• Molecular formulae.
• Pharmacopoeial information.
Not a “complete” drug reference, but a very good general reference source. The treatment reviews are basic.
Micromedex Limited use for treatment pathways. App available. The AI Assistant is too basic for the detailed needs of MI services.
UpToDate Drug-focused data such as pharmacokinetics. Available as an app for point-of-care use. Useful for disease information not found easily in other resources.

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Disclaimer

You should always consult local policies and/or guidance. This document is intended to supplement these, not to replace them.

The information and opinion in this document are general information. The information and opinion are not legal advice, and should not be treated as such.

The information is provided without any representations or warranties, either express or implied.

Although we have attempted to ensure that the information and opinion are true, accurate, complete, current and non-misleading, to the best of our ability, we do not warrant that we have succeeded.

You must not rely on this document as an alternative to legal advice from a legal professional.

If you have any specific questions about a legal matter, you should contact your legal services provider.

Nothing in this disclaimer will:

  • Limit or exclude any liability for death or personal injury resulting from negligence;
  • Limit or exclude any liability for fraud or fraudulent misrepresentation; or
  • Limit or exclude any liabilities in any way that is not permitted under applicable law.

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Last Reviewed: May 2023