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Patient safety

e-Therapeutics released, for doctors and pharmacists

TORONTO – Assisted by $8.8 million in development funds from Health Canada, the Canadian Pharmacists Association has launched a web-based medication management tool that’s designed to offer quick decision-support at the point of care.

The CPhA calls it “a second opinion from Canadian experts on what works, when – that you can consult anytime, anywhere.”

Dubbed e-Therapeutics, the system enables physicians, nurses, pharmacists and other practitioners to check on various drugs, obtain warnings about possible interactions with other medications and herbal remedies, and view ‘best treatment’ options for a wide variety of medical conditions.

All of this is presented in a Canadian context, with Canadian drug names, and advisories and alerts from Health Canada.

Care-givers can use the system through the e-Therapeutics web portal or on handheld computers, like the Palm or Pocket PC.

“It’s important to note that the information is unbiased, that it’s not coming from a drug company,” said Janet Cooper, senior director of professional affairs at the Canadian Pharmacists Association. As such, said Cooper, healthcare professionals can have confidence in the service as a trusted source of information.

Cooper spoke at a launch event for e-Therapeutics, held in Toronto in May.

She said e-Therapeutics is the result of a three-year project that involved nearly two dozen developers, along with some 200 pharmacists, nurse practitioners and physicians. “We received feedback from them in pilots, and built their recommendations into the system,” said Cooper.

The system was developed with the assistance of IBM Canada and the College of Family Physicians of Canada. Major resources – which have been incorporated into the solution – include the CPHA’s publications, such as:

• “The Compendium of Pharmaceuticals and Specialties” (CPS). According to the association, this is the definitive Canadian source of drug information. It contains nearly 3,000 current product monographs, including 108 drug or drug-class monographs prepared by CPhA, quick reference drug information and clinical tools, directories of sources of drug and healthcare information, a list of discontinued products and a comprehensive crossed-reference index of generic and brand names.

• “Therapeutic Choices”, which offers comparative and evaluative information on treatment options on 118 common medical conditions. Data are organized in a clear and concise format, including decision trees, tables and a comprehensive index.

• Lexi-Comp’s Lexi-Interact, providing comprehensive drug-to-drug, drug-to-herb and herb-to-herb interaction information.

“When it comes to appropriate therapies, the system shows when various classes of drugs are appropriate, and whether drugs are needed at all,” said Cooper. “It’s evidence-based, and it shows the sources of the evidence.”

Moreover, she said e-Therapeutics also notes the costs of various drug therapies. “Doctors often don’t know the costs for many medications, or if a generic is available.
Some generics can be 10 times or 20 times less expensive,” adding that cost is an important issue for patients and the healthcare system, in general.

Dr. John Maxted, associate director of the College of Family Physicians of Canada, said “there have been changes in the way physicians practice medicine in recent years,” with doctors constantly looking up information. “They need to access information as quickly as possible, while seeing patients.” For that reason, he believes e-Therapeutics will become a valuable addition to the tools used by primary care physicians.

“Instead of browsing through heavy textbooks, we can go online,” said Dr. Maxted.

Information about the service is available at It’s a subscription-based service; individuals can subscribe for $389 per year.

Because it uses industry standards, the system is designed to integrate with various electronic medical record systems. However, actual integration with leading EMRs hasn’t yet been accomplished.

In the future, e-Therapeutics might be used to double-check current and proposed therapies for a patient’s medical condition while a physician is studying the chart.

Wayne Lepine, director of pharmaceutical policy for Health Canada, said the e-Therapeutics project is expected to lead to healthcare renewal, to improvements in patient safety through the use of technology.

Canadians now use approximately $25 billion worth of medications annually, and it is a problem to ensure they are used appropriately. Various Canadian and U.S. studies have pointed out the high levels of medication error that currently exist.

“The Health Council of Canada has recommended that we look for solutions to increase the accuracy of prescribing,” said Lepine. For its part, the Canadian government has also been developing a national pharmaceutical strategy. “This could provide one conduit,” said Lepine.

Neil Stuart, practice leader for IBM, also highlighted the patient safety challenge.

“There’s a gap between what we know [about medications] and what we do in practice,” said Stuart. “The e-Therapeutics application gets knowledge to the point-of-care, and helps close that gap.”