App developer

National Library of Medicine (NLM)

Primary author:

Philip O. Anderson, Pharm.D., FASHP - “originated LactMed and is responsible for compiling and summarizing the scientific literature and for crafting its ‘Summary of Use’ statements.”

Assisted by:

Jason Sauberan, Pharm.D. - “wrote the records for opioid drugs”.

Contact

No specific contact information is provided in-app. The developer’s website listed in the Apple App Store is linked to the LactMed TOXNET database website (https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACTMED). On the TOXNET website there is the following information:

Email: tehip@teh.nlm.nih.gov
Telephone: (301) 496-1131
Fax: (301) 480-3537

In the Google Play Store, the developer’s website is listed as the general NLM website.  The email used is: nlm.android.dev@gmail.com

Devices

iPhone and iPod Touch. The app can be downloaded to and does work on an iPad, however, there is no specific iPad version so the screen size is restricted.

In order to download the app onto an iPad, search for LactMed in the App Store and under the Filters menu (top left corner), select “iPhone Only” in Supports.

iOS 10.0 or later

https://itunes.apple.com/ca/app/lactmed/id441969514?mt=8

July 4, 2018

Android phones and tablets

OS 3.0 and up

https://play.google.com/store/apps/details?id=gov.nih.nlm.sis.lactmed

June 1, 2017

Country of origin

Size

Specialties/ Disciplines

Pediatrics, obstetrics, pharmacy, nutrition.

Physicians, midwives, pharmacists, nurses, dieticians, other health care practitioners.

Comments

This is based on assumption. No information on specialty is provided in-app. 

It is clear that LactMed is used by parents, breastfeeding mothers in particular. According to the reviews, some users express that the medical information is difficult to understand.

Stated purpose

“LactMed, part of the National Library of Medicine's (NLM) Toxicology Data Network (TOXNET®), is a database of drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives are provided to those drugs where appropriate. All data are derived from the scientific literature and fully referenced. Data are organized into substance-specific records, which provide a summary of the pertinent reported information.” (Source: Google Play Store listing)

Note that the App Store summary for LactMed does not include the statements regarding data.

Notes

The web version of LactMed is available, free of charge at:        https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm

Part 1: Editorial committee, content updates, and evidence grading

Both the apps creators and editors are reputable in regard to their expertise and affiliations. However, editorial committee members are not listed in-app, nor is there a link provided that directs users to the appropriate website where this information can be found. In addition, the app does not use an evidence grading system.

Another major issue with the app is the discrepancy in content updates between Apple and Android. The Android version of the app is not as frequently updated and at the time of this review, was several versions behind what is available in the Apple App Store. However, it appears that LactMed is quite popular for Android users based on Google Play Store reviews. The reviewers could not find a statement as to why the Android version of the app has not been updated since June 2017.

Part 2: Source and authorship information for 3 entries

While references are provided in each entry, it should be noted that the reviewers encountered the issue that not all articles cited in an entry were listed in the specific “Reference List” section but could be found in the “Full Record”. Also, for one entry reviewed (Tretinion) almost all sections stated that “Relevant published information was not found as of the revision date.” According to some user reviews in the Google Play Store, the lack of relevant published information for entries is a widespread issue.

Organization of information

The organization of the app is simple and easy to understand. The home page has a brief description of the type of information contained in the app and provides two options:

•  Drug Name Search
•  Drug Class Search

Each entry for a particular drug is divided into several categories or sections that reflect the information contained in the individual category/section: 

• Summary of Use
• Drug Levels
• Effects in Infants
• Effects on Lactation
• Alternate Drugs
• Drug Class
• References 

There is also a “Full Record” for each entry that sums up all the information provided under each category.

Navigation

The navigation used is a simple hierarchy, with two top-level searches provided (search by drug name or drug class). Once a user selects one of the two options, a scrollable listing of all entries is provided. There is also a search function that allows users to search for a particular drug name or class if known. However, in order to access the manual search, one has to select the “Drug Name Search” or “Drug Class Search” buttons first; there is no capability to manually search on the apps homescreen. Another navigation feature included is the ability to scroll back to the top of the drug name and class lists. A back button is also available to return to the drug name or class lists once an entry is selected. A navigation bar is provided, with the options to return “Home”, go to the drug name and class lists, and bring up the app’s “Info”.

When reading an entry, a magnifying glass appears with the option to zoom in or out to adjust the size of the text.

Internet connection required for use: No

Text search field: Yes

Browsable content: Yes

Advertisements: No

Pop-up advertisements: No

In-app purchases: No