Physicians' Desk Reference

The "Physicians' Desk Reference" ("PDR") is a commercially published compilation of manufacturers' prescribing information (package insert) on prescription drugs, updated annually. While designed to provide physicians with the full legally mandated information relevant to writing prescriptions (just as its name suggests), it is widely available in libraries and bookstores, widely used by other medical specialists, and in significant part valuable to consumers. It is financially supported in part by pharmaceutical manufacturing corporations which create drugs listed within its pages.

Since the late 20th century, a consumer edition has been offered at a much reduced price. Electronic editions are available on CD-ROM and the World Wide Web to subscribers. PDR is owned by the Thomson Corporation of Toronto.

The main edition is usable by determined consumers in conjunction with a medical dictionary. Many practicing physicians receive free copies of the PDR and are willing to give a patient a previous year's edition when they receive their new one but a recent edition generally differs from the current one by the absence of the drugs introduced during the course of the intervening year.

About the PDR

The 2005 version is the 59^th edition, and has information on over 4000 drugs.

The PDR material contained includes::*Comprehensive indexing (4 sections):**by Manufacturer:**Products (by company's or trademarked drug name):**Category index (for example, "antihistamines"):**Generic/chemical index (non-trademark common drug names):*Color images of medications:*Product information, consistent with FDA labelling:**Chemical information:**Function/action:**Indications & Contraindications:**Trial research, side effects, warnings

Related references

There are several versions and related volumes:
*PDR
*PDR for Nonprescription Drugs, Dietary Supplements, and Herbs
*PDR Drug Interactions and Side Effects Index
*PDR"health" - Version in lay terms.
*PDR Family Guide to Over-the-Counter Drugs - Lay term guide to non-prescription medication.
*PDR for Ophthalmic Medicines
*PDR Drug Guide for Mental Health Professionals

Controversies with the PDR

Originally distributed as a promotional item, the PDR has come under recent scrutiny with the lack of reporting of updated and accurate drug dosages along with adverse drug effects. Often dosage information can be taken from phase 1 trial information where clinical drug information is incomplete, resulting in higher PDR-recommended dosages than therapeutically effective dosages for many medications. And since most of the information is taken from drug data sheets generated by drug manufacturers, it is more likely to not include drug studies reporting the worst side-effect and adverse effect data. [ Cohen JS. Dose Discrepancies Between the Physicians’ Desk Reference and the Medical Literature, and Their Possible Role in the High Incidence of Dose-Related Adverse Drug Events. Arch Intern Med. 2001;161:957-964 ] This is opposed to evidence-based medicine or clinical reviewed material which examines all such data but is not contained within the PDR.

The PDR has also been criticized for its being paid for by the various pharmaceutical manufacturers that present mediciations within its pages. This criticism stems from the lack of special interest disclosure and the potential for guiding medical recommendations apart from evidence-based medicine [ Cohen JS, Insel PA. The Physicians' Desk Reference. Problems and possible improvements. Arch Intern Med. 1996 Jul 8;156(13):1375-80. ] The lack of medical editorial capacity within the PDR which is standard in the review of all scientific literature by informed scientific peers has also been criticized. [ Mindel JS, Teich SA, Teich CM, Beam P. Editorial: Limitations of the Physicians' Desk Reference 2007 Surv of Ophth 2008;53:82-84 ]

While proponents may argue that the controversies with the PDR may seem insignificant, critics site that in fact, most physicians and pharmacists rely on it in a bound, online or PDA version for drug dosaging and the lack of transparency in its formation most certainly leads to adverse patient outcomes. [ Cohen JS. Dose Discrepancies Between the Physicians’ Desk Reference and the Medical Literature, and Their Possible Role in the High Incidence of Dose-Related Adverse Drug Events. Arch Intern Med. 2001;161:957-964 ]

Online version

* [http://www.pdr.net PDR online] - online version, free for US medical professionals only.
* [http://www.pdrhealth.com PDR Health] - free consumer drug and medical information site.

References