Clinical: A new look for MIMS

Dr John Chapman takes a look through the redesigned MIMS, and finds changes for the better.

When January's MIMS arrived, I noticed something subtly different about it.

Not the flyer on the front that obscures the detail of the front cover: that is still there, and it still tears the cover when removed.

However, beneath that, the typeface was less fussy, cleaner and larger, the month was more prominently displayed, and there was a short table of contents with new sections.

Structurally, the book is almost imperceptibly thicker and it now has four tagged sections, which are clearly labelled towards the back; Tables, Guidelines, Palliative care and Visual guides.

Changes for the better
Like many ageing GPs I'm suspicious of change. But as I refer to MIMS several times a surgery and, because I gave up on the BNF when I left hospital medicine, there was nothing to do but dive in.

The first few pages have been subtly altered, which will help inexperienced users find their way around the book, but the days when that description applied to me are long gone.

Thankfully, there have been no changes made to the format of the basic drug information - it's as easy as ever to check those that I don't use quite often enough to be confident of their dosage, contraindications or adverse effects.

It's also useful to check what other people have used (or look around the listings for inspiration when out of options).

New tables
Another feature that remains are the incredibly useful tables that, when I look for them, warn me about such things as sensitisers in emollients. And they are now available both in the relevant section so handy for browsing and in a new section.

Under the cunning label of 'Tables' and accessible by its coloured page tag where they are all collected together, there are lists of contraceptives, DMARD monitoring, insulins, lancets, eye and skin sensitisers in preparations and even the travel vaccination and malaria prophylaxis charts.

There are useful things in there that I wasn't aware were in MIMS - although, checking December's issue assures me they were there all along but not so easily accessible.

All this makes for a thicker, and presumably more expensive book, but I like having the information available in both the relevant section and the collated area.

Guidelines
The next tag collects summaries of some of the most prominent guidelines. Again they also appear in the relevant drug section.

I'm not sure that many established GPs will need to refer to the BTS asthma, or BHS hypertension guidelies too often but, if and when they do, they are there for reference and will be useful for GP registrars.

The JBS prevention of cardiovascular disease guidelines are there too, along with H pylori eradication.

I expect there is potential for this section to expand as other guidelines achieve the same level of significance.

Palliative care
Next there is an interesting little section devoted to palliative care. I have an interest in palliative care and there are useful ideas here for add-on therapy, and dosage equivalents of different preparations and routes of opioid treatment.

There is also a compatibility chart for syringe driver mixtures, which I don't often need but am very pleased to find.

Devices
The last new section is a pictorial one, with asthma devices, diabetes lancets and insulin pens and testing strips illustrated clearly and in colour.

Referring back to the tables, there's a list of which lancets go into which device.

This, coupled with the pictorial section could may solve my personal problem of getting this stuff on the system with the correct compatibility and codes when a patient established on treatment comes as a new arrival at the surgery.

Functionality retained
The good news is that none of the established functionality of MIMS has been degraded by these changes.

The better news for me is that some of the resources I was aware of and use have been made available in an alternative section. They have also been bundled with other things that I will very probably use more now I know where to find them easily.

MIMS changed to include generic as well as branded drug information some time ago. I miss the cumulative list of discontinued drugs, which served me as a reminder of the need to keep my own practice up-to-date. And, rather like the obituaries in the BMJ, it was usually the first thing I looked at each month, followed by the new products and preparations section.

So I was pleased to hear that the cumulative list will be re-instated later this year.

The MIMS redesign reinforces its utility and, with an average of 200 changes to the medicines information each month and its provision free of charge to every practising GP in the UK, for me it is still the best quick reference for medications available for day-to-day use in consultation.

It just got rather better.

Dr Chapman is a GP in Sutton Coldfield, West Midlands.

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