P01S01: Osteoporosis
Bottom line: Information on osteoporosis was used to justify the management of the patient
(change in medication), and it contributed to increase patient satisfaction.
Level 1 outcome (situational relevance): On July 14, 2008, P01 did a search at work with a patient (during the
encounter). They retrieved one information hit about osteoporosis. The reported
search objectives were: to address a clinical question, to look up something
they forgot, and to share the information with a patient or caregiver. “[The patient was an] 83 year-old female. […] She has osteoporosis and her previous doctor had
put her on […] the Didrocal, and she wanted something that was simpler to
remember, because the Didrocal comes in a package, it’s a kit, and you have to
take it every day, but you have to remember which day you take the pill and
which day you take the calcium. She found it a little more inconvenient, and
because she had a bit of a memory problem I thought it would be better if she
just had it once weekly. […] I wanted to find out was whether Fosamax and
Actonel could be taken weekly, and whether or not I could switch her to a once
weekly. […] I had remembered that one or the other or both could be taken
weekly, but I just couldn’t recall. […] It was more to let her know that they
are alternative regimes, so that she could have something simpler.” According to P01, the information from e-Therapeutics+ was in
agreement with and more relevant than the information from another electronic
resource (Family Practice Notebook on the web), and also in agreement with and
equally relevant to the information from another paper-based resource (RX files
textbook). “[The other website] told me that I could give her those two [drugs], but
it didn’t tell me what the dosage was.”
Level 2 outcome (cognitive impact): One hit was associated with a report of positive
cognitive impact (see table). Regarding practice improvement, P01 stated: “Now I realize I can
use both of them weekly [Fosamax and Actonel], but Didrocal I can’t. So now I
have two choices to use in a weekly regime for some people.”
Retrieved information hit(s):
1) e-Therapeutics+ (CIRT): Therapeutic
tab – osteoporosis – table 2 – extract on Actonel (P01S01H01).
Level 3 outcome
(information use): Information on osteoporosis was retrieved
for a patient, and used to justify the management of the patient (information
used as presented in e-Therapeutics+). “I
needed it [the information] to be exact before I actually prescribed it. I
didn't want to just take a guess. […] I basically wanted to switch her from
the Didrocal pack which was kind of a complicated process of taking medication
to something that was simpler. So I was modifying how she took her medication.”
Level 4 outcome (patient health): Regarding patient health, P01 reported that the information
contributed to increase the patient’s satisfaction with the treatment. “Taking it [the medication] once a week, she [the patient] said it would
be easier to remember, and it would be more acceptable for her, so she would
likely not forget anything.”
Levels of outcome of information-seeking
|
Situational
relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Look up something forgotten Share information |
Practice improved Confirmed Reassured Reminded something |
Justify choice |
Patient satisfaction |