P01S07: Smoking cessation (drug prescription)
Bottom line: Information on drug for smoking cessation was used to maintain the management of
the patient (prescription of varenicline). There were no information-related
patient health outcomes.
Level 1 outcome (situational relevance): On November 3, 2008, P01 did a search at work, by themselves, and
during an encounter with a patient. P01 searched for information outside the
examination room, and retrieved two information hits about Champix
(varenicline). The reported search objectives were: to address a clinical
question, to look up something they forgot, and to share the information with
the patient. “It was a man. I
think he was probably about thirty [...] and wanted to quit smoking and he’d
tried everything and he just basically said he had friends that were on Champix
and he wanted to be on it too. He wasn’t familiar with it but he just wanted a
prescription for it. And I usually discuss the drug with the patients and the
side effects. And then I give the patients the handout to read and then they
come back in a week so that they are familiar with it. [...] The clinical
question was: is this person a candidate for Champix? So I wanted to make sure
that none of the drugs that he was taking interacted with other drugs. [...] So
basically, I wanted to check that information and then give him the handout.
[...] I prescribed Champix a few times but I had known about a few drugs that
interacted but I didn’t remember all of the drugs that interacted with it.”According to P01, e-Therapeutics+ was the only source for information,
and the found information was relevant.
Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding practice improvement, P01 stated: “Every time I go to
it [information source] and do it again and again, I remember more and more
drugs that interact with it [Champix]. [...] [My practice will be changed] just
in the ease with which I can prescribe it more quickly without having to look
things up all the time (regarding P01S07H01).”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT): e-CPS tab – Champix – drug
interactions section (P01S07H01)
2) e-Therapeutics+ (CIRT): e-CPS tab – Champix – Patient handout (P01S07H02)
Level 3 outcome
(information use): Information on Champix was retrieved for a patient, and used to better
understand a specific issue with respect to the management of a patient, and to
maintain (be more certain about) the management of the patient (information
used as presented in e-Therapeutics+). “Basically to give him something
[varenicline] to stop smoking (regarding P01S07H01). […] Once I printed out the
patient pamphlet then I went back and talked to the patient and I told him
“here are things that you need to be aware of if you are going to be prescribed
it. It doesn’t interact with any of your medications. So here is the pamphlet,
you read up on…” [...] And then told him to come back in a week and then we
could discuss the pamphlet (regarding P01S07H02).”
Level 4 outcome (patient health): Without this information, P01’s management of the patient would have
been the same. There were no clear relationships between the use of
information and expected patient health outcomes.
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 Learned something Reminded something Confirmed Reassured |
Be more certain Understand issue |
No outcome |