P03S05: Contraceptive patch
Bottom line: Information on adverse effects of the contraceptive patch was used to justify the management of a
patient (stop medication). There were no information-related patient health
outcomes (no follow-up).
Level 1 outcome (situational relevance): On August 13, 2008, P03 did a search at home, by themselves, and after
an encounter with a patient. They retrieved two information hits about the side
effects of Evra (once-a-week contraceptive patch). The reported search objectives were: to address a
clinical question, to share the information with a patient or caregiver, and to
exchange information with other health professionals. “[The patient was] I believe about 17. […] She was a patient that I had started on Evra,
and had come to me two weeks later with side effects or I guess whatever
clinical situation that I didn't know if it was related to the patch itself or
related to something else. […] She had nausea, vomiting, weight loss, some
dizziness. […] [I searched] just to see if what she was experiencing could be
related to the Evra patch itself […] and to share that information with the
patient just because she wanted to know if it was related to the patch, if she
should go off of it or not. […] [I talked] with the clinic nurse that works
with us as well, to let her know.” According to P03,
e-Therapeutics+ was the only source for information, and the found information
was relevant.
Level 2 outcome (cognitive impact): Two hits were associated with a report of positive cognitive impact (see table). Regarding practice
improvement, P03 stated: “I learned more about the side effects that people can experience. […] It
let me better verbalize the possible side effects to the patient (regarding both hits).”
Retrieved information hit(s):
1) e-Therapeutics+ (CIRT): e-CPS tab – Evra – Table 1: Evra (P03S05H01).
2) e-Therapeutics+ (CIRT): e-CPS tab – Evra – extract on
adverse reactions (P03S05H02).
Level 3 outcome
(information use): Information on Evra side effects was retrieved, and used to better
understand a specific issue with respect to the management of the patient, and to justify the management of the patient (information used as presented
in e-Therapeutics+). “I called her and asked her to come into clinic, but she didn't follow up
with me. But I did talk to her. […] I
would recommend that she had stopped the treatment, because of the side effects
she was experiencing. I had thought that they were side effects, so it
confirmed that they were the side effects from the patch. […] [I used the
information] to better understand if the symptoms she was having were true side
effects from the drug, and the modification [we did] was to discontinue
treatment (regarding both hits).”
Level 4 outcome (patient health): There was no clear relationship between the information use and
information-related health outcomes. There was no follow-up, and we do not
know whether the patient stopped her contraceptive patch (or not).
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information Exchange information |
Practice improved Learned something Reminded something Motivated to learn Confirmed Reassured |
Justify choice Understand issue |
No outcome |