P03S09: Chemotherapy for colorectal cancer
Bottom line: Information on capecitabine (chemotherapeutic
agent for colorectal
cancer) was used to maintain the management of the patient (drug dosage). There
were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On November 5, 2008, P03 did a search at work, by themselves, and
during an encounter with a patient. P03 searched outside the examination room,
and went back with information. They retrieved one information hit about
Capecitabine and blood monitoring. The reported search objectives were: to look
up something they forgot and to share information with a patient or caregiver.
The patient was on Capecitabine and I wanted to see
what we
monitor for, what the dose limitations are, and creatinine clearance
for being on Xeloda. [
] He [the patient] is seventy five. [
] I knew about the
dose modifications but I wanted to be confident by looking it up first. [
]
Just to let them know what we monitor when they are on Capecitabine. According to P03, 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, P03 stated: I was
able to sort of verify the information and had a concrete [
] understanding of
it. [
] The improvement is that I now have the chart to go by to understand the
dosing changes. [
] It confirmed the dose modification depending on creatinine
clearance.
Retrieved information hit(s):
1) e-Therapeutics+ (CIRT): e-CPS tab Capecitabine Table
11: Xeloda (P03S09H01).
Level 3 outcome
(information use): Information on Capecitabine and blood monitoring was retrieved, and used
to maintain (be more certain about) the management of the patient (information
used as presented in e-Therapeutics+). I got the results from that patients
blood work and reviewed it with the patient. [
] We didnt require any dose
adjustment for that patient and since they have been doing well on the
treatment [
] [we] maintained his treatment on the current dose level.
Level 4 outcome (patient health): Without this information, P03s 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 |
|
Look up something forgotten Share information |
Practice improved Reminded something Confirmed Reassured |
Be more certain |
No outcome |