P04S05: Constipation (abdominal pain)
Bottom line: Information on constipation was used maintain the management of the patient
(non-pharmacological and pharmacological treatment). There were no
information-related patient health outcomes.
Level 1 outcome (situational relevance): On June 3, 2008, P04 did a search at work, by themselves, and during
an encounter with a patient. P04 searched outside the examination room, and
went back with information. “I left the
room and did the search.’ They retrieved one information hit about
constipation. The reported search objectives were: to address a clinical
question and to look up something they forgot. “[A woman] in her 20s […] presented with abdominal pains, it was thought it was due
to constipation and I was trying to help her get back on track. […] I don't
think I remembered the specifics on how to prescribe Metamucil, and how much
fibre somebody should be getting on a daily basis. […] [I wanted to know] how
much, to tell her how much fibre she should be getting and how to take the
medication.” According to P04,
the information from e-Therapeutics+ was in agreement with and equally relevant
as the information from another paper-based resource (CPS). “I do remember going
through the CPS. […] [It was] complementary.”
Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding practice
improvement, P04 stated: “[My practice is
changed and improved] because I had forgotten. […] I probably won't need
to look it up the next time; it will be fresh.” For this
patient, “I knew what I wanted to do. [The information]
confirmed how I needed to do it.”
Retrieved information hit(s):
1) e-Therapeutics+ (CIRT): Therapeutics tab – constipation –
pharmacologic and nonpharmacologic choices (P04S05H01).
Level 3 outcome
(information use): Information on constipation was retrieved, and used to maintain (be more
certain about) the management of the patient (information used as presented in
e-Therapeutics+). “There were no red flags, and I was on the right
track. […] [I used the information] to justify all the non-pharmacological
choices that I had recommended and that yes [Metamucil] is first line, and then
[…] it seemed like she needed just a little extra help just to get her over the
acute phase.”
Level 4 outcome (patient health): Without this information, P03’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 |
Practice improved Reminded something Motivated to learn Confirmed Reassured |
Be more certain |
No outcome |