P04S09: Dyslipidemia, diabetes and chronic renal failure
Bottom line: Information on dyslipidemia was used to justify the management of a patient with dyslipidemia,
diabetes and chronic renal failure (referral). There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On September 17, 2008, P04 did a search at work, by themselves, and
after an encounter with a patient. They retrieved two information hits about dyslipidemia. The reported search objectives were: to
address a clinical question, to exchange information with other health
professionals, and to plan, manage, coordinate, delegate or monitor tasks with
other health professionals. “[The patient
was a] 62 year old female with diabetes, dyslipidemia and chronic renal
failure. […] [She] is a patient of one of my [physician] colleagues. And I had
seen her about something and I believed she had the lab work to review on the
chart. And it showed that her cholesterol was above target and she was already
on Lipitor and I was wondering what else we could do for her. She has poor
kidney function. So, I told my colleague I’d look into some options for her.
And see if we could figure out what to do for her. […] With her poor kidney
function, I wasn’t sure what would be the best medication to put her on. My
colleague also did not know what to put her on […] It was to plan care with
this colleague since it was her patient because we could not come up with a
plan.” According to P04,
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 reminder,
P04 stated: “It’s not new information. It’s just I didn’t retain it (regarding P04S09H02).”
Retrieved information hit(s):
1) e-Therapeutics+ (CIRT): Therapeutics tab – dyslipidemia - Table 6: Lipid lowering agents (P04S09H01).
2) e-Therapeutics+ (CIRT): e-CPS tab – Ezetrol (and other
medications) – section on renal function (P04S09H02).
Level 3 outcome
(information use): Information on dyslipidemia was retrieved, and used to justify the management of the patient
(information modified: considering the
patient’s specific health concerns). “I came back to my
colleague; we discussed all the potential risks and benefits of putting her on
something and just decided that her renal function was really not at a point
where we were comfortable starting her on anything. And I believe she had tried
another medication or two and had adverse reactions to them. So, in conjunction
with the physicians it was left that she was referred to the lipid clinic so
they can make further changes. […] [The information was used to] justify not
putting her on anything else at this point in time, because the risks were
considered to be too great.”
Level 4 outcome (patient health): Regarding patient
health, P04 did not associate the information with any health outcomes.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question |
Reminded something |
Justify choice |
No outcome |