P05S06:
Drug interaction (antidepressant and antibiotic)
Bottom line: Information on drug interaction
(antidepressants and antibiotics) was used to justify the management of a
patient (prescription of antibiotics). There were no information-related
patient health outcomes.
Level 1 outcome (situational relevance): On January 15,
2008, P05 did a search at work, by themselves, and during an encounter with a
patient. P05 searched outside the examination room. They retrieved one
information hit about drug interactions with antibiotics. The reported search
objectives were: to address a clinical question, and to share information with
a patient or caregiver. “[The patient was
a] female, twenty-five, […] [and she] required antibiotics. Anytime we start on
a new medication we have to take a medication history of what they're already
on. She told me that the other medication she was on for different disorders
[Celexa] so I may have to look it up to make sure it was safe. […] [I had a]
clinical question [about] drug interaction or drug safety, so that's what led
me to use the system [e-Therapeutics+]. I think that it creates trust with the
clients that they know that you are insuring their health and safety, so I
always let clients know: "well, this is what we're going to start today
but I first have to make sure that it's safe with the other medication that
you're on", so I do share information with patients.” According to
P05, 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, P05 stated: “[My practice] is improved,
because if I wouldn't have looked for that information then I could have been
putting the patient at harm. […] Just because I wouldn't know off the top of my
head the million drugs that we have interactions that are possible.”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT): Drug
interactions tab – Antibiotics name - Celexa – summary and patient management
paragraphs (P05S06H01).
Level 3 outcome
(information use): Information on drug interactions with
antibiotics was retrieved, and used to justify the management of the patient
(information used as presented in e-Therapeutics+). “I went back to the patient, let her know that the medication that I was
going to prescribe was safe with her other one and I ordered a prescription.
[…] Knowing the two medications were safe together just reinforced my plan.”
There was no follow-up.
Level 4 outcome (patient health): Regarding
patient health, P05 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 Share information |
Practice improved Learned something Confirmed |
Justify choice |
No outcome |