P06S01:
Migraine (replace triptan)
Bottom line: Information on migraine was used
to maintain the plan for the management of the patient, and persuade the
patient to make a change (replace triptans by Naproxen). There were no
information-related patient health outcomes.
Level 1 outcome (situational relevance): On July 30,
2008, P06 did a search at work on two occasions: with a patient (during the
encounter), and by themselves (after the encounter with the patient). They
retrieved two information hits about triptans and migraine. The reported search
objective was to address a clinical question. “She [the patient] is a young woman in her twenties. She often has
migraines and it had been two or three days that it wouldn’t go away but she
had taken her triptans. She had tried different samples of I don’t know what.
[...] But she didn’t want to try anymore; she was tired of it. And so she asked
if there was anything else. So I addressed the question by looking in there
[e-Therapeutics+]. And since I haven’t prescribed a lot of triptans, I wanted to
know if there was another option for her. And then, looking at the table, I
said to her: “have you ever tried Naproxen?” And she said: “no”. So I said: “Ok
then, let’s try that!” According to P06, 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 motivation, confirmation, reassurance, and reminder, P06 stated: “I don’t have a lot of experience with
triptans so this gave me more information and it [motivated me to learn more].
I never knew which one you should choose. […] It was a good search because I
learned information about triptans. […]
I already knew it but it had been such a long time since I read it, so
it’s more like ‘it reminded me’. […] Because I was thinking of giving her
Naproxen and it confirmed that in fact I could give her Naproxen. […] It
confirmed that it was a good choice and that I was not way off track. […] They
are so used to going directly with triptans [doctors] that they bypass Naproxen
(regarding both hits).”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT):
Therapeutics tab – Migraine, headache in adult – Highlight (P06S01H01).
2) e-Therapeutics+ (CIRT):
Therapeutics tab – Migraine, headache in adult – Table 2: Medications for
symptomatic treatment of headache (P06S01H02).
Level 3 outcome
(information use): Information on triptans and migraine was
retrieved, and used to better understand a specific issue with
respect to the management of the patient, to maintain (be more certain about) P06’s plan for the management of the patient,
and to persuade the patient to make a change (information used as presented in
e-Therapeutics+). “I thought I could give
her Naproxen and it [e-Therapeutics+] confirmed that in fact I can give her
Naproxen. […] [The patient] was not completely convinced [to try Naproxen] but
I said “look”. I showed her the [computer] screen and I said “look, it says we
can use it”. […] When she saw that, she said “yes, ok.” […] They [patients] are
keener to accept a treatment if you involve them in the decision process.”
Level 4 outcome (patient health): Without this
information, P06’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 |
Reminded something Motivated to learn Confirmed Reassured |
Persuade Be more certain Understand issue |
No outcome |