P06S05: Smoking cessation counseling

Bottom line: Information on smoking cessation was used to justify the management of the patient (smoking cessation counseling). There were no information-related patient health outcomes.

Level 1 outcome (situational relevance): On December 31, 2008, P06 did a search at work, by themselves, and on two occasions (before and during an encounter with patients). They retrieved one information hit about smoking cessation. The reported search objectives were: To address a clinical question, to look up something they forgot, and to share information with a patient. “[The patients, 26 or 27 years old], they had already chosen Champix. [...] I knew what I wanted to do but I wanted to make sure that I would be able to give good answers. Because one of the questions they asked me was “well, what’s the success rate compared to Zyban?” [...] They were a married couple and they had three children and their children kept on bothering them to stop smoking. And everybody around them was quitting smoking so they decided that maybe they should stop too. And they know of family members who were successful with Champix. [...] And the man, he had already tried Zyban and [...] he started smoking again, so this time he wanted to try Champix. [.....] That’s not something I often do [prescribe Champix]. And I couldn’t answer questions concerning Champix because that’s something new. I didn’t know the exact dosing, [...] to be able to compare. [...] And I wanted to be able to answer to the question.” According to P06, 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, P06 stated: “It reminded me of all the different medications available, the dosages, and the new thing that I learned was the dosage for Champix because I didn’t know it. [...] Now I’m more aware of what’s available for Champix and that it can have a better success rate than Zyban.”

Retrieved information hit(s):

1) e-Therapeutics+ (CIRT): Therapeutics tab – smoking cessation – whole chapter including comparison Zyban/Champix (P06S05H01).

Level 3 outcome (information use): Information on smoking cessation was retrieved, and used to justify the management of the two patients (information used as presented in e-Therapeutics+). “So I saw them two days later [after the first search], and then I revised with them. [...] I was able to show them that they could have better success by choosing Champix. [...] I used tables. I was able to show them different things, and the different options, and [...] that encouraged them. [...] I told them that it [Champix] was more expensive [information from the table]. [...] That’s what I had in mind [to look at the information with them], and it confirmed that my idea was a good one.”

Level 4 outcome (patient health): Regarding patient health, P06 reported that information-related patient health outcomes were unknown. There was no follow-up with the two patients.

Levels of outcome of information-seeking

Situational relevance	Positive cognitive impact	Information use	Patient health
Address a clinical question Look up something forgotten Share information	Practice improved Learned something Reminded something Motivated to learn Confirmed Reassured	Justify choice	No outcome

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