P07S05: Back and neck pain

 

Bottom line: Information on back and neck pain was used to justify the management of the patient (prescription). It contributed to avoid inappropriate treatment.

                                                                                                                                                                                          

Level 1 outcome (situational relevance): On May 12, 2008, P07 did a search at work and with a patient (during the encounter). They retrieved one information hit about back and neck pain. The reported search objectives were: to address a clinical question, to look up something they forgot, and to share information with a patient. “[The patient was] a woman in her forties with back and neck pain secondary to working in a daycare and picking up children all the time, [...] having back spasm, muscle spasms. [...] [The clinical question was] the actual dosing [of Flexeril]. [...] [It was also to share the dosing with the patient].” According to P07, 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).

Retrieved information hit(s):

1) e-Therapeutics+ (CIRT): e-CPS tab – Flexeril - cyclobenzaprine - dosage and administration section (P07S05H01)

 

Level 3 outcome (information use): Information on back and neck pain was retrieved, and used to justify the management of the patient (information used as presented in e-Therapeutics+). “I gave her a few days off work and some Flexeril. [...] [The information] justified that I was using the right medication. [...] I was not sure of the dose. [...] I think it says TID [three times a day] and I probably would not have given it that often, not being sure.

 

Level 4 outcome (patient health): Regarding patient health, P07 reported that the information contributed to avoid inappropriate treatment. “I did not want to not give her enough medication so that it wouldn’t help. But nor did I want to give more than I should have. [...] If I look it [the information] up in front of a patient, then they feel secure that I am giving them the appropriate dosing.

 

 

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

Reminded something

Motivated to learn

Confirmed

Reassured

Justify choice

Avoid

 

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