P07S06: Vertigo (drug dosage)

Bottom line: Information on vertigo was used to justify the management of the patient (maximum dosage of the medication). It contributed to avoid unnecessary intervention and inappropriate treatment.

Level 1 outcome (situational relevance): On June 26, 2008, P07 did a search at work and with a patient (during the encounter). They retrieved one information hit about the treatment of vertigo. 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] fifty-five [years old] or so. [...] He was prescribed SERC in the past for vertigo, and it did not work. So I wanted to make sure it was the right dose for him and that it was the maximum he could take. [...] I knew it in the past [the maximum dosage], but [I forgot] ... [...] [The patient] was next to me. So we talked about the maximum dose. Some patients tend to ... if it does not work, they double the dosage. So it was to show him that yes, this was the maximum he could take.” 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). Regarding practice improvement, P07 stated: “It will be more effective, because next time I will probably remember the dosage and it will not be necessary to look for it. [...] I knew the dosage, but I did not know the maximum.”

Retrieved information hit(s):

1) e-Therapeutics+ (CIRT): e-CPS tab – Serc – Dosage section (P07S06H01)

Level 3 outcome (information use): Information on the treatment of vertigo was retrieved, and used to justify the management of the patient (information used as presented in e-Therapeutics+). “I suspected that he was already taking the maximum dose. So I did not want to increase it without proof that I could do it. [...] I saw that I could not increase his dose. [...] We kept the same dose of Serc.”

Level 4 outcome (patient health): Regarding patient health, P07 reported that the information contributed to avoid unnecessary intervention and inappropriate treatment. “[The information contributed to avoiding] thet use of resources [referral to a specialist]. [...] If he had continued as it was, he [the patient] probably would have increased his SERC. ”

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 Confirmed Reassured	Justify choice	Avoid

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