P07S07:
Insomnia (benadril)
Bottom line: Information on insomnia was used
to justify the management of the patient and to persuade the patient to make a
change (medication). It contributed to avoid unnecessary treatment.
Level 1 outcome (situational relevance): On June 23,
2008, P07 did a search at work and with a patient (during the encounter). They
retrieved one information hit about insomnia. The reported search objectives
were: to address a clinical question, to fulfill an educational or research
objective, and to share information with a patient. “This was a woman in her fifties, an immigrant. [...] She works nights
and cannot sleep. And she did not want to take medication without my
permission, so she tried Tylenol, she tried the Zopiclone that I had given her,
and it did not work. And a friend at work gave her Simply Sleep. [...] So I
looked to see [...] what Simply Sleep contained. [...] I had never heard of it
before. [...] [I looked to be able] to tell her that it was something reputable
[well-known] that she could use.” 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: “For those [patients] who
cannot sleep, [Simply Sleep] is another alternative, an alternative that I can
now use. [...] It's Benadryl. I did not know that it was recommended to use
this medication for insomnia.”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT): e-CPS tab –
Simply sleep – whole page (P07S07H01)
Level 3 outcome
(information use): Information on insomnia was retrieved, and
used to justify the management of the patient and to persuade the patient to
make a change (information used as presented in e-Therapeutics+). “[About Simply Sleep], she did not want to
try it [before talking to me]. [...] I tell my patients that [when a treatment]
is not working after several days, to come back to see me, and she did not come
back. [...] I also gave her a few days off so [she could] try to catch up on
her sleep.”
Level 4 outcome (patient health): Regarding
patient health, P07 reported that the information contributed to avoid
unnecessary treatment. “Instead of
getting her to take sleeping pills that are more likely to lead to an
addiction, she could use this [drug] which very clearly states that it does not
cause dependence. [...] She was reassured that it was something that she could
take.”
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Fulfill educational objective Share information |
Practice improved Learned something Motivated to learn Reassured |
Persuade Justify choice |
Avoid |