P08S03: Insomnia (antidepressant)
Bottom line: Information on insomnia was used
to maintain the management of a patient (prescription of anti-depressants).
There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On July 24,
2008, P08 did a search at work, by themselves, and after an encounter with a
patient. They retrieved one information hit about insomnia. The reported search
objective was to fulfill an educational or research objective. “It was a woman [in her] mid-forties. […] The
question in my mind was “what’s the most recent guideline now for insomnia”,
especially if the person has a lot of mood or anxiety symptoms. So does a
person go with anti-depressant, depending on the situation or do you go with
hypnotics instead. [...] I had a sense for where I was going with it but I
wanted to read up on what the most current recommendations are. [...] [I
wanted] to see what latest research shows.” According to P08,
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, P08 stated: “In my
experience, I’ve seen a lot of patients coming to me with histories of
insomnia. And they’ve been put on hypnotics. And so, to me, from the look of
it, they may have been better off with an anti-depressant. It may have been
more appropriate.”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT):
Therapeutics tab – insomnia - Highlight (P08S03H01)
Level 3 outcome
(information use): Information on insomnia was retrieved, and
used to maintain (be more certain about) the management of
the patient (information used as presented in e-Therapeutics+). “I tend to lean towards, depending on the
patient history, more use of anti-depressants for long term insomnia. And this
basically confirmed that. [...] The green highlight was agreeing with what I
was doing. [...] [The information was used] for the discussion with my
collaborating physician and for decision making with regards to which treatment
to start with.”
Level 4 outcome (patient health): There was no
clear relationship between the information use and patient health outcomes. The
information was found after the encounter (not exchanged with the patient), and
there was no follow-up (yet).
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Fulfill educational objective |
Practice improved Reminded something Motivated to learn Confirmed Reassured |
Be more certain |
No outcome |