P08S11:
Implanted defibrillator
Bottom
line: Information on implanted defibrillator was used to maintain the
management of a patient (patient counseling to follow-up with a specialist). It
contributed to increase patient knowledge about the necessity of a follow-up.
Level 1 outcome (situational relevance): On October 11,
2008, P08 did a search at home, by themselves, and after an encounter with a
patient. They retrieved one information hit about implanted defibrillator. The
reported search objectives were: to search in general or for curiosity, to
share information with a patient or caregiver, and to exchange information with
other health professionals. “This patient
came in with diabetes, newly diagnosed. I don’t recall if he had a heart attack
or stroke in the past or anything like that. But I remember being surprised
that he had an implanted defibrillator. […] He was about sixty-five. […] I just
logged in e-Therapeutics, I was just looking around, and happened to see this
and thought: Oh! I just had a patient with that! I wonder what they have to say
about this. […] I was wondering why he had this. […] He was asking me and he
says to me he doesn’t even know why he has it. And I don’t think that he was
even seeing anybody for follow-up; it was kind of one of those things you go:
wait a minute, if he has got this thing, he should be following up with a
specialist, do something, you know, kind of a trigger in your head. I knew I
would see him again, the following week, so… I would help get some information.
[…] [It was also to exchange the information with] some of the nurses in
emergency, because we had talked about it. Then I was just telling them after
the fact that: Oh! I searched and I found this information” and, you know, he
needs to be reconnected with his cardiologist, and stuff like that.”
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 learning, P08 stated: “[I learned about] the effectiveness of the
defibrillator, so it says as the thirty-nine percent reduction in total
mortality. I didn’t know that. […] And if you compare that to, let’s say drugs,
it’s more effective, and I did not know that.”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT):
Therapeutics tab – cardiovascular disorders - ventricular arrhythmias –
Highlight (P08S11H01)
Level 3 outcome
(information use): Information on implanted defibrillator was retrieved, and used to maintain (be more certain about) the management of the patient (information
used as presented in e-Therapeutics+). “I
was able to give the patient, when I saw him again, I was able to tell him some
of this stuff, that there’s thirty-nine percent reduction in mortality after a
year, even when you compare to the use of medication, and I said I don’t have
the information about using the medication and the defibrillator what the
reduction is, but it shows benefits, and also because of the complexity of the
device,he really needs to be seeing a specialist for follow-up, on an ongoing
basis, so that was the information that I was passing on to the patient. […] He
ended up going back to his family doctor, and after being recommended this two
weeks in a row and did reconnect with the cardiologist, so… The reconnection
did happen. […] This information was used to be sure that the follow-up
actually happened.”
Level 4 outcome (patient health): Regarding
patient health, P08 reported that the information contributed to increase
patient knowledge. “He needs to be
reinforced that this is not something to take lightly, that he needs follow-up,
that was the first thing. […] The information made him realize how important it
was.”
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Satisfy curiosity Share information Exchange information |
Learned something Motivated to learn |
Be more certain |
Patient knowledge |