P09S03: Epilepsy and contraception
Bottom line: Information on epilepsy and contraception was used to
maintain the management of the patient, and to persuade a patient and another
health professional to make a change (use oral contraceptive with higher dose of estrogen). It contributed to increase patient
knowledge.
Level 1 outcome (situational relevance): On August 1, 2008, P09 did a search at work, by themselves, and after
an encounter with a patient. They retrieved one information hit about seizures and
contraception. The search objective was to fulfill an educational
or research objective. [The patient] was a woman, about 19. [
] She
was looking for birth control, and she was on Tegretol, and [
] I had referred
her to the seizure clinic and they recommended putting her on a birth control
pill at higher levels, which was similar to what was being stated here. But she
subsequently transferred care to a gynaecologist who put her on a birth control
pill that was not high. [
] it did not have that high dose that is recommended. [
]
It was a difference in opinion between me and the gynecologist. [
] That was the
reason why I went to look, to see if theres something new. [
] [I did this
search because] that was a product I had to review [e-Therapeutics+
Highlights]. That was the reason I caught on to this in the first place and
that happened to be relevant to the situation that I had. According to P09, 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 motivation,
confirmation, reassurance, and reminder, P09 stated: I have a few patients with seizures, so it was kind of good for me. I
actually went through the page to look at all the other details on this
particular item. [
] I kept looking in. [
] [And the information confirmed what
I did] around birth control, and the amount of estrogen needed. [
] I was
reassured that I wasnt giving this person too much
that this was absolutely
the correct thing to do. [
] I knew [before] that women with anti-epilepsy
drugs needed to be on oral contraceptives because of the risk of fetal
abnormalities.
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT): Home tab Evaluate Therapeutic
Information Epilepsy - Highlight (P09S03H01)
Level 3 outcome
(information use): Information on seizures and contraception was retrieved,
and used to better understand a specific issue with respect to
the management of the patient, to maintain (be more
certain about) the management of the patient, and to persuade the patient and
another health professional to make a change (information used as presented in
e-Therapeutics+). The patient had already transferred care, so
I just e-mailed, I just sent the information on to the gynaecologist. [...] I
don't know what he or she did. I just passed the info. [
] [The information was
used to] encourage her [the patient] to use a higher dose, which she did not
want, [
] which is why she sought another opinion. That's why she went on to
the gynecologist. [
] [The information was used to persuade] the patient, and
in this case, also the gynecologist.
Level 4 outcome (patient health): Regarding patient
health, P09 reported that the information contributed to increase patient
knowledge. It contributed to teach the patient the type of
dose she would need to use to prevent her from becoming pregnant.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Fulfill educational objective |
Reminded something Motivated to learn Confirmed Reassured |
Persuade Be more certain Understand issue |
Patient knowledge |