P09S05:
Intermittent claudication (change medication)
Bottom line: Information on intermittent
claudication was used to justify the management of the patient, and to persuade another health professional to make a
change (medication change). There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On October 10, 2008, P09 did a search at work, by themselves, and
after an encounter with a patient. They retrieved one information hit about
intermittent claudication. The search objective was to exchange information
with other health professionals. “[The
patient was an 80 year old] woman. [...] She had symptomatic intermittent claudication and I
wanted to know what options were for treatment for her. […] For example, I heard
about Trental [rheologic modifier]. So I wanted to know if it was one of the
recommendations who are here for it and is there a contraindication for her
[also interactions with other drugs]. […] [And] I had a physician that’s
working with me who also had a similar question. She also had the same problem,
the same question.” According to P09, the information from
e-Therapeutics+ was in agreement with and more relevant than the information
from another paper-based resource.
Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding practice
improvement, P09 stated: “The piece of information [about] Ramapril,
that, I didn’t know. […] [My practice will be changed and improved] basically
making sure my patients are on ACE (angiotensin-converting
enzyme) inhibitors. If I’m treating them for PAD (Peripheral vascular disease); they usually are
already [on ACE inhibitors].”
Retrieved
information hit(s):
Level 3 outcome
(information use): Information on intermittent claudication was retrieved,
and used to better understand a specific issue with respect to
the management of the patient, to justify the
management of the patient, and to persuade another health professional to
make a change (information used as presented in e-Therapeutics+). “I shared it [the
information] with one of the colleagues that I’m working with. So we reviewed
my [patient’s] profile and her patient’s profile to see if we had made the
changes that were recommended. […] [And my patient] had already been on
Ramapril. I didn’t realize that that was the recommendation. But there was no
change particularly for me because she was already on the medicine. […] I had
to modify it [the dosage] with the Ramapril because of her kidney function.
[And I used the information to persuade] the other health professional [about]
[…] the change to Ramapril. ”
Level 4 outcome (patient health): There was no clear
relationship between information use and patient health outcomes.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Exchange information |
Practice improved Learned something Reminded something Motivated to learn Confirmed Reassured |
Persuade Justify choice Understand issue |
No outcome |