P10S02: Attention-deficit hyperactivity disorder (ADHD) :
Prescription
Bottom line: Information on attention deficit
hyperactivity disorder (ADHD) was used to maintain the
management of a patient (prescription of a medication). It contributed to increase patient knowledge.
Level 1 outcome (situational relevance): On July 30, 2008, P10 did a search at work, by themselves, and during
an encounter with a patient. P10 retrieved two information hits about Attention Deficit Hyperactivity Disorder (ADHD). The search objectives were: to address a clinical question, to share
information with a patient or caregiver, to exchange information with other
health professionals, and to plan, manage, coordinate, delegate or monitor
tasks with other health professionals. “It was a little twelve year-old and her aunt. […]
The search was that the little girl had an assessment done at school by the
school psychologist. And they had recommended that she be started on medication
and they brought that assessment to me. But he or she didn’t say what
medication that they wanted to start on. So I was kind of going to try to find
out what was most recommended, and what not, and side effects and... […] [I
wanted] to let her [the aunt who is a nurse] know what was recommended by a
reputable website and to give her a handout and to give her information on
medication and ADHD too. […][And] I needed the doctor to write the prescription
for me. And then, my student was here too. So I shared [the information] with
both [of them]. I did talk to the pharmacist too. […] [I needed to coordinate
with the doctor] because I can’t write triplicates.” According to P10,
the information from e-Therapeutics+ was in agreement with and equally relevant
as the information from other professionals (pharmacist and physician).
Level 2 outcome (cognitive impact): Two hits were associated with a report of positive cognitive impact (see table). Regarding confirmation,
reassurance, and reminder, P10 stated: “I wrote a whole paper on the Clinical Practice
Guidelines for ADHD in my master. [...][I was reassured] that it validated what I knew
from training and from other clinical experiences. […] It validated what I had
learned.”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT): Therapeutics tab – ADHD - Attention deficit hyperactivity disorder – Table 2: Drugs
Used in ADHD (P10S02H01)
2) e-Therapeutics+ (CIRT): e-CPS tab – Concerta – whole page (P10S02H02)
Level 3 outcome
(information use): Information on ADHD was retrieved, and used to better understand a specific issue with respect to the management of
the patient, and to maintain (be more certain about) the management of
the patient (information used as presented in e-Therapeutics+). “I’ve heard of all those meds. [...] It was the first time I ever started a child on
medication for ADHD and I just wanted good background information. ”
Level 4 outcome (patient health): Regarding patient
health, P10 reported that the information contributed to increase patient
knowledge. “I
had given her the handout and we had discussed what was in it and I had
highlighted certain parts of that for her. […] I wanted to teach
them about side effects and all that stuff and [the aunt] was a nurse so I said
“I think… I mean, if there’s something you come across and you don’t know,
ask”, and I wanted to be very detailed.”
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information Exchange information Manage patient care |
Reminded something Confirmed Reassured |
Be more certain Understand issue |
Patient knowledge |