P13S08: Acute
bronchitis
Bottom line: Information on acute
bronchitis was used to justify the management of the patient (stop steroids
inhaler). There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On October 10, 2008, P13 did a search at work, by themselves, and
after an encounter with a patient. They retrieved one information hit about acute bronchitis. The reported search objective was: to address a
clinical question. “I had spoken to
[the] patient, [a woman in her fifties], [to do] a follow-up on
her asthma. [I] did an asthma questionnaire with her, and
her asthma seemed very well controlled. […]I asked her about her inhaler use and she
said that she had just started […] using her steroid, inhaled steroid, over the
last few days in order to prevent bronchitis. She [the patient] said she tends
to get bronchitis every fall. Although she wasn’t having necessarily symptoms
that she was having bronchitis, [she was using her inhaler] to prevent herself from having it. […] My question to
myself was: are steroids really indicated for the [preventive] treatment of
bronchitis?” According to P13, 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, P13 stated: “[My practice will be changed] in terms of treatment approach. […] I knew after
reading that, that certainly inhaled steroids were not the treatment for acute
bronchitis. […] It [the information] changed […] how I would approach it [treatment for
acute bronchitis] in the future. […] And [it] also [improve my practice] in terms of […] prevention of
bronchitis. I knew that [after reading] that [the use of the inhaler] was not an
effective means in order to prevent an acute bronchitis attack.”
Retrieved
information hit:
1) e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Bronchitis – Acute bronchitis – Highlight (P13S08H01)
Level 3 outcome
(information use): Information on Acute
bronchitis was retrieved, and used to better understand a
specific issue with respect to the management of the patient, and to justify the management of the patient (information used as presented
in e-Therapeutics+). “[…] I wasn’t quite
sure as to whether she [the patient] was justified in using a steroid to prevent
bronchitis. […] So, it [the retrieved information] led me to
suggest that she discontinue that therapy, that it wouldn’t be effective if
even it was bronchitis. [...] What I did was I contacted the physician in writing,
[...] to advise him of the discussion I’d had with the patient. [...] I
contacted the patient back, and I confirmed this information with her [after
agreement with the physician].”
Level 4 outcome (patient health): Health outcomes were unknown since there was no follow-up.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question |
Practice improved Learned something Confirmed Reassured |
Justify choice Understand issue |
No outcome |