P15S04: Rheumatoid
arthritis
Bottom line: Information on the treatment
of rheumatoid arthritis was used to persuade the
patient to change (prescription for methotrexate medication). It contributed to increase
patient knowledge about the disease and the treatment.
Level 1 outcome (situational relevance): On July 23, 2008, P15 did a search at work by themselves, during the
encounter with the patient. They retrieved one information hit about methotrexate. The reported
search objectives were: to address a clinical question, to look up something
they had forgotten, to share information with a patient and to plan, manage or
coordinate tasks with other health professionals. She [the patient, a woman around fifty years old]
was just newly diagnosed with rheumatoid arthritis, so the doctor wanted
to give her methotrexate, but I knew there were other options out there to give
her. [...] So the clinical question was "what do we
start her with?", [and] I was trying to remember what the monitoring
parameters were for methotrexate. [...] We were just trying to make a monitoring
plan for her, when to do her blood work [and] how quickly she'd see some side effects. According to P15, the information from e-Therapeutics+ was in agreement
with (complementary), and less relevant than, the information from another
electronic resource (MicroMedics) where P15 found the monitoring parameters for methotrexate.
Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding
confirmation, reassurance and reminder, P15 stated: [This
information confirmed I was doing the right thing because] I guess if you
were to look at the dosing, it confirms what dose I would normally give. [...] [And] the
information [also] confirmed what I already knew.
Retrieved
information hit:
1) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Methotrexate Methotrexate (Wyeth Canada) Printable pdf
version (P15S04H01)
Level 3 outcome
(information use): Information on methotrexate was retrieved,
and used to persuade the patient to make change (information used as presented in
e-Therapeutics+). I gave her the patient
information [P15 printed out the handout document for patients, and gave it to
the patient]. [...] I was giving her more information and,
hopefully, increased her acceptance to comply with the medication
(methotrexate). [...] I gave her the handout [...] [and I
used it] to persuade her a little bit, not too much.
Level 4 outcome (patient health): Regarding patient
health, P15 reported that the information contributed to increase patient
knowledge. Yes,
for increasing [the patients] knowledge about the medication and rheumatoid
arthritis, [...] [and] increase her adherence to the medication.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Look up something forgotten Share information Manage patient care |
Reminded something Confirmed Reassured |
Persuade |
Patient knowledge |