P15S07: High blood pressure
Bottom line: Information on adverse
reactions of a treatment for high blood pressure was used to maintain the
management of a patient (continue medication). It contributed to increase
patient knowledge about this medication (adverse reactions).
Level 1 outcome (situational relevance): On December 15, 2008, P15 did a search at work, by themselves, during
the encounter with the patient (in the presence of the patient). They retrieved
one information hit about Rasilez &
hot flashes. The reported search objectives were: to address a clinical question and
to share information with the patient. She [the patient, a woman in her seventies] had resistant
hypertension so we have her on Rasilez that is not covered on the Ontario Drug
Benefit. [
]We give her samples for a few months and now [its] [the
Rasilez medication] about fully covered. I was trying to get her
a prescription and then she would say: oh I had these warm feeling when I wake
up. She [the patient] thinks its from the drug because she has had
many adverse reactions to many drugs so I just looked it up. [The clinical
question was] Does rasilez cause hot flashes? According to P15, at
the time of the interview, e-Therapeutics+ was the only source for information.
Level 2 outcome (cognitive impact): Three hits were
associated with a report of positive
cognitive impact (see table). Regarding reminder, P15 stated: I already knew all these side effects [table 1 &
2]. [
][Under adverse reactions] there are even
more side effects, and I already knew these. The first hit was also associated with a report of negative cognitive
impact (dissatisfaction). [
] [But] its pretty
general. Some of it is specific some is not. If you look under digestive it is
just listed, but it doesnt say what the incidence is.
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Rasilez Monograph Adverse reactions (P15S07H01)
2) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Rasilez Monograph Table 1 (P15S07H01)
3) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Rasilez Monograph Table 2 (P15S07H01)
Level 3 outcome
(information use): Information on Rasilez & hot flashes 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 a patient (information used as presented in e-Therapeutics+). I was trying to
rule out whether or not the adverse reactions were due to this drug [Rasilez] or something
else. [
] I just worried that there is no adverse
reactions for Rasilez and then I asked her after if she could tolerate it. And
she was oh, yeah I can tolerate it. [
][So] she was going to continue [the Rasilez
medication]. [
] She has a history of stopping her medication
without telling us, so I was trying to get her to still go ahead with it, keep
taking her medication.
Level 4 outcome (patient health): Regarding patient
health, P15 reported that the information contributed to increase patient
knowledge. She [the patient] had a question
to ask about whether or not this drug would cause adverse reactions, so I was
able to reply that information for her.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information |
Reminded something |
Be more certain Understand issue |
Patient knowledge |