P16S01: Malaria prevention
Bottom line: Information on treatment to
prevent malaria was used to justify the management of a patient (combine anticoagulant and antimalarial
medications, and increase the frequency of the monitoring of anticoagulation).
It contributed to increase patient knowledge, and to prevent health
deterioration.
Level 1 outcome (situational relevance): On January 8, 2009, P16 did a search at work, by themselves, and
before an encounter with a patient. They retrieved three information hits about Malarone. The reported 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, tasks with other
health professionals. The physician called and he had a patient [a man between
fifty and sixty years old] going to Africa [and] who needed to
take an antimalarial. [
] Malarone had been recommended to him [the patient], and he wanted
to know what he should do about his Warfarin treatment while he was away in
Africa. [
][The clinical question was] from the
physician about the management of the patients Warfarin. [
][I needed
to] find out if there would be an interaction [with] the patients
Warfarin therapy [
] and then advised the physician and the
patient on what to do. [
][I wanted] to kind of coordinate his prescribing therapy
before he left, [because] [
] he is going to work as a volunteer in a
hospital in Africa, so he might have to have some monitoring done while he is
there. According to P16, the
information from e-Therapeutics+ was in agreement with and equally relevant as
the information from another professional (pharmacist). I talked to another pharmacist to see whether
or not they had had any experience with this drug.
Level 2 outcome (cognitive impact): The three hits were associated with a report
of positive cognitive impact (see table). Regarding practice improvement and learning, P16 stated: I learned what the constituents of Malarone
are and how they work. [
] [Now] I have an understanding of how its dosed. I
didnt know much about this product beforehand. [
] Ill know that this is an option for the
malarial prophylaxis [
] [and] Ill have additional information going
forward to deal with a similar situation.
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Malarone First paragraph (Constituents) (P16S01H01)
2) e-Therapeutics+ (CIRT): e-CPS Tab Keyword: Malarone Dosage section (P16S01H02)
3) e-Therapeutics+ (CIRT): Drug interactions Tab Keywords: Warfarin and Malarone Analyse Warfarin Reaction Print whole page (P16S01H03)
Level 3 outcome
(information use): Information on Malarone 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+). We are going to
give him the drug [Malarone] but, because there is a potential interaction
[with Warfarin], we would monitor [the INR
International Normalized Ratio] more frequently.
Level 4 outcome (patient health): Regarding patient
health, P16 reported that the information contributed to
increase patient knowledge, and to prevent health deterioration. He [the patient] was [now] aware that there was a potential interaction [between
Malarone and Warfarin]. [
] so this way he [the doctor] could give him
the right drug but just monitoring appropriately. [
] Because he [the patient] would be
monitored while he was away, we would hopefully prevent a situation of
bleeding. [The patient knew] [
] that he could
correspond with me by email while he was gone.
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 |
Practice improved Learned something Motivated to learn Confirmed Reassured |
Justify choice Understand issue |
Prevent Patient knowledge |