P16S04: Drug interaction (Famvir and Warfarin)
Bottom line: Information on a drug interaction
between Famvir and Warfarin was used to justify the
management of a patient (Warfarin dosing and INR monitoring). It contributed to increase patient
knowledge and to avoid inappropriate procedure.
Level 1 outcome (situational relevance): On December 2, 2008, P16 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 the interaction
between Famvir and Warfarin. The reported search objectives were: to
address a clinical question, to share information with a patient, and to
exchange information with another health professional. She [the patient, a woman between fifty and sixty
years old] was with me and she was told that she might
have to start on Famvir and so she was wondering if there was any interaction
with Warfarin. Her doctor had told her to check with us. [
] [I gave] her the
information back and she was going to discuss it further with her doctor. [
] Another
pharmacist was potentially going to be involved, so [I] shared [the
information] with another pharmacist as well. According to P16, 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
learning, P16 stated: [I learned] that there
wasnt an interaction with Famvir.
Retrieved
information hit:
1) e-Therapeutics+ (CIRT): Drug interactions Tab Keywords: Warfarin and Famvir Analyse No
interaction (P16S04H01)
Level 3 outcome
(information use): Information on interaction between Famvir and Warfarin was retrieved,
and used to better understand a specific issue with respect to
the management of the patient, and to justify the management of a patient
(information used as presented in e-Therapeutics+). I learned something new. [
] [I wanted] to have an understanding of whether or not
the Famvir would potentially impact on her treatment plan. She [the patient] does need to go
on Famvir [and] she will know that there is no interaction
and so we wont have to increase our monitoring or change the Warfarin dosing. [
] We [P16, the
doctor and the pharmacist involved] [
] have maintained on her regular interval of
INR [International Normalized Ratio] checking without having to modify that.
Level 4 outcome (patient health): Regarding patient
health, P16 reported that the information contributed to increase patient
knowledge and avoid inappropriate procedure. She [the patient]
[is now] aware that there [is] no interaction
[between Famvir and Warfarin]. [...] She wouldnt have to come and have her INR done more
frequently. [
] We [P16, the doctor and the pharmacist involved]
have avoided unnecessary diagnostic work for her INR.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information Exchange information |
Learned something Confirmed Reassured |
Justify choice Understand issue |
Avoid Patient knowledge |