P17S12: Restless legs syndrome (start medication)
Bottom line: Information on restless legs
syndrome was used to maintain the management plan for a patient (start
medication), and to persuade other health professionals to make this change.
There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On September 9, 2008, P17 did a search at work, by themselves, and
before an encounter with a patient. They retrieved one information hit about
Restless legs syndrome. The reported search objectives were: to address a clinical question, to
share information with the patient, to exchange information with other health
professionals, and to plan, manage or coordinate tasks with other health
professionals.“ It was one of
her [nurse practitioner] patients. […] She [the nurse] just wanted me
to see if there was anything that could be done [for this patient, a woman in her forties] about restless
legs [syndrome]. [We wanted] to see if we needed to make any changes in
her therapy.” According to P17, the information from
e-Therapeutics+ was in agreement with and more relevant than the information
from another electronic resource (Micromedics).
Level 2 outcome (cognitive impact): Two hits
(Figure 1 and table 1) were associated with
a report of positive cognitive impact (see table). Regarding practice
improvement and learning, P17 stated: “I will obviously look at non-pharmacologic
therapy a little bit more, and I may consider trying new agents or novel
agents, like certain ones we haven’t tried before. […] [As for the
drug therapy], […] I am [now] aware that these [new] drugs can be
used for this condition [restless legs syndrome]. [Which piece did you learn?] I think the
actual newer drugs for restless legs. [...] The Figure [...] just gave
directions to say “ok, you know what, we’ve looked at anything else so let’s
now treat”.”
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Neurologic
disorders – Management of restless legs
syndrome – Figure 1 (P17S12H01)
2) e-Therapeutics+ (CIRT):
Therapeutics Tab – Keyword: Neurologic
disorders – Drug therapy for restless legs
syndrome – Table 1 (P17S12H02)
3) e-Therapeutics+ (CIRT):
Therapeutics Tab – Keyword: Neurologic
disorders – Highlight (P17S12H03)
Level 3 outcome
(information use): Information on Restless legs syndrome was retrieved,
and used to better understand a specific issue with respect to the management
of the patient, to maintain (be more certain about) the management plan for a
patient (start medication), and to persuade other health professionals to make
this change (information used as presented in e-Therapeutics+). “I recommended something based on the fact
that we already knew the answers to our questions. […] We’ve already
tried everything else [non-pharmacologic]. […] Now we know it’s time to use medication. […] I did make a
recommendation regarding medication. […] She [the nurse practitioner] was asking for
a referral so she definitely took it whole heartedly. Whether she acted on it
as it was, again, I don’t know.”
Level 4 outcome (patient health): Health outcomes were unknown since there was no follow-up. P17 cannot
confirm the rating (expected outcomes) with clinical observation.
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 Reminded something Motivated to learn Confirmed Reassured |
Persuade Be more certain Understand issue |
No outcome |