P18S05: Obsessive-Compulsive Disorder
Bottom line: Information on Obsessive-Compulsive
Disorder was used to maintain the management plan for a patient (start
medication), and to persuade the patient to make this change. It contributed to
increase patient knowledge.
Level 1 outcome (situational relevance): On July 7, 2008, P18 did a search at work, by themselves, and after an
encounter with a patient. They retrieved one information hit about treatments for Obsessive-Compulsive Disorder
(OCD). The reported search objectives were: to address a clinical question, to
look up something they had forgotten and to share information with a patient or
caregiver. “He [the patient, a
man of 22 years old] has been diagnosed OCD and he is trying to
deal without medication. But he’s going back to University in the fall and he
just needed to have something to help out a little bit more. So he heard that
SSRI’s [Selective Serotonin Reuptake Inhibitor] were useful and he wanted to know which SSRI
would be the better choice for him, which has little side effects. […] I wasn’t sure
if they [SSRIs] all work exactly for OCD or if one works more
[…] or in terms of side effects what, what’s more
useful what’s not. […] We [P18 and patient] discussed what
some of his options were.” According to P18, the
information from e-Therapeutics+ was in agreement and equally relevant as the
information from another electronic resource (Up-to-Date).
Level 2 outcome (cognitive impact): One hit was associated with a report of positive
cognitive impact (see table). Regarding learning, P18 stated: “I probably just brushed up on the side
effects in terms of comparing one to another. [I learned] that Cipralex is not used for OCD.”
Retrieved
information hit:
1) e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Obsessive Compulsive Disorders – Anxiety
disorders – Table 3 Drugs used for the management of
Anxiety Disorders – Check all drugs under SSRI’s and SNRI’s–Compare drugs (P18S05H01)
Level 3 outcome
(information use): Information on treatments for
Obsessive Compulsive Disorder 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 the patient to make this change (information presented in
e-Therapeutics+ was modified). “I added more information [about] what are
the options for OCD […] [I had] to persuade or I’d say
educate [him, the patient] because
he was concerned about all the side effects he thought he would have from these
meds. […][I told him that] based on the percentage of
people who experienced certain side effects […], for him, the benefits
would probably lean more towards taking the medication.”
Level 4 outcome (patient health): Regarding patient
health, P18 reported that the information contributed to increase patient
knowledge. “He [the patient] came looking
for information about medication for OCDs. […] He didn’t know anybody that has OCD or he
didn’t know of other people who took those medications [SSRI] so I guess it
becomes […] more acceptable if you hear that some people
do take it and they have no side effects.”
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 |
Learned something Reminded something Confirmed Reassured |
Persuade Be more certain Understand issue |
Patient knowledge |