P18S06: Endometriosis
Bottom line: Information on endometriosis was used to
justify the management plan for a patient (stop DepoProvera injections, and check bone mineral density),
and to persuade the patient and other health professional to make this change. It contributed to increase patient
knowledge, and prevent health deterioration.
Level 1 outcome (situational relevance): On June 30, 2008, P18 did a search at work, with a patient, during the
encounter. They retrieved two information hits about Endometriosis. The reported
search objectives were: to address a clinical question, and to share
information with a patient or caregiver. “The patient [a 28-year old
woman] has endometriosis [that was not controlled after] five or six
years on DepoProvera. […] I needed to find an option for her […] because she has
terrible pain with the endometriosis, that she is not able to control […] [with] the DepoProvera
injections. […] At least she shouldn’t be using DepoProvera
anymore.” According to P18, the information from e-Therapeutics+
was in agreement and equally relevant as the information from two other
electronic resources (Up-to-Date and
Micromedex).
Level 2 outcome (cognitive impact): The two hits were associated with a report of positive cognitive
impact (see table). Regarding learning, P18 stated: “I didn’t know anything about endometriosis.”
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Endometriosis – Highlight (P18S06H01)
2) e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Endometriosis – Drug used for Endometriosis-Associated pain - Table 2 (P18S06H02)
Level 3 outcome
(information use): Information on Endometriosis was retrieved, and used to better understand a specific issue with respect to the management of
the patient, to justify the management plan for a patient (stop DepoProvera injections, and
check bone mineral density), and to persuade the patient and other health
professional to make this change (information used as presented in
e-Therapeutics+). “[With the
retrieved information] I wanted to be able to justify that she [the patient]
[…] have a bone mineral density [test]. […] The doctor put her back on the birth control pill [stopped DepoProvera
injections], and [...] that was fine. [...] The patient was pleased in terms of pain
control. She was [then] well controlled in terms of endometriosis, but she
wasn’t aware of the damage that she was doing to her bones [with the DepoProvera
injections she had taken for so long]. […][Her] healthcare professional [gynaecologist]
thought that she was too young [to have a bone mineral density test]…until the test
was done, and then they realized the effect the drug has [on the
patient, i.e., osteopenia]. […][I needed to persuade] the patient
and the physician [to do the test].”
Level 4 outcome (patient health): Regarding patient
health, P18 reported that the information contributed to increase patient
knowledge, and prevent health deterioration. “She [the patient] needed to be
educated on the medication she was on. […]I guess she [also] needed to be open and
accepting to have the test [bone mineral density test] done.[…] She’s already
osteopenic so I guess [I wanted] to prevent osteoporosis. […][Her] healthcare
professional [gynaecologist] thought that
she was too young [to have a bone mineral density test]…until the test
was done, and then they realized the effect the drug has [on the
patient, i.e., osteopenia]. […][I needed to persuade] the patient
and the physician [to do the test]. […] Hopefully [it would] reverse some
of the changes or at least to stop the bones from deteriorating.”
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information |
Learned something Motivated to learn Reassured |
Persuade Justify choice Understand issue |
Prevent Patient knowledge |