P19S09: Constipation (Metamucil same dose)
Bottom line: Information on constipation was used to maintain the
management of a patient (continue the same Metamucil preparation and dose to
prevent constipation). There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On November 10, 2008, P19 did a search at work, during an encounter
with a patient and a colleague (dietician). They retrieved two information hits
about Metamucil preparations. The reported search objectives were: to address a clinical question, to
share information with a patient, and to exchange information with another
health professional. “It was a woman [in her
fifties] and she’s a type 2 diabetic. […] The clinical
question was, was the amount of Metamucil this lady was using going to impact
her blood sugars? […][We - P19 and the dietician - wanted to
know] if it was ok for her to keep using this or if she had to switch to the
sugar free [Metamucil].” According to P19,
e-Therapeutics+ was the only source for information, and the found information
was relevant.
Level 2 outcome (cognitive impact): The second hit was associated with a report of positive cognitive
impact (see table). Regarding practice improvement and learning, P19 stated: “[I have learned] the amount of
carb or sugar in the [Metamucil] product. […] I know that depending on the dose that the
person is using - a teaspoon or two a day -, that it probably won’t have much
impact on their blood sugars, […] unless they’re very brittle. [For future
patients] I wouldn’t necessarily be too concerned
about using this particular product if they have diabetes. […] I could take
into account how much they’re using and how often. [...] [From the found
information, we learned] that four teaspoons has about 45 calories. So we kind
of estimated that was 11 grams of carbohydrates. ”
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): eCPS Tab – Keyword: Metamucil – Metamucil preparations – Supplied – Orange flavor (P19S09H01)
2) e-Therapeutics+ (CIRT): eCPS Tab – Keyword: Metamucil – Metamucil preparations – Dosing
recommendation – Orange flavour – Table 3 (P19S09H02)
Level 3 outcome
(information use): Information on Metamucil preparations was
retrieved, and used to better understand a specific issue with
respect to the management of the patient, and to maintain (be more certain about) the management of the patient (information used as presented in e-Therapeutics+). “The dietician
and I had a joint appointment with the patient and we went through their
medications. […]She[the patient] was using a low dose[of Metamucil] so we said:
“That’s fine, if you’re just using a little bit it’s probably not going to make
too much difference to your blood sugar levels”. […] And so she [the patient] continues to
use it.”
Level 4 outcome (patient health): Without these information hits, P19’s management of the patient would
have been the same. There was no clear relationship between the information use
and patient health outcomes.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Share information Exchange information |
Practice improved Learned something Reminded something |
Be more certain Understand issue |
No outcome |