P26S02: Depression
Bottom line: Information on an
antidepressant was used to better understand
a specific issue about a patient (adverse effects associated with Seroquel).There were no
information-related patient health outcomes.
Level 1 outcome (situational relevance): On April 21, 2009, P26 did a search at work, by themselves, and after
an encounter with a patient. They retrieved one information hit about Seroquel. The reported search objectives were: to address a
clinical question and to look up something they had forgotten. “The patient [a man in his thirties]
presented with depression and [had] paranoid ideas. The staff that I was with
suggested that if the anti-depressive treatment didn’t work, that maybe we
could give small doses of Seroquel at bed time. I went to see what adverse
effects he could have if I started treating him with that. It seems this was a
patient who really didn’t like medication. [INT: what was your clinical
question?] What are Seroquel’s adverse effects? [...] I didn’t remember that by
heart at all.” According to P26, 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 practice improvement and learning, P26 stated: “I think there’s an improvement when you
really know the adverse effects of the medication that you prescribe, and so
then you can better monitor and prevent them. [...] We are more aware of
possible adverse effects. [I learned which ones were] the types of possible
pain with Seroquel.”
Retrieved
information hit:
1)
e-Therapeutics+ (CIRT): eCPS Tab – Keyword: Seroquel – Seroquel (M) – Adverse
reactions – Table 1 (P26S02H01)
Level 3 outcome
(information use): Information Seroquel was retrieved, and
used to better understand a specific issue about this patient (information used
as presented in e-Therapeutics+). There was no follow-up. “The patient left, but I told myself that if I see him again and if his
treatment with anti-depressives didn’t work, [Seroquel] could have been an
option. [I wanted to verify about Seroquel] and to have tools [if I needed to
intervene later]. [INT: Was this information used for this patient?] I didn’t
just treat him now, but I will consider [Seroquel if needed.]”
Level 4 outcome (patient health): Not applicable
(conceptual use).
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Look up something forgotten |
Practice improved Learned something Reminded something Motivated to learn Confirmed Reassured |
Understand issue |
No outcome |