P27S03: Migraine (prescribe triptan)
Bottom line: Information on migraine was used to
modify the management of a patient (prescribe triptans). It contributed to avoid inappropriate
treatment, and to improve health.
Level 1 outcome (situational relevance): On February 6, 2009, P27 did a search at work, by themselves, and after
an encounter with a patient. They retrieved one
information hit about migraine. The reported search objective was: to look up something they had
forgotten. “The poor
patient [a 17-year old girl],
was suffering from migraines for 2 years. [I] searched to
find something, the best solution, to relieve the pain. [...] I was looking for a way to control
the migraines, a preventive measure. [...] [She missed time from school when] she had to stay
home because of photophobia. [...] I had forgotten the
dosing for all triptans. [...]
I looked for different doses, for how long
the therapeutic effect lasted, and all that.” According to P27, e-Therapeutics+ was in agreement and less relevant
than 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
motivation, confirmation, reassurance and reminder, P27 stated: “[I still
had questions, so] I was motivated to go search
in other sources]. [...] [The information confirmed that] I used the
correct dose, the one indicated in the table, [...] [and it reassured me]. [...] I had already, [...] but it was to make sure.”
Retrieved
information hit:
1)
e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword:
Migraine – Headache in adults – Whole page (P27S03H01)
Level 3 outcome
(information use): Information on migraine was retrieved, and used to modify the management of a patient (information used as presented in e-Therapeutics+). “[The patient]
came after two years of headaches and she expected a negative response, [for me to say
that I have no
other treatment to offer her]. [...] She has [tried]
about twenty different drugs. [...] [I wanted] her to
use one of the triptans. [...]
I saw her 2 times after that and I [actually] changed
the treatment.”
Level 4 outcome (patient health): Regarding patient
health, P27 reported that the information contributed to avoid inappropriate
treatment and to improve health. “She [the
patient] had already used multiple medications, so [I was] just
wanted to prevent unnecessary medications.
[...] [I wanted] to improve her health and enable her to go back to [school] instead
of staying at
home. [...] She returned to her studies. [...] [Regarding pain] She showed evolution, improvements. The second time I saw the patient, I saw progresses.”
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Look up something forgotten |
Reminded something Motivated to learn Confirmed Reassured |
Manage differently |
Improve Avoid |