P28S05: Panic
disorder
Bottom line: Information on panic disorder was used to justify the management of a
patient (prescribe anti-depressant). There were no information-related
patient health outcomes.
Level 1 outcome (situational relevance): On May 19, 2009, P28 did a search at work, by themselves, and during an
encounter with a patient. P28 left the examination room, retrieved three
information hits about panic disorder,
discussed with their supervisor, and went back to the room. They retrieved three information hits about panic disorder. The reported search
objectives were: to address a clinical question, to share information with the
patient, and to exchange information with other health professional. She [the patient, a
37 years old woman] came in complaining of anxiety. She was
crying, very nervous during the interview. In my head, I kind of thought she
either had generalized anxiety disorder of panic disorder because she said she
wasnt really leaving the house much. [
] So I needed a way to treat it. [
] I didnt know
exactly what was the first line treatment for anxiety disorders, so I looked
that up. [
] The patient also had a phobia of taking
pills, [so I needed to reassure her] and tell her, you know, this [citalopram, an
antidepressant, Selective Serotonin Reuptake Inhibitors (SSRIs)] is a recommendation. [
] I looked it up
and afterwards I discussed with my staff [supervisor] and they agreed. According to P28, e-Therapeutics+ was in agreement with and equally relevant as the information from another
health professional (family medicine team).
They recommended that I use Celexa [citalopram] as well.
Level 2 outcome (cognitive impact): Two hits were associated with a report of
positive cognitive impact (see table). Regarding practice improvement and learning, P28 stated: I learned how to treat an anxiety disorder
and Ill probably remember the Celexa next time I see one. [
][I also
learned] which medications are first line for
generalized anxiety disorder. (P28S05H01, P28S05H03).
Retrieved information hits:
1) e-Therapeutics+ (CIRT): eTherapeutics Tab Keyword: Panic disorder Anxiety disorders Highlight Antidepressants (P28S05H01)
2) e-Therapeutics+ (CIRT): eTherapeutics Tab Keyword: Panic disorder Anxiety disorders Benzodiazepine (P28S05H02)
3) e-Therapeutics+ (CIRT): eTherapeutics Tab Keyword: Panic disorder Anxiety disorders Generalized anxiety disorder (P28S05H03)
Level 3 outcome
(information use): Information on panic disorder was retrieved, and used to better understand
a specific issue with respect to the management of the patient, and to justify
the management of a patient (information used as presented in e-Therapeutics+). [The information was used] just for
prescribing. [...] She [the patient] was on no medication. [
] I prescribed
her Celexa and I also gave her a consultation with a psychologist for her
anxiety. [
] Im not sure how much its going to work the
Celexa, because shes had it [the panic disorder] for over 15
years.
Level 4 outcome (patient health): Patient
health outcomes were unknown (no follow-up).
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 Motivated to learn Reassured |
Justify choice Understand issue |
No outcome |