P28S07: Asthma
in children (corticosteroids)
Bottom line: Information on asthma
was used
to maintain the management of a patient (use corticosteroids). 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 after an encounter with a patient. They retrieved two
information hits about asthma. The reported search objective was: to search in general or for
curiosity. I
had finished the admission and I just wanted to be prepared for when I spoke
with the staff the next day, [
] with
respect to one of the patients [in]
pediatrics. [
] It
was a child [a boy under 10 years old] with
fairly advanced asthma. We were trying to decide what corticosteroid to put him
on. Theres kind of an understanding that corticosteroids in young age do
actually change height, or thats what I was under the impression of. So I was
looking at what other corticosteroids are indicated, because I know
Sequesonide, and another one, can be used in asthma treatment, and are supposed
to have less systemic effects but, apparently Budesonide can be used as well. According to P28, e-Therapeutics+ was the only source
for information, and the found information was relevant.
Level 2 outcome (cognitive impact): Both hits were associated with a report of positive
cognitive impact (see table). Regarding confirmation, reassurance and
reminder, P28 stated: The page goes over where
you would start, what is the principle of management. It talks about
short-acting beta-agonists, long-acting beta-agonists, so it was a nice review
I guess of the therapeutic approaches which I already had a grasp of. [
][The
highlight] does confirm Im doing the
right thing, because [
] I
did eventually use Budesonide in the patient [
] I
was reassured that I was doing the right thing. [
] I
remember hearing about loss of height in children on systemic steroids.
[
] I asked the staff the next day what he thought and
he also said that Budesonide doesnt cause height decreases, although now they
tend to use Sequesonide anyway.
Retrieved
information hits:
1) e-Therapeutics+ (CIRT): eCPS Tab Keyword: Asthma Asthma
in infants and children Whole page (P28S07H01)
2) e-Therapeutics+ (CIRT): eCPSTab Keyword: Asthma Asthma
in infants and children Highlight (P28S07H02)
Level 3 outcome
(information use): Information on asthma was retrieved, and used to
maintain (be more certain about) the
management of a patient (information used as presented in
e-Therapeutics+). I had put the patient on
corticosteroid and it [the retrieved information]
justified that.
Level 4 outcome (patient health): Without
these information hits, P28s 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 |
|
Satisfy curiosity |
Reminded something Confirmed Reassured |
Be more certain |
No outcome |