P29S02: Contraception
Bottom line: Information on contraception was used to maintain the management of a patient (prescribe a
contraceptive pill). There were no
information-related patient health outcomes.
Level 1 outcome (situational relevance): On February 5, 2009, P29 did a search at work, by themselves, and after
an encounter with a patient. They retrieved two
information hits about contraception. The reported search
objective was: to look up something they had forgotten. “[…] It was an adolescent woman [17 or 18 years
old] I’d seen. […] Lots of [adolescent women] come in
wanting the pill. I had seen her in the past couple weeks, and every time I see
a woman and she wants the pill, I’m reminded that I don’t remember the
contraindications, and so, this was just the most recent [patient]. [...] She had
migraine without aura.” According to P29, e-Therapeutics+ was the
only source for information, and the found information was relevant.
Level 2 outcome (cognitive impact): Two hits were associated with a report of positive
cognitive impact (see table). Regarding practice improvement, P29 stated: “[My practice will be improved because] I might
remember one more contraindication. Every time I look at the list, hopefully
I’ll remember a couple more.” Regarding confirmation and reminder, P29 stated: “I already knew the highlight. […] I [don’t] give it [the pill] to patients who
have migraine with aura. […] I’ve been using that information in my
practice and it just confirmed that.”
Retrieved
information hits:
1)
e-Therapeutics+ (CIRT): Therapeutics Tab – Sexual health –
Contraception –Table 1 (P29S02H01)
2)
e-Therapeutics+ (CIRT): Therapeutics Tab – Sexual health –
Contraception –Highlight (P29S02H02)
Level 3 outcome
(information use): Information on contraception was retrieved, and used to maintain (be more certain about) the
management of a patient (information was used as presented in
e-Therapeutics+). “I know them all [absolute
contraindications], I just don’t remember them when I’m with the patient [P29
double-checked the 13 absolute contraindications in e-Therapeutics+ after the
encounter, and did not call back the patient to ask further questions]. [...] When I saw the
patient, I asked questions [based on P29 knowledge of 3 absolute
contraindications] to determine whether she had a migraine with aura or not. I
didn’t consider alternative contraceptive methods because she didn’t have
migraines with focal neurological signs. She didn’t smoke and she wasn’t
hypertensive. […] So basically I gave her the pill because
there were none of those worrisome things.”
Level 4 outcome (patient health): Without these
information hits, P29’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 |
|
Look up something forgotten |
Practice improved Reminded something Confirmed Reassured |
Be more certain |
No outcome |