P29S05: Constipation in pregnancy
Bottom line: Information on constipation (lactulose) was used to
maintain the management of a patient (add fiber to diet). There were no information-related patient
health outcomes.
Level 1 outcome (situational relevance): On May 14, 2009, P29 did a search at home, by themselves, and after an
encounter with a patient. They retrieved one information hit about constipation
(lactulose). The reported search objective was: to address a clinical question. She [the patient] is 19 years old, she's pregnant, anxious and
constipated. [
] It's been a problem for a while. She's at the
end of her 2nd trimester now. [
] She came in for regular obstetrical
follow-up. [
] I decided to not give [Lactulose]. [But my clinical question was]: can I give her
Lactulose. According to P29,
e-Therapeutics+ was in agreement with and equally relevant as the information
from another electronic resource (Up-to-Date). [
] I went to e-Therapeutics and I was actually
valuing the eCPS's answer over Up-To-Date. It just happened to be the same as
Up-To-Date in this case.
Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding
practice improvement and learning, P29 stated: Its [my practice] always improved whenever [
] you can feel a
bit less like youre guessing. [
][I will be] more confident not giving Lactulose. [
] I can just more
confidently say, lets try All-Bran first. [
] I learned something new, because I thought
it [Lactulose] was benign thing to give. Now if I am really gonna give it, I
will try other things first and I sort of give them a little caveat before.
Retrieved
information hit:
1)
e-Therapeutics+ (CIRT): eCPS Tab Lactulose Search for
word: Pregnant Paragraph on pregnant women (P29S05H01)
Level 3 outcome
(information use): Information on constipation was retrieved,
and used to maintain (be more certain about) the management of
a patient (information used as presented in e-Therapeutics+). It [the retrieved information] just confirmed
that I had made the right decision on the spot, and that I didnt have to go
back and change my plan.
Level 4 outcome (patient health): Regarding patient
health, P29 reported that there were no information-related outcomes. I didnt really expect a health benefit.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question |
Practice improved Learned something Confirmed Reassured |
Be more certain |
No outcome |