P30S01: Meningitis
Bottom line: Information on meningitis was used to maintain the
management of a patient (double-check rules for prescribing vaccine against
meningitis for a child over 5 years old). There were no information-related
patient health outcomes.
Level 1 outcome (situational relevance): On April 5, 2009, P30 did a search at work, by themselves, and after an
encounter with a patient. They retrieved one information hit about meningitis.
The reported search objectives were: to address a clinical question, to
fulfill an educational or a research objective, and to share information with a
family caregiver. “It was a 10 year-old boy coming in for a general examination. He’s
from another country so I revise his vaccination and I see that he didn’t get
the meningitis vaccine when he was about one year old. […] I discuss with a
supervisor who tells me that […] when you’re more than five years old, you
don’t need this coverage anymore. But there’s a new quadrivalent vaccine that
covers all rarer types of meningitis that can possibly occur at a more advanced
age and that is not covered by the government since it’s optional. […] I am
told that it’s important to discuss with the parents, that it’s the parents’
decision, but that it’s not mandatory. The risks for meningitis are not like
during childhood. […] The question was
[to verify what] the other vaccine [was], […] and to know if we should
recommend it or not. [...] [I searched] for my own personal education. […] It
allows me to share the information with future patients with greater
confidence.” According to P30,
e-Therapeutics+ was in agreement with and equally relevant as the information
from another health professional (supervisor), and more relevant compared to
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
practice improvement, P30 stated: “I wasn’t aware of this vaccine before, so I wouldn’t even have talked
about it. Ma practice is changed in the sense that now I know what to say about
this vaccine.”
Retrieved
information hit:
1)
e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: Meningitis – Bacterial Meningitis – Prevention vaccines (P30S01H01)
Level 3 outcome
(information use): Information on meningitis was retrieved, and used to better understand a
specific issue with respect to the management of the patient, and to maintain (be more certain about) the management of a patient (information used
as presented in e-Therapeutics+). “The child was with his parents. In this context, I did the search after
the parents left. So I used the information that my supervisor just gave me [...],
and with the financial context, and since this vaccine was not clearly
indicated, the parents preferred not to take it. [...] [The information] was used for me, to
better understand the use of this vaccine. [...] The information that was
transmitted, and that came from the supervisor, was the same as the information
that I found. So I didn’t have to call back the parents or to change anything.”
Level 4 outcome (patient health): Without these
information hits, P30’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 |
|
Address a clinical question Fulfill educational objective Share information |
Practice improved Motivated to learn Confirmed Reassured |
Be more certain Understand issue |
No outcome |