Patient Education and Counseling vol:68 issue:1 pages:61-65
Objective: The project aimed to search for online evidence in a structured way in consultation with the patient, to investigate whether the evidence discovered changed directions. Methods: We developed the 'Online on-the-spot' method (OOS) as a part of a quality improvement program. Within a general practice consultation three physicians and two trainees searched in a fixed pattern and sequence the nationa guidelines of general practitioners developed by the Dutch College of General Practitioners, Clinical Evidence, Trip-database and the British Medical Journal. All GPs who performed this quality improvement program were in facor of the project. Results: During 3 months five GPs registered 365 searches out of 2920 patient-doctor contacts. For each eight patient-doctor contacts there was one online search. Patients were actively involved in 53% of the searches (95%CI: 48-57%). On average, two databases were consulted. An answer to the question was found in 87% of cases and in almost half of cases it was relevant new information for the doctor. The GP changed his diecision due to the problem in 26% (95%CI: 21-29) of cases. At the end of the OOS project, the number of searches within 5 min were significantly higher than at the start: 51% (95%CI: 44-59) to 33% (95%CI: 24-43), respectively. Conclusions: The OOS project is a timely answer to the doctor's educational needs in attending to the patient. Practice implications: OOS could connect the patient, the doctor and the evidence.