Online on-the-spot searching increases use of evidence during consultations in family practice.
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 decisions.


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 national 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 favor 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%C.I.: 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 decision due to the problem in 26% (95%C.I.: 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% C.I.: 44-59) to 33% (95% C.I.: 24-43), respectively.


CONCLUSIONS
The OOS project is a timely answer to the doctors' educational needs in attending to the patient.


CONCLUSIONS
OOS could connect the patient, the doctor and the evidence.
Van Duppen
Dirk
D
Group Practice Doctors for the People, Deurne, Belgium.
Aertgeerts
Bert
B
Hannes
Karin
K
Neirinckx
Jasna
J
Seuntjens
Lieve
L
Goossens
Filip
F
Van Linden
Annelies
A
D001291:Attitude of Health Personnel; D001530:Belgium; D016208:Databases, Factual; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000193:education / Q000458:organization & administration*; D005194:Family Practice / Q000193:education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D020407:Internet / Q000458:organization & administration*; D010358:Patient Participation; D018802:Patient-Centered Care; D019095:Point-of-Care Systems / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D015397:Program Evaluation; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration; D013996:Time and Motion Studies; D017749:Total Quality Management