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

ObjectiveThe project aimed to search for online evidence in a structured way in consultation with the patient, to investigate whether the evidence discovered changed decisions.MethodsWe 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.ResultsDuring 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.ConclusionsThe OOS project is a timely answer to the doctors’ educational needs in attending to the patient.Practice implicationsOOS could connect the patient, the doctor and the evidence.