Anonymous Story (July 29, 2009)
“Many of our patients have been seeing naturopathic doctors for alternative treatments. After they’re seen, I find they come to the pharmacy and ask me what I think of the naturopathic products. In order to give a full explanation to my patients, I always check the evidence so that I know I’m giving them the best, evidence-best, advice. I use Cochrane Systematic Reviews to look for meta-analyses that may show that these products work.
My patients were able to make informed decisions about their health care. I find the access I have to this information empowers our patients to make better decisions on their own. It’s important to me as a health care professional because I no longer have to fight to prove to patients that evidence is the way to go when making decisions. I provide them with the information and they make their choices.
The end result is amore educated population of patients and also less stress on our health care system. Rather than booking multiple appointments with physicians, I can quickly give people information that could ultimately save everyone lots of time and energy.”
Jason’s Story (July 15, 2009)
Jason Murdoch, a family physician in Burlington, Ontario shares his story on using Cochrane reviews when making medical decisions for his patients:
“It is becoming increasingly difficult to find honest, reliable, and practical information to run my family practice. I have relied on The Cochrane Library to inform me what the best non-biased evidence is on many different topics.
In 2007, there was a big pharmaceutical push to use Acetyl cholinesterase Inhibitors for Mild Cognitive Impairment (MCI). I was unsure how reliable the data was regarding the effectiveness of this treatment, so I looked up The Cochrane Library and the review clearly stated it was unlikely to be helpful—as I felt anyway—so I don’t typically prescribe cholinesterase inhibitors for MCI.
Having avoided prescribing drugs with bad side effects and no clear benefit, I now feel that my patients are safer. Less is more!”
Karen's Story (July 8, 2009)
“I know several people—mostly older—who are looking for symptom relief for digestive and respiratory problems. None of them are rich and all of them would rather not take any more medications than they are already taking. I read the reviews and clinical trials for three easy-to-obtain ingredients that could be taken in combination as a “tea” drink to reduce inflammation, upper and lower gastrointestinal symptoms with no significant effects on cholesterol (or anything else). Now four people that I know are drinking a tea composed of turmeric, ginger, honey and hot water; each is reporting improved digestion.
Although the drink is an acquired taste, it has a calming effect on the digestive tract and it is very inexpensive to make. However, in order to convince members of my family and friends that a safe and cheap remedy was available in their spice cabinet, I needed Cochrane reviews to lend credibility to this advice because otherwise, it was just too simple to believe.
Knowing that other people have been involved in clinical trials that demonstrate they had a true reduction in symptoms from irritable bowel, dry cough and reflux by using a simple combination of spices has given members of my family and friends the curiosity and desire to try such remedies themselves. My mother and my aunt are now including their daily tea tradition as preventive medicine against cough and digestive flare-ups.
An ounce of prevention is really worth a pound of cure for these chronic conditions that need not decrease the quality of life if they can be better controlled with safe and economical ingredients. More people should be encouraged to experiment with foods that heal. Using The Cochrane Library just helps substantiate a decision to incorporate into our diet the things that will help with the symptoms we need to relieve.”
Alison's Story (June 30, 2009)
Health care professionals rely on solid research to support evidence-based decision making. Alison Hoens, a Physical Therapy Knowledge Broker from the University of British Columbia and Physiotherapy Association of BC, shares her story on how Cochrane is “a crucial piece of the puzzle in providing evidence-informed care.”
"I use Cochrane to foster evidence-informed decision making in all areas of my work: (1) teaching physiotherapy students and clinicians, (2) facilitating the incorporation of evidence into clinical practice standards and (3) informing research.
With respect to teaching, I use and teach the use of Cochrane as the first line of evidence when doing a literature search. Other databases such as CINAHL, EMBASE, EBMreviews and MEDLINE/PubMed are used to supplement evidence obtained from Cochrane. According to best practices of evidence-based medicine, meta-analyses and systematic reviews are the highest level of evidence and thus I always access Cochrane prior to looking for Randomized Controlled Trials. Additionally, the Cochrane collaboration is highly respected given its methodological rigor. I teach clinicians to use Cochrane to quickly obtain the best summary of the evidence to date.
With respect to the development of clinical practice standards, I primarily use Cochrane to establish the evidence base for specific physiotherapeutic interventions. This evidence is then used to guide clinical practice for the 100 physiotherapists across our six facilities of Providence Health Care that incorporate the spectrum of acute, rehabilitation and residential care. For example recent decisions on best practices for management of hemiplegic shoulder were guided by incorporation of evidence obtained from Cochrane.
Finally, in my research role, I use Cochrane to identify key evidence for the literature review that guides the research plan.
In summary, for my efforts to incorporate evidence into practice for physiotherapy clinicians Cochrane is a gift. The authors have done the hard work for us in rigorously collecting, analyzing and synthesizing the best available evidence. Decision-making for health care is extremely challenging but would be infinitely more challenging and less satisfying, without Cochrane."
Anonymous Story (June 24, 2009)
Cochrane evidence can be a powerful enabler to policy-making or to introducing new protocols that will benefit the health of certain populations. This story is from an associate professor at a Canadian university, who has also acted as a dental consultant for Health Canada, more specifically to the First Nations and Inuit Health Branch:
“I was setting protocols for dental prevention programs and carrying out systematic reviews of preventive dental interventions and risk assessment in order to clarify best practice in dental care, such as frequency of brushing, teeth to involve, when to intervene, what pattern, etc. By using the most recent dental prevention studies by Marinho et al. and incorporating that with the epidemiology and level of risk of the target population –the First Nation and Inuit children—I was able to give authority to my recommendations. This way, First Nations and Inuit children will get services targeted to their level of need in the most appropriate manner in order to prevent or reduce oral diseases in this particularly vulnerable population. They will benefit much more from the new protocol which will reduce diseases, pain and suffering. This is especially important in a geographically-isolated population where access to care and treatment is difficult. Changing policy and protocols is an up-hill battle. Having sound evidence has certainly made it more convincing and easier to create new policies regarding who and when should receive certain services. It has also enabled me to not only draft new protocols but to also have them accepted.”
Johanna's Story (June 15, 2009)
The Cochrane Library is an excellent start-point for consumers seeking the best care for their family members because Cochrane evidence can not only serve as an empowerment tool for health clients but can also result in a much more efficient visit to the doctor. Here is Johanna’s story for using Cochrane systematic reviews to help her evaluate the drugs prescribed to elders in her family:
“I use Cochrane reports to aid in having conversations with health care professionals about drugs being prescribed to elders in my family. Over-medication of the elderly is a serious problem in Canada. For patients, it has serious side-effects, both mentally and physically. It also has significant implications on our health care system. Hospital admissions due to adverse drug reactions or drug interactions are extremely costly, not to mention the costs of drugs themselves! Using hard evidence in discussions with doctors helps raise credibility when questioning prescribing decisions and asking certain drugs to be removed. I believe some of my elders have lived longer and healthier by using fewer drugs. I got to enjoy their company longer and they were in a much less confused state of mind and more comfortable physically.”
