Since the beginning of our collaboration with UpToDate (UTD) on the International Grant Subscription Program in 2009, more than 120 organizations and close to 200 clinicians have benefited from a donated subscription. Most have been able to renew the donation every year.
Clinicians regularly share with us how they use this resource in a private community on GHDonline.org. They change patients’ treatment courses or provide medical education opportunities to their colleagues for example. Here is a selection of their testimonials.
We use UTD for a myriad of activities, including the creation of protocols for rural health centres, as well as hospitals, and reviewing quick clinical questions. The ability to have a local copy on a computer and to access UTD on the web is useful and makes us able to be more versatile in accessing UTD. – Katherine Liu, Fellow, Centre for Infectious Disease Research in Zambia – CIDRZ (May 10, 2012)
We find it [UTD] invaluable in answering clinical queries, especially in situations that we often have when we do not have access to specialists for advice. We also use it for running CPD sessions for doctors and nurses in our clinic and in preparing teaching for the community health workers. – Alison Malcolm, Physician, Good Shepherd Clinic in Jeedimetla, India (May 11, 2012)
We also use it [UTD] in the clinic at the point of care in China. We have found it especially useful before sending patients to specialists and communicating with them, because it gives us reliable standard of care and evidenced-based care perspective. – Kenneth Rudd, volunteer physician in China (May 11, 2012)
We have two Medical officers in the School Clinic Where I work. That is where we use UPTODATE most.Upon reaching a Diagnosis, we use UPTODATE to review our impression.We study the History and Clinical features as presented by UPTODATE and compare to what we have in our notes. We also study the treatment suggested by UPTODATE and compare it to what we had earlier planned.We then adopt the most suitable for the patient. – Dr Christopher Innocent Akpan, Medical Officer, Africa Partners Medical, Nigeria (May 10, 2012)
UTD has helped me in so many ways as I care for patients. I use it all the time. I recently had a pt that I suspected was having a reaction to the medicines that she was taking. By using UTD, I was able to quickly look at the side effects of her medicines and then determine that she was having Serotonin Syndrome. I then, was able to treat her according to the recommendations on UTD. Without UTD, it would have taken me a while to get to that diagnosis, especially with our outdated textbooks that are available to me here in PNG. – Erin Meier, Physician, Kudjip Nazarene Hospital, Papua New Guinea (September 30, 2011)
UpToDate is a great resource which is a ready available source of current evidence-based medical practice. It is also an available and accessible reference on conditions affecting our patients. I had a patient who had tranverse colectomy for transverse colon cancer. Histology was moderately differentiated adenocarcinoma. We planned for adjuvant chemotherapy because she had lymphadenopathy(2 nodes). 2 issues that arose:
- choice of chemotherapy
- when to start
With UpToDate we were able to chose bolus 5FU with leucovorin (but later found out that she could not afford leucovorin) so we settled for 5FU with levamisole, an older and less effective regimen though common here. Thankfully it was still useful and backed by evidence but learnt that there were reports of multifocal cerebral demyelinating syndrome, which we will watch out for.
With UpToDate we realized that starting within 8 weeks after surgery was probably better (we started after 4 weeks).
Sometimes we are limited in the quality of care we can offer in our environment because of challenges of poverty and infrastructure, but right now, thanks to UpToDate, it is not due to lack of knowledge about what is best. Thanks Bashiru – Bashiru Ismaila, Fellow, Nigerian Medical Association (October 1, 2011)
Our organization runs a medical school/hospital and clinic inside the war-zone in Myanmar. UTD has been of value on two fronts. We use the clinical and pharmaceutical information in preparing and enhancing our lectures. We use it as a reference for patient care. There have been times when it made the crucial difference in patient survival:
- a boy with difficult to manage status epilepticus
- a pregnant woman with wet beri-beri
- an adult with severe orbital cellulitis
- clarifying the ‘tropical’ causes of persistent right upper quadrant pain.
In many other clinical experiences, in our isolated context, it was so helpful to have this complete source of knowledge in a format that doesn’t depend on the internet or a book that will rot in the rainy season or get eaten by termites! One of my colleagues likes to say “All a good doctor needs is compassion, competence and supply.” UpToDate is a superlative aid to competence. – John Shaw, MD, Free Burma Rangers (October 4, 2011)
Greetings from Tanzania. In the almost two months that we have access to TUD, we made use of the service after basically every ward round or day in the clinic.
It helped us to improve care of very common disorders like ascites in liver cirrhosis in a setting, where current recommendations or expert opinions aren’t accessible otherwise. Our junior doctors found good answers to daily questions, like how much fluid to draw on paracentesis at what intervals, or if fluid replacement is necessary. It gave good arguments against old but locally established norms of how to treat it. Also senior doctors found good advice on symptoms like e.g. hematospermia, where we otherwise wouldn’t have ressources to find comprehensive information. The same accounts for seminars or lectures – UTD saves a lot of time in preparation of such events and certainly improves their quality. – Fabian Franzeck, MD, Ifakara Health Institute, Republic of Tanzania (November 17, 2011)