Isabelle Côté

Laval University, Quebec City, Quebec, Canada

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Publications (26)56.08 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Transplant glomerulopathy (TG) is a diagnostic criterion for chronic active antibody-mediated rejection (CAABMR), with C4d, donor-specific antibodies (DSA) and other lesions of chronic tissue injury. However, TG often presents without C4d or DSA. Until recently, such cases were termed suspicious for CAABMR, and their prognosis remains unclear.
    Transplantation 07/2014; 99(1). DOI:10.1097/TP.0000000000000310 · 3.78 Impact Factor
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    ABSTRACT: Delayed graft function (DGF) has a negative impact on graft survival in donation after brain death (DBD) but not for donation after cardiac death (DCD) kidneys. However, older donor age is associated with graft loss in DCD transplants. We sought to examine the interaction between donor age and DGF in DBD kidneys. This is a single-center, retrospective review of 657 consecutive DBD recipients transplanted between 1990 and 2005. We stratified the cohort by decades of donor age and studied the association between DGF and graft failure using Cox models. The risk of graft loss associated with DGF was not significantly increased for donor age below 60 years (adjusted hazard ratio [aHR] 1.12, 1.51, and 0.90, respectively, for age <40, 41-50 and 51-60 years) but significantly increased after 60 years (aHR 2.67; P = 0.019). Analysis of death-censored graft failure yielded similar results for donor age below 60 years and showed a substantially increased risk with donors above 60 years (aHR 6.98, P = 0.002). This analysis reveals an unexpectedly high impact of older donor age on the association between DGF and renal transplant outcomes. Further research is needed to determine the best use of kidneys from donors above 60 years old, where DGF is expected.
    Transplant International 12/2012; DOI:10.1111/tri.12016 · 3.16 Impact Factor
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    ABSTRACT: Aortic stiffness is a novel cardiovascular risk factor in patients with chronic kidney disease (CKD). The purpose of the present study is to examine whether there is a blood pressure-independent improvement in aortic stiffness 3 months after successful kidney transplantation (KTx), and whether this improvement is age-dependent. In this prospective, longitudinal observational study, we studied hemodynamic and biological parameters prior to and 3 months after a KTx in 52 stage 5 CKD patients. Aortic stiffness was measured by carotido-femoral pulse wave velocity (c-f PWV) and enhanced central wave reflection was evaluated by the heart rate-adjusted central augmentation index (AIx) by means of arterial tonometry. Endothelin-1, L-arginine, asymmetric dimethylarginine (biomarkers of endothelial dysfunction), pentosidine (advanced glycation end-products) and mineral metabolism parameters were also measured. After adjusting for the reduction in mean blood pressure, c-f PWV decreased significantly from 12.1 ± 3.3 to 11.6 ± 2.3 m/s (P < 0.05). In an analysis stratified by age, this improvement was only present in patients older than 50 years of age as compared with patients younger than 50 years of age (-5.5 ± 2.2 vs. 2.1 ± 1.9%, P < 0.05). AIx decreased from 22 ± 11 to 14 ± 13% (P < 0.01), but this reduction was not age-dependent. We also observed a similar degree of improvement in the biomarker levels of endothelial dysfunction and pentosidine in both groups. This study shows for the first time that there is an age-dependent improvement in aortic stiffness after KTx. These observations suggest that older patients may have an added cardiovascular risk reduction after a successful KTx.
    Journal of Hypertension 01/2011; 29(1):130-6. DOI:10.1097/HJH.0b013e32833f5e68 · 4.22 Impact Factor
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    ABSTRACT: Organ shortage has led to the use of dual-kidney transplant (DKT) of very marginal donors into a single recipient to increase the use of marginal organs. To date, few data are available about the long-term outcome of DKT and its usefulness to increase the pool of available organ. We conducted a single-center cohort study of DKTs with longitudinal follow-up over an 8-year period. Between 1999 and 2007, 63 DKTs were performed. All kidneys from donors younger than 75 years refused by all centers for single transplantation, and kidneys from donors aged 75 years or older were routinely evaluated based on preimplantation glomerulosclerosis. Renal function, patient or graft survival, and perioperative complications were compared with 66 single kidneys from expanded criteria donors (ECD) and 63 ideal kidney donors. After a median follow-up of 56 months, patient or graft survival was similar between the three groups. Twelve-, 36-, and 84-month creatinine clearance were similar for DKT and ECD (12 months: 58 and 59 mL/min; 36 months: 54 and 60 mL/min; and 84 months: 62 and 51 mL/min, respectively). For the study period, the routine evaluation of very marginal kidneys for DKT in our center has led to an increase of 47% in the transplants from donors aged 50 years or older, which represent 12% at the level of our organ procurement organization. DKT patients can expect long-term results comparable with single kidney ECD. The implementation of a DKT program in our unit safely increased the pool of organs from marginal donors.
    Transplantation 10/2010; 90(10):1125-30. DOI:10.1097/TP.0b013e3181f8f2b8 · 3.78 Impact Factor
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    ABSTRACT: Polyomavirus associated nephropathy (PVAN) is an important cause of graft failure in the renal transplant population. It has been shown that viremia precedes PVAN, suggesting that measurement of blood viral load could be used for PVAN screening. To verify the utility of BK virus (BKV) blood viral load measurement for PVAN screening in the renal transplant population, establish a threshold value, and determine the sensitivity and specificity of the test. We developed a real-time PCR assay for BKV blood viral load measurement and included this assay in the PVAN screening protocol of the renal transplant recipients of our institution. We report results for 60 patients who had a blood viral load measurement concomitantly with an allograft biopsy with immunohistochemistry for polyomavirus. 14 patients were found to have a PVAN on allograft biopsy together with a viral load above 3.0x10(3)copies/ml. None of the patients with a viral load under 3.0x10(3)copies/ml had a PVAN on allograft biopsy. The area under the receiver operating characteristic (ROC) curve was 0.95 (95% CI: 0.91-1.00) and using a threshold value of 3.0x10(3)copies/ml yielded a sensitivity of 100% (95% CI: 76.8-100%) and a specificity of 89.6% (95% CI: 77.3-96.5%) for PVAN screening. BKV blood viral load measurement is sensitive and specific for PVAN screening when a threshold value is precisely determined.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 07/2009; 45(4):318-21. DOI:10.1016/j.jcv.2009.05.025 · 3.47 Impact Factor
  • Annales de Pathologie 02/2006; 26(1):77-78. DOI:10.1016/S0242-6498(06)70684-8 · 0.29 Impact Factor
  • Annales de Pathologie 02/2006; 26(1):72-72. DOI:10.1016/S0242-6498(06)70675-7 · 0.29 Impact Factor
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    ABSTRACT: In a previous study, we observed that a pharmacy-based intervention programme decreased the blood pressure of hypertensive patients. The objective of the present study was to assess the effect of this pharmacy programme on the health-related quality of life (HRQOL) of individuals treated for hypertension. In a quasi-experimental cohort pilot study, we recruited 91 participants from nine pharmacies in the Quebec City area. We offered the intervention programme over a 9-month period to participants enrolled at four of the pharmacies. The other participants were not exposed to pharmaceutical services other than those usually given by their pharmacists. We used the SF-36 to evaluate HRQOL. Covariance analysis was used to test for significant differences of HRQOL scores between participants exposed and not exposed to the programme. When compared with the non-exposed participants, those receiving the intervention and with high income had an improvement in vitality score (P=0.05). On the contrary, low-income exposed participants did not show this benefit and had a decline in mental health score (P=0.01). Improvement in vitality is likely due to increased physical activity and to a reduction in systolic blood pressure in the high-income exposed group. The negative effect of the programme on the mental health of those exposed in the low-income group might be due to the fact that the programme was not effective in reducing blood pressure and may therefore have caused anxiety. Pharmacists' interventions can have both a positive and negative impact on the HRQOL of individuals, treated with antihypertensive agents, depending on income level.
    Journal of Clinical Pharmacy and Therapeutics 09/2005; 30(4):355-62. DOI:10.1111/j.1365-2710.2005.00663.x · 1.53 Impact Factor
  • Annales de Pathologie 04/2005; 25(2):190-191. DOI:10.1016/S0242-6498(05)86207-8 · 0.29 Impact Factor
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    ABSTRACT: The Short Form 12 (SF-12) is widely used in primary care settings. The RAND-12 Health Status Inventory (HSI) and the Health Utilities Index Mark 3 (HUI3) have not been as widely used in such settings. The objective of this study was to examine the construct validity of the RAND-12 and HUI3 in the context of high-risk primary care patients. The SF-12, HUI2, and HUI3 were administered to a cohort of high-risk primary care patients. RAND-12 summary scores for physical and mental health were generated. Single-attribute utility scores for each dimension of health status and overall health in HUI3 were computed. A priori hypotheses were specified. In general, the relationships among RAND-12 and HUI3 scores were consistent with construct validity. Twelve of 24 a priori predictions were confirmed. However, predictions about the correlations between the number of medical conditions and the number of medications and the measures of health-related quality of life were, in general, not confirmed. The RAND-12 and HUI3 seem to be useful among primary care patients with diverse chronic conditions. Further investigation is warranted.
    Journal of Clinical Epidemiology 03/2005; 58(2):138-41. DOI:10.1016/j.jclinepi.2004.08.005 · 5.48 Impact Factor
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    ABSTRACT: Communication between community-based providers is often sporadic and problem-focused. To implement collaborative community-based care among providers distant from one another and to improve or maintain the health of high-risk community-dwelling patients, with a focus on medication use. Six primary health care teams were formed of a family physician, a pharmacist, and a home care case manager (nurse). Three of these teams also had a family physician's office nurse. Teams received training and decided on processes of care that included a home visit, medication history, and weekly 1.5-hour face-to-face team meetings. In 151 team conferences, 705 medication or health issues were identified for 182 patients over 6 months. Medication adherence was improved at 3 and 6 months. After 6 months, all providers had a greater understanding of the roles of the other providers. Primary health care teams developed in this study require few structural changes to existing health care systems, but will require more reimbursement options.
    Canadian family physician Médecin de famille canadien 08/2004; 50:998-1003. · 1.40 Impact Factor
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  • Chris M Blanchard, Isabelle Côté, David Feeny
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    ABSTRACT: Summary physical health scores for the Short Form (SF) measures are computing using positive weights for physical items and negative weights for mental health items. Mental health summary scores use positive weights for mental items and negative weights for physical. The RAND Health Status Inventory (HSI) measures do not use negative weights. Do these different approaches to scoring matter? The objective was to compare summary scores using both the SF and RAND-HSI. SF-36 and the Health Utilities Index Mark 3 (HUI3) were administered to a cohort of patients waiting for elective total hip arthroplasty (THA). SF-12 and HUI3 were administered to a cohort of high-risk primary-care patients. Summary scores were generated and compared. Single-attribute utility scores for emotion in HUI3 were also computed. Canadian and US norms for SF, RAND-HSI, and HUI3 were used to interpret results. For THA patients, mean physical health scores were 28 and 36 for SF and RAND-HSI. Mean mental health scores were 55 and 42. For the primary-care patients, the scores were 34 and 36 for physical and 46 and 40 for mental health. SF and RAND-HSI provided somewhat similar summary scores in the THA study. However, SF and RAND-HSI mental health scores differed in the primary-care patient cohort and results from HUI3 corroborate the mental health deficits identified by the RAND-HSI. It may be wise for investigators to use both SF and RAND-HSI scoring systems.
    International Journal of Technology Assessment in Health Care 02/2004; 20(2):230-5. DOI:10.1017/S0266462304001011 · 1.56 Impact Factor
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    ABSTRACT: The SF-36 has frequently been used to measure health related quality of life (HRQOL) in hypertension. Recently, the SF-12, a shorter form of the SF-36, has been proposed. However, the validity of the SF-12 in hypertension has not yet been assessed. To determine the extent to which the SF-12 provides similar measurements of HRQOL to those of the SF-36 in hypertensive individuals. A study assessing the impact of a pharmacy-based intervention program on hypertensive individuals served as background for this study. One hundred and twelve individuals participated in this study. We compared the SF-36 with the SF-12 on item scores and summary measures using intraclass correlation coefficients (ICC), Pearson correlation coefficients and linear regression. The concordance between the SF-12 and the SF-36 on both physical (ICC=0.88) and mental (ICC=0.92) component summary scores (PCS and MCS respectively) is high and the relationship is linear and positive. Most of the variance in the SF-36 PCS (R2=0.78) and MCS (R2=0.85) can be explained by their SF-12 counterparts. The SF-12 PCS and MCS are the only significant predictor variables for the corresponding measure of the SF-36. The SF-12 appears to be a valid alternative to the SF-36 for clinical practice or research purposes when studying hypertensive individuals and their treatment.
    The Canadian journal of clinical pharmacology = Journal canadien de pharmacologie clinique 02/2004; 11(2):e232-8.
  • Annales de Pathologie 02/2004; 24(1):88-89. DOI:10.1016/S0242-6498(04)93912-0 · 0.29 Impact Factor
  • Isabelle Côté, Karen Farris, David Feeny
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    ABSTRACT: Adherence to drug treatment and health-related quality of life (HRQL) are two distinct concepts. Generally one would expect a positive relationship between the two. The purpose of this study was to assess the relationship between adherence and HRQL. HRQL was measured using the physical and mental summary measures of the RAND-12 (PHC-12, MHC-12), the SF-12 (PCS-12, MCS-12), HUI-2 and HUI-3. Adherence was assessed using Morisky's instrument. Three longitudinal datasets were used. One dataset included 100 hypertensive patients. Another dataset covered 199 high risk community-dwelling individuals. The third dataset consisted of 365 elderly patients. Spearman's correlation coefficients were used to assess association. Subgroup analyses by type of medication and inter-temporal analyses were also performed. Correlation between adherence and PHC-12 ranged from 0.08 (p = 0.26) to 0.22 (p < 0.01). Correlations between adherence and MHC-12 ranged from 0.11 (p = 0.11) to 0.15 (p < 0.01). Similar results were observed using HUI-2, HUI-3, and SF-12 as well as by type of medication and in the lagged analyses. Correlations between HRQL and adherence were positive but typically weak or negligible in magnitude.
    Quality of Life Research 09/2003; 12(6):621-33. DOI:10.1023/A:1025180524614 · 2.86 Impact Factor
  • Value in Health 05/2003; 6(3):226-226. DOI:10.1016/S1098-3015(10)63918-6 · 2.89 Impact Factor
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    ABSTRACT: To weigh the costs and benefits of a pharmacy-based health promotion programme implemented in four pharmacies of the Quebec City area, Canada. This programme was developed to improve blood pressure control through activities aimed at improving the quality of prescribing and the adherence to treatment. Nine pharmacies in Quebec City were included, of which four pharmacies were assigned to the implementation of the health promotion programme. Each time a study participant came to one of these pharmacies to refill his/her antihypertensive medication, the pharmacist would measure and record the participant's blood pressure and assess adherence to drug treatment. The other five pharmacies delivered usual care. The duration of the intervention programme was 9 months. Costs included direct, indirect, and fixed costs, and the costs of pharmacist intervention. Benefits were measured using cost savings induced by pharmacist intervention. Willingness to pay was also considered. A bootstrap method was used to test the between-group difference. The study was performed from a societal perspective. 100 individuals aged between 34 and 80 years residing in the Quebec City area and taking antihypertensive medication. Main outcome measures and results: Participants exposed to the programme had a significant decrease in mean direct costs and a significant increase in mean indirect costs compared with non-exposed participants. Pharmacist interventions involved a mean cost of 30.68 Canadian dollars ($ Can) per participant exposed to the programme. On average, exposed participants were willing to pay $ Can 0.54 per month after the intervention period. Benefits were about ten times higher than costs (1998 values). The implementation of this intervention programme seems promising in the quest to improve blood pressure control in terms of both costs and benefits.
    PharmacoEconomics 02/2003; 21(6):415-28. DOI:10.2165/00019053-200321060-00005 · 3.34 Impact Factor
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    ABSTRACT: Discontinuation of medication use constitutes a major barrier to adequate control of high blood pressure. We examined the effect of an array of potential predisposing, enabling and reinforcing factors on the discontinuation of newly prescribed antihypertensive medications. We conducted a prospective cohort study through a network of 173 pharmacies across Canada where were identified individuals newly prescribed an antihypertensive monotherapy. We interviewed participants by telephone four times to obtain information for a minimum duration of 18 months after entry into the cohort. We analyzed data using a multivariate proportional hazard model. Of 682 eligible participants, 43.3% had discontinued their initial medication at the end of the observation period. Individuals more likely to discontinue their initial medication were those who perceived side effects from this medication [Hazard Ratio (HR) = 1.91; 95% Confidence Interval (CI) 1.47-2.47). Individuals with medication insurance coverage were less likely to discontinue (HR = 0.74; 95% CI 0.55-0.99). Persistence with newly prescribed medications could be improved by selecting antihypertensive medications containing fewer side effects and by lifting economic barriers to drug treatment.
    Journal of Clinical Epidemiology 08/2002; 55(7):728-35. DOI:10.1016/S0895-4356(02)00400-6 · 5.48 Impact Factor
  • Transplantation Proceedings 11/2001; 33(7-8):3626-9. DOI:10.1016/S0041-1345(01)02560-X · 0.95 Impact Factor

Publication Stats

289 Citations
56.08 Total Impact Points

Institutions

  • 2001–2010
    • Laval University
      • • Faculté de Pharmacie
      • • Department of Medicine
      Quebec City, Quebec, Canada
    • Institute of Health Economics
      Edmonton, Alberta, Canada
  • 2009
    • Hotel Dieu Hospital
      Kingston, Ontario, Canada
  • 2000–2005
    • Université du Québec
      Québec, Quebec, Canada