Andrea Gruneir

Andrea Gruneir
University of Alberta | UAlberta · Department of Family Medicine

PhD

About

194
Publications
19,461
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5,776
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Publications

Publications (194)
Article
Full-text available
Family or friend caregivers’ concerns about assisted living (AL) residents’ mental health are reflective of poor resident and caregiver mental health. COVID-19-related visiting restrictions increased caregiver concerns, but research on these issues in AL is limited. Using web-based surveys with 673 caregivers of AL residents in Western Canada, we a...
Article
The Action-Project Method (A-PM) is a qualitative research approach used to understand the actions and experiences co-constructed by individuals. We applied the A-PM in a nursing home (NH) setting with the aim to explore how NH residents and the people closest to them describe their priorities for care and act on these priorities. Due to the health...
Article
Background Chronic non-cancer pain is common among older residents of long-term care (LTC) homes and often poorly recognized and treated. With heightened concerns regarding opioid prescribing in recent years, it is important to examine the current prevalence of opioid use and its association with resident characteristics to help identify those pote...
Article
Full-text available
Background Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of a...
Article
Background and objectives: Frailty has been investigated for decades with a proliferation of frailty instruments attributed to many existing conceptual models and operational criteria. The purpose of this systematic review was to understand how instruments were developed to assess frailty in community dwelling older adults. Research design and me...
Article
The qualitative action-project method (A-PM) was developed in counseling psychology and is useful for studying human actions in various contexts. With this article we provide a guide to A-PM data analysis with a focus on the method’s coding technique. We briefly outline the theory underpinning the method as well as the different phases of data coll...
Article
Full-text available
Background: Older adults (≥65 years) with diabetes and multiple chronic conditions (MCC) (> 2 chronic conditions) experience reduced function and quality of life, increased health service use, and high mortality. Many community-based self-management interventions have been developed for this group, however the evidence for their effectiveness is l...
Article
Objectives To examine the association between the COVID-19 pandemic and opioid use among nursing home residents followed up to March 2021, and possible variation by dementia and frailty status. Design Population-based cohort study with an interrupted time series analysis. Setting and Participants Linked health administrative databases for residen...
Article
Full-text available
Background Loneliness is a public health concern and its influence on morbidity and mortality are well documented. The association between loneliness and emergency department visits is less clear. Further, while sex and gender-related factors are known to be associated with loneliness and health services use, little research looks at the relationsh...
Article
Full-text available
Background: Supportive living (SL) facilities are intended to provide a residential care setting in a less restrictive and more cost-effective way than nursing homes (NH). SL residents with poor social relationships may be at risk for increased health service use. We describe the demographic and health service use patterns of lonely and socially i...
Article
Objectives To determine which nursing home (NH) resident-level admission characteristics are associated with potentially preventable emergency department (PPED) transfers. Design We conducted a population-level retrospective cohort study on NH resident data collected using the Resident Assessment Instrument-Minimum Data Set Version 2.0 and linked...
Article
Full-text available
Background Aging in place (AIP) is a policy strategy designed to help older adults remain in their community. While planners internationally have modified aspects of the older adult care continuum (e.g., home care, assisted living, nursing homes) to facilitate AIP, further improvements to community-based supports and services are also required. Thi...
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Background Researchers often use survey data to study the effect of health and social variables on physician use, but how self-reported physician use compares to administrative data, the gold standard, in particular within the context of multimorbidity and functional limitations remains unclear. We examine whether multimorbidity and functional limi...
Article
Full-text available
Background: The Translating Research in Elder Care (TREC) program is a partnered health services research team that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in nursing homes. This team includes academic researchers, trainees, research staff, citizens (persons living with dementia and f...
Article
Full-text available
Introduction Increasing multimorbidity is often associated with declining physical functioning, with some studies showing a disproportionate impact on functioning when mental health conditions are present. More research is needed because most multimorbidity studies exclude mental health conditions. Objectives This study aims to improve our underst...
Article
Full-text available
Importance: COVID-19 has had devastating effects on the health and well-being of older adult residents and health care professionals in nursing homes. Uncertainty about the associated consequences of these adverse effects on the use of medications common to this care setting remains. Objective: To examine the association between the COVID-19 pan...
Article
Background: Understanding the needs and values of older people is vital to build responsive policies, services and research agendas in this time of demographic transition. Older peoples' expectations and priorities for ageing, as well as their beliefs regarding challenges facing ageing societies, are multi-faceted and require regular updates as po...
Article
Full-text available
Objective Physical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterise the extent of loneliness during the first wave in a sample of older adults living in the community and asses...
Article
Full-text available
Background This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods We linked multiple cycles (2005–2006, 2007–2008, 2009–2010, 2011–2012) of the Canadian Community Health S...
Article
Full-text available
The action-project method (APM), developed in counselling psychology and used in various disciplines, has been shown to be useful for understanding major life transitions in different contexts. We argue that the APM is beneficial for studying the impact of nursing home (NH) home admission and daily life of residents and their families/friends. The...
Article
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The aim of the “Trajectories” project is to compile measures of nursing home (NH) quality to better characterize the final year of life for residents. In the first phase, we worked with various stakeholder groups to identify their priorities to focus the selection of possible outcomes relevant to end-of-life needs. Policy- and decision-makers from...
Preprint
Full-text available
Objective Physical distancing and stay-at-home measures implemented to slow transmission of novel coronavirus disease (COVID-19) may intensify feelings of loneliness in older adults, especially those living alone. Our aim was to characterize the extent of loneliness in a sample of older adults living in the community and assess characteristics asso...
Article
Objective: Lithium is an important mood disorder treatment; however, the renal risks of its use in older adults are unclear. We wished to determine in older adults (1) whether lithium is associated with increased risk of renal decline compared to valproate and (2) whether this association differs with higher vs lower baseline serum lithium concent...
Preprint
Full-text available
Background: This study explores how a broad-range of socio-demographic factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) among older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Communit...
Preprint
Full-text available
Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health...
Preprint
Full-text available
Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health...
Article
Full-text available
Objective To examine agreement between administrative and self-reported data on the number of and constituent chronic conditions (CCs) used to measure multimorbidity. Study Design and Setting Cross-sectional self-reported survey data from four Canadian Community Health Survey waves were linked to administrative data for residents of Ontario, Canad...
Article
Full-text available
Background: The Translating Research in Elder Care (TREC) program is a longitudinal partnered program of research in Western Canada that aims to improve the quality of care and quality of life for residents and quality of worklife for staff in long-term care settings. This program of research includes researchers, citizens (persons living with dem...
Article
Background The concept of prefrailty lacks clarity. Often, prefrailty is defined in relation to frailty and less often as a distinct concept. Theoretical evidence for prefrailty is minimal unlike frailty, which has been examined for decades although consensus about how to measure frailty has not been achieved. Objective The aim of this study was t...
Article
Objective To compare multimorbidity prevalence using self-reported and administrative data and identify factors associated with agreement between data sources. Study Design and Setting Self-reported cross-sectional data from four Canadian Community Health Survey waves were linked to administrative data in Ontario, Canada. Multimorbidity prevalence...
Article
Objective To describe agreement between administrative and self-report data on the number and type of chronic conditions (CCs) and determine whether associations between CC count and health service use differ by data source. Study Design and Setting We linked Canadian Community Health Survey and administrative data for a cohort of adults aged 45+...
Article
Background Cholinesterase inhibitors (ChEIs) are one of only two drug therapies available to manage cognitive decline in dementia. Given sex-specific differences in medication access and effects, it is important to understand how ChEIs are used by women and men. Objective The objective of this study was to provide contemporary sex-stratified evide...
Article
Full-text available
Aims: The objective of our study was to quantify the association between SGLT2 inhibitors and each of genital mycotic infection and urinary tract infection (UTI) within 30 days of drug initiation among older women and men. Materials and methods: We performed a retrospective cohort study using linked administrative databases of women and men aged...
Article
Objectives: Sedative and hypnotic medications are associated with harm, and guidelines suggest limiting their use. Only limited evidence has described how older adults are managed following an initial sleep disorder diagnosis. We aimed to describe clinical management patterns of sleep disorders in older women and men at the time of initial diagnos...
Article
Full-text available
Background Most studies that examine comorbidity and its impact on health service utilization focus on a single index-condition and are published in disease-specific journals, which limit opportunities to identify patterns across conditions/disciplines. These comparisons are further complicated by the impact of using different study designs, multim...
Article
Objectives: To assess (1) temporal changes (2008-2015) in nursing home (NH) length of stay (LoS) in 3 Canadian health jurisdictions (Edmonton, Calgary, Winnipeg), (2) resident admission characteristics associated with LoS, and (3) temporal changes of admission characteristics in each of the 3 jurisdictions. Design: Retrospective cohort study usi...
Article
Objective: Lithium is an effective treatment for mood disorders, but lithium level and renal monitoring every 3 months is recommended in older patients treated with lithium to prevent serious adverse events. This study examined lithium monitoring practices in a large geriatric cohort. Methods: This population-based cohort study (N = 11,006) used...
Article
Full-text available
IMPORTANCE:Subtle but important differences have been described in the way that male and female physicians care for their patients, with some evidence suggesting women are more likely to adhere to best practice recommendations. OBJECTIVE:To determine if male and female physicians differ in their prescribing practices as measured by the initiation o...
Data
Dose categories for oral cholinesterase inhibitor therapy. (DOCX)
Data
List of nine linkable administrative health care databases housed at the Institute for Clinical Evaluative Sciences (ICES). (DOCX)
Article
Background: Despite the fact that many older adults receive home or long-term care services, the effect of these care settings on hospital readmission is often overlooked. Efforts to reduce hospital readmissions, including capacity planning and targeting of interventions, require clear data on the frequency of and risk factors for readmission amon...
Article
Full-text available
Background: There are multiple multimorbidity measures but little consensus on which measures are most appropriate for different circumstances. Objective: To share insights gained from discussions with experts in the fields of ageing research and multimorbidity on key factors to consider when measuring multimorbidity. Design: Descriptive study...
Article
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Background The goal of the Aging, Community and Health Research Unit (ACHRU) is to promote optimal aging at home for older adults with multimorbidity (≥2 chronic conditions) and to support their family/friend caregivers. This protocol paper reports the rationale and plan for this patient-oriented, cross-jurisdictional research program. Objectives...
Data
Supplemental_File_1_Production_(June_26_2018) - Protocol for a program of research from the Aging, Community and Health Research Unit
Article
Objectives: To examine dose-related prescribing and short-term serious events associated with initiation of cholinesterase inhibitor (ChEI) therapy. Design: Retrospective, population-based cohort study. Setting: Ontario, Canada. Participants: Women (n=47,829) and men (n=32,503) aged 66 and older who initiated a ChEI between April 1, 2010, an...
Article
Full-text available
Background: Nursing home (NH) residents are frequent users of emergency departments (ED) and while prior research suggests that repeat visits are common, there is little data describing this phenomenon. Our objectives were to describe repeat ED visits over one year, identify risk factors for repeat use, and characterize "frequent" ED visitors. Me...
Article
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Purpose: To examine the association between new antipsychotic use and mortality over 6 months among community-based older adults with cognitive impairment, and variation in risk by frailty and sex. Methods: We conducted a retrospective cohort study of older (aged 66+) home care clients in Ontario, Canada, using linked administrative health and c...
Article
Full-text available
Objectives To estimate the attributable costs of multimorbidity and assess whether the association between the level of multimorbidity and health system costs varies by socio-demographic factors in young (<65 years) and older (≥65 years) adults living in Ontario, Canada. Design A population-based, retrospective cohort study Setting The province o...
Article
Background: To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). Method: Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT t...
Article
Morbidity and mortality after deliberate self-harm (DSH) are high, so mental health care shortly after DSH is recommended. Using population-level health data we determined the association between a mental health visit and risk for repeat DSH with or without intensive care unit (ICU) admission or all-cause death. Over two years, 23,140 individuals h...
Article
This presentation will summarize evidence arising from a multi-year population-based study of over 6 Million people in Ontario, Canada who have one of 17 common chronic conditions, and particularly the more than 2.5 Million individuals with multiple chronic conditions. Aside from the expected increases in health care utilization, adverse outcomes a...
Article
Objectives: To determine the prevalence of and resident characteristics associated with the prescription of medications of questionable benefit (MQBs) near the end of life in older adults with advanced dementia in nursing homes. Design: Population-based, cross-sectional study using Resident Assessment Instrument Minimum Data Set 2.0 linked to he...
Article
Full-text available
Background: For community-dwelling older persons with dementia, the presence of multimorbidity can create complex clinical challenges for both individuals and their physicians, and can contribute to poor outcomes. We quantified the associations between level of multimorbidity (chronic disease burden) and risk of hospitalization and risk of emergen...
Data
Prevalence of 16 chronic conditions by level of multimorbidity. (PDF)
Data
RECORD statement (cohort studies). (PDF)
Data
Description of the health administrative datasets used for this research. (PDF)
Data
List of diagnostic information for defining dementia and the 16 selected chronic conditions under investigation in this study. (PDF)
Data
Counts per study inclusion criterion. (PDF)
Data
Proportion of long-stay home care clients with dementia in Ontario in 2012 who experienced each outcome under investigation during the 1-y follow-up period, by low and high continuity of care. (PDF)
Data
Results from sensitivity analyses 1 and 2 (subset of study population). (PDF)