Caroline Sirois

Caroline Sirois
Laval University | ULAVAL · Faculty of Pharmacy

B.Pharm, PhD

About

103
Publications
6,546
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969
Citations
Additional affiliations
June 2012 - February 2016
Université du Québec à Rimouski UQAR
Position
  • Professor (Associate)

Publications

Publications (103)
Article
Background: Older adults with major neurocognitive disorder (MNCD) are often exposed to polypharmacy. We aimed to assess the prescribing and discontinuation patterns of medications following diagnosis of MNCD among community-dwelling older adults. Methods: Using the Quebec Integrated Chronic Disease Surveillance System, we conducted a population...
Preprint
Full-text available
The use of longitudinal finite mixture models such as group-based trajectory modeling has seen a sharp increase during the last decades in the medical literature. However, these methods have been criticized especially because of the data-driven modelling process which involves statistical decision-making. In this paper, we propose an approach that...
Article
Reliable treatment burden measures are needed given the aging population and the associated increase in multimorbidity and polypharmacy. Treatment burden is defined as the effort to care for one’s health and the resulting impact on one’s daily life. This study aimed to translate the Multimorbidity Treatment Burden Questionnaire (MTBQ) for French-Ca...
Preprint
Purpose Successful deprescribing requires understanding the attitudes of older adults and caregivers towards this process. This study aimed to capture these attitudes in four French-speaking countries, and to investigate associated factors. Methods A multicenter cross-sectional study was conducted by administrating the French version of the revised...
Article
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Background: Long-term opioid use, which may have signifcant individual and societal impacts, has been documented in up to 20% of patients after trauma or orthopaedic surgery. The objectives of this scoping review were to systematically map the research on strategies aiming to prevent chronic opioid use in these populations and to identify knowledge...
Article
Full-text available
This study aimed to describe attitudes toward deprescribing among older adults and caregivers. We recruited 110 adults 65 years and above using at least one prescribed medication for at least 3 months, and 95 unrelated caregivers (18+) of older adults with such characteristics, who answered the validated French version of the revised Patients' Atti...
Article
Full-text available
Objectives To study the association between polypharmacy and the risk of hospitalisation and death in cases of COVID-19 in the population over the age of 65. Design Population-based cohort study. Setting Quebec Integrated Chronic Disease Surveillance System, composed of five medico-administrative databases, in the province of Quebec, Canada. Par...
Article
Full-text available
Background: Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions. Objective: This paper presents the protocol of a study that a...
Article
Full-text available
Background In Québec primary care, antimicrobial use is higher in patients with chronic diseases, but it is unclear whether this utilization may be reduced. We aimed to measure the proportion of compliant antimicrobial prescriptions according to the provincial guidelines for the treatment of common respiratory and urinary infections and measure var...
Article
Full-text available
Background Chronic diseases may increase one’s risk of infection and ensuing complications, which in turn may lower clinicians’ tolerance threshold for antimicrobial prescription, while potential drug interactions may limit therapeutic options. Objective of the study was to measure the impact of chronic diseases on the rates of antimicrobial use in...
Preprint
Full-text available
The robust Poisson model is becoming increasingly popular when estimating the association of exposures with a binary outcome. Unlike the logistic regression model, the robust Poisson model yields results that can be interpreted as risk or prevalence ratios. In addition, it does not suffer from frequent non-convergence problems like the log-binomial...
Article
Background: Pharmacist-led transitions of care (TOC) interventions have been described as some of the most promising interventions to reduce medication-related harm (MRH) in older adults. This study analyzed the feasibility of pharmacist-led TOC interventions between hospitals, multidisciplinary primary care clinics (PCC), and community pharmacies...
Preprint
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Purpose: To inform recommendations by the Canadian Task Force on Preventive Health Care on potentially inappropriate prescribing and over-the-counter (OTC) medication use among adults aged 65 years and older in primary care settings. This protocol outlines the planned scope and methods for a systematic review of the benefits and harms and acceptabi...
Article
Background Benzodiazepines and other hypnotic alternatives are associated with increased risks of adverse events. Heightened awareness of risks may have changed prescribing habits over the years. However, these trends are not fully described, especially in vulnerable people such as multimorbid older adults. Objective We aimed to describe the annua...
Article
Background: We aimed to identify and characterize adult population-based multimorbidity measures using health administrative data and the International Classification of Diseases (ICD) codes for disease identification. Methods: We performed a narrative systematic review of studies using or describing development or validation of multimorbidity m...
Article
Background Pharmacist-led transitions of care (TOC) interventions have been associated with improved health outcomes. Community pharmacists’ (CP) TOC communications have been described whereas limited evidence is available for hospital pharmacists (HP) and none for non-dispensing pharmacists, integrated into Family Medicine Groups (FMG). Objective...
Article
Full-text available
Background Polypharmacy is common among older adults and it represents a public health concern, due to the negative health impacts potentially associated with the use of several medications. However, the large number of medication combinations and sequences of use makes it complicated for traditional statistical methods to predict which therapy is...
Preprint
Full-text available
In a real-life setting, little is known regarding the effectiveness of statins for primary prevention among older adults, and analysis of observational data can add crucial information on the benefits of actual patterns of use. Latent class growth models (LCGM) are increasingly proposed as a solution to summarize the observed longitudinal treatment...
Article
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Purpose: To conduct a systematic review of the economic impact of interventions intended at optimizing medication use in older adults with multimorbidity and polypharmacy. Methods: We searched Ovid-Medline, Embase, CINAHL, Ageline, Cochrane, and Web of Science, for articles published between 2004 and 2020 that studied older adults with multimorb...
Article
Purpose: To lay the fundamentals of drug-related problems (DRPs) in older adults, and to organize them according to a logical process conciliating medical and pharmaceutical approaches, to better identify the causes and consequences of DRPs. Materials and methods: A narrative overview. Results: The causes of DRPs may be intentional or unintent...
Article
Objectives Clinical services have allowed pharmacists to shift from product-oriented to patient-oriented services. However, the policy and social implications of clinical services in community pharmacies are not well described. The purpose of this scoping review was to identify these implications. Key findings We searched Pubmed and Embase, from i...
Article
Full-text available
Background Frequent healthcare users place a significant burden on health systems. Factors such as multimorbidity and low socioeconomic status have been associated with high use of ambulatory care services (emergency rooms, general practitioners and specialist physicians). However, the combined effect of these two factors remains poorly understood....
Article
Objectives Older patients with cancer often present with multimorbidity and polypharmacy, but there is little information on the challenges these conditions raise. We aimed to describe health professionals' practice, perceptions and needs related to polypharmacy for older adults receiving cancer treatment. Materials and Methods We performed a mixe...
Article
Background The revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire allows capture of the beliefs and attitudes of older adults and caregivers towards deprescribing. Objectives To translate and validate the rPATD questionnaire into French. Methods The French rPATD was translated using forward-backward translation. Psychometric...
Article
Objectives Assess the impact of a new pharmaceutical care model on (1) polypharmacy and (2) potentially inappropriate medication (PIM) use in long-term care facilities (LTCFs). Design Pragmatic quasi-experimental study with a control group. This multifaceted model enables pharmacists and nurses to increase their professional autonomy by enforcing...
Preprint
Full-text available
BACKGROUND Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions. OBJECTIVE This study aims to contribute to the knowledge on depr...
Conference Paper
Full-text available
Background Schizophrenia is a severe psychiatric disorder associated with an increased risk of type 2 diabetes, dyslipidemia and obesity. As adults with schizophrenia age, they become at high risk for multimorbidity and polypharmacy. However, little is known about the trends in total medications use within this population. The objective of this stu...
Article
Background Transitions of care (TOC) is one of three key action areas identified in the World Health Organization (WHO)'s third Global Patient Safety Challenge, Medication Without Harm, released in 2017. Systematic reviews have shown that TOC interventions can improve health outcomes, although few studies have evaluated the role of the community ph...
Preprint
Full-text available
Background Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions. This study aims to contribute to the knowledge on deprescribing b...
Article
Aim To study the population-based prevalence of potentially inappropriate medication (PIM) among older individuals with diabetes, and to identify factors associated with their use. Methods We used the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database to conduct a population-based cohort study of individuals with diabetes ≥66...
Article
Full-text available
Introduction: Globally every year, millions of patients sustain traumatic injuries and require acute care surgeries. A high incidence of chronic opioid use (up to 58%) has been documented in these populations with significant negative individual and societal impacts. Despite the importance of this public health issue, optimal strategies to limit th...
Article
Full-text available
Introduction Polypharmacy and potentially inappropriate medication use is common in older adults and is associated with adverse outcomes such as falls and hospitalisations. Methods and analysis This study is a pharmacist-led medication optimisation initiative using an electronic tool (the Drug Burden Index (DBI) Calculator) in four hospital sites...
Article
Objectives Chronic respiratory diseases (CRD) put patients at increased risk of respiratory infection and antimicrobial use, but surveillance results on community antimicrobial use are generally not adjusted for this risk factor. The objective of this study was to demonstrate the importance of accounting for CRD when interpreting indicators of comm...
Article
Aims: To assess the one-year persistence of PIM use and identify associated factors in community-dwelling older adults in Quebec, Canada. Methods: A population-based cohort study was conducted using the Quebec Integrated Chronic Disease Surveillance System. Individuals insured by the public drug plan and aged ≥66 years who initiated a PIM betwee...
Chapter
With the intensification of chronical disease within older people, concurrent use of different drugs (polypharmacy) is becoming increasingly frequent. However, there is no established manner to determine whether polypharmacy is appropriate or not. We propose an original method of classifying polypharmacy using a Delphi survey results and multi-crit...
Article
Full-text available
Our objectives were to describe the use of pharmacological treatments in older adults with diabetes and to identify the factors associated with the use of a combination of hypoglycemic, antihypertensive and lipid-lowering agents. Using the Quebec Integrated Chronic Disease Surveillance System, we conducted a population-based cohort study among indi...
Article
Background Multimorbidity and polypharmacy are common in older people. Despite the existence of quality criteria for medication use among this population, there is little guidance for managing the complex pharmacological arsenal in a multimorbidity context. Objective To establish consensus on benefits, risks and impacts on quality of life of medica...
Article
Background: Non-optimal medication use among older adults is a public health concern. A concrete picture of potentially inappropriate medication (PIM) use is imperative to ensure optimal medication use. Objective: To assess the prevalence of PIMs in community-dwelling older adults and identify associated factors. Methods: A retrospective popul...
Article
Background: The use of benzodiazepines in relation to cognitive decline remains an area of controversy in aging populations. Objective: This study aims to evaluate the risk of cognitive impairment–not dementia (CIND), Alzheimer disease (AD), and all-cause dementia with benzodiazepine use. The effect modification by sex was also investigated. Method...
Article
Full-text available
There are numerous definitions of polypharmacy to describe the use of many medications among older adults, but there is a need to clarify if they are purposive and meaningful. By means of a systematic review, we identified definitions of polypharmacy used in multimorbid older adults (≥65 years). We evaluated if the definitions align among the domai...
Book
Full-text available
On considère qu’un médicament est inapproprié si les risques sont supérieurs au bénéfice attendu, en particulier lorsque des alternatives thérapeutiques plus sûres existent pour la même indication. L’utilisation de médicaments potentiellement inappropriés est problématique au sein de la population âgée puisqu’elle est associée à la survenue d’effet...
Book
Full-text available
La multimorbidité, soit la co-occurrence de plusieurs maladies chroniques chez un même individu, représente l’un des défis les plus importants de santé publique dans les pays industrialisés (Lancet, 2018). Le vieillissement de la population, combiné au progrès du traitement des maladies chroniques, contribue à l’augmentation de la multimorbidité. L...
Book
Full-text available
Les maladies chroniques sont la première cause de mortalité dans les pays industrialisés. La multimorbidité (cooccurrence d’au moins 2 maladies chroniques chez un même individu) toucherait environ 15 % des Canadiens âgés de 20 ans et plus et 30 % de 65 ans et plus. Le vieillissement de la population, combiné au progrès du traitement des maladies ch...
Article
The treatment of chronic obstructive pulmonary disease (COPD) and concomitant diseases requires several medications. Yet there is little data on how the pharmacological burden progressed over time among older individuals with COPD. We aimed to: 1) describe the proportion of older adults with COPD in Quebec, Canada, that were exposed to polypharmacy...
Article
Purpose of Review The use of multiple medications is common in older adults but is associated with negative health outcomes. However, polypharmacy is not uniformly defined, and there is scant data on how the variety of definitions and their limitations hinder the development of sound scientific knowledge. The article intends to illustrate the chall...
Article
Full-text available
Background: Multimorbidity and mental disorders are independently associated with frequent visits to the emergency department (≥ 3 visits/yr), but their interaction has been little studied. We aimed to measure the interaction between mental disorders and physical multimorbidity with respect to frequent visits to the emergency department. Methods:...
Article
Background: Clinical practice guidelines are useful to suggest pharmacological therapies for the treatment of single chronic diseases. However, there is little guidance for multimorbidity, and specific quality measures for people with multimorbidity that can be used at a population level are lacking. Objective: To describe what pharmacists and g...
Article
Knowledge of the benefit/risk ratio of drugs in older adults is essential to optimise medication use. While randomised controlled trials are fundamental to the process of drug development and bringing new drugs to the market, they often exclude older adults, especially those suffering from frailty, multimorbidity and/or receiving polypharmacy. Ther...
Article
Background The Canadian Emergency Team Initiative (CETI) cohort showed that minor injuries like sprained ankles or small fractures trigger a downward spiral of functional decline in 16% of independent seniors up to 6 months post-injury. Such seniors frequently receive medications with sedative or anticholinergic properties. The Drug Burden Index (D...
Article
Background Canada leads in opioid prescription and consumption rates, and this has resulted in high levels of opioid-related morbidity and mortality. Pharmacists’ input could contribute significantly to understanding the disadvantages of opioid prescribing and dispensing and improving the service. This study aimed to examine the experiences of comm...
Article
Objectives: To validate and compare performance of an International Classification of Diseases, tenth revision (ICD-10) version of a combined comorbidity index merging conditions of Charlson and Elixhauser measures against individual measures in the prediction of 30-day mortality. To select a weight derivation method providing optimal performance...
Article
Résumé Introduction La polymédication est fréquente chez les aînés et est associée à de multiples conséquences négatives. La déprescription, le processus actif de cesser des médicaments en partenariat avec la personne polymédicamentée, apparaît comme une réponse à ces problématiques. Méthode Cet article propose une revue narrative de la littératu...
Article
Background: The use of drugs with anticholinergic properties (AC drugs) has been associated with decreased functioning and impaired cognition in older adults. Studies assessing the association between AC-drug use and health-related quality of life (HRQoL) show conflicting results. Objective: The aim was to evaluate the association between AC-dru...
Article
Full-text available
Background Polypharmacy, the concurrent use of multiple medications, consistently evokes a negative connotation, notably because it is associated with a plethora of adverse events. Nonetheless, the number of individuals exposed to polypharmacy is increasing steeply, especially for older people with multiple diseases. There is a need to carefully st...
Article
Objective To verify the efficacy of school-based interventions aimed at reducing sugar-sweetened beverage (SSB) consumption among adolescents in order to develop or improve public health interventions. Design Systematic review of interventions targeting adolescents and/or the school environment. Setting The following databases were investigated:...
Article
Full-text available
Introduction : Des lacunes en mathématiques ont souvent été mises en évidence chez les étudiants en sciences infirmières, mais il n’existe pas de données au Québec. Méthode : Nous avons développé une auto-formation en ligne composée de textes, de vidéos et de quiz, portant sur les bases de mathématiques. Les étudiants se sont prêtés à un test de v...
Article
Background: While there is evidence that supervised withdrawal of inappropriate medications might be beneficial for individuals with polypharmacy, little is known about their attitudes towards deprescribing. Objective: This study aimed to describe the situation among older community-dwelling Canadians. Methods: A self-administered survey was a...
Article
Aim The use of multiple medications is rising steadily among older individuals, but little is known about the impact of polypharmacy at a population level, both over time and across countries. Surveillance of polypharmacy is required to overcome these gaps. There currently exists no standard population indicator of polypharmacy. The objective of th...
Article
Avec l'augmentation de la prévalence et l'incidence des maladies chroniques, la polypharmacie devient une réalité pour plusieurs individus. L'étude de la polypharmacie dans la population présente un intérêt certain en raison des conséquences, bonnes et néfastes, que peut avoir ce phénomène. Or, il n'existe pas de définition officielle de la polypha...
Book
Le diabète est un problème majeur de santé publique qui touche particulièrement les personnes âgées. Selon les données de l'Institut national de santé publique du Québec (INSPQ), plus de 300 000 personnes de 65 ans et plus étaient atteintes de diabète au Québec en 2011-2012, soit près d'un aîné sur quatre (23,6 %). La prise en charge du diabète, n...
Article
Full-text available
Pharmacists record data on all drugs claimed and may build a personal relationship with their clients. We hypothesized that loyalty to a single pharmacy could be associated with a better quality of drug use. To assess the association between pharmacy loyalty and quality of drug use among individuals treated with oral antidiabetes drugs (OADs). This...
Article
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Le Point en administration de la santé et des services sociaux • Vol. 10, n o 3 40 lA surprescription auprès de la personne âgée – cOMMENT iNTErVENir ? Article n o 10.03.12 Mots-clés : médicaments, surprescription, effets néfastes des médicaments, soins de longue durée, maladie d'Alzheimer et troubles apparentés. Quelques statistiques canadiennes L...
Article
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With the growing burden of chronic diseases, surveillance will play an essential role in improving their prevention and control. The Institut national de santé publique du Québec has developed an innovative chronic disease surveillance system, the Quebec Integrated Chronic Disease Surveillance System (QICDSS). We discuss the primary features, stren...
Article
Full-text available
Introduction Avec l'accroissement du fardeau des maladies chroniques, la surveillance est fondamentale pour améliorer la prévention et la prise en charge de ces dernières. L'Institut national de santé publique du Québec a donc développé un système novateur de surveillance des maladies chroniques, le Système intégré de surveillance des maladies chro...
Conference Paper
Among individuals newly treated with oral antidiabetes drugs (AD), to assess the effect of pharmacy loyalty on adherence to AD and on the guidelines-recommended drugs: 1) ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB); 2) lipid-lowering drug use.
Article
AimsAlthough many elderly individuals suffer from type 2 diabetes, the effectiveness of cardioprotective drugs in primary prevention of cardiovascular events in clinical practice in this population has rarely been evaluated. We aimed to assess the effectiveness of, (i) angiotensin converting enzyme inhibitors or angiotensin receptor blockers, (ii)...