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Publications
Publications (352)
Study objective:
We described the experiences and preferences of people with opioid use disorder who access emergency department (ED) services regarding ED care and ED-based interventions.
Methods:
Between June and September 2020, we conducted phone or in-person semistructured qualitative interviews with patients recently discharged from 2 urban...
Background
Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since a 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPS 2019 survey instrument to explore changes of the abortion provider workforce, their clinical care as well as expe...
Background
Cardiovascular diseases are the leading cause of death and disability worldwide. Little is known about the organizational priorities of patients and clinicians involved in primary cardiovascular care. This study aimed to identify their shared top priorities and explore on which aspects their perspectives differed.
Methods
A three-round...
Objectives
Before mifepristone became available in January 2017 in Canada, only physicians provided abortion, and most abortions were surgical and in the largest cities. Risk Evaluation and Mitigation Strategy (REMS)-like restrictions were removed in November 2017, so that mifepristone became a normal prescription. We hypothesized this would increa...
Background:
Since 2016, abortion care has undergone several important changes, particularly related to the provision of medical abortion using mifepristone. We aimed to document characteristics of the abortion care workforce in Canada after the update of clinical practice guidelines of mifepristone use for medical abortion.
Methods:
We conducted...
As the leading risk for death, population control of increased blood pressure represents a major challenge for all countries of the Americas. In the early 1990’s, Canada had a hypertension control rate of 13%. The control rate increased to 68% in 2010, accompanied by a sharp decline in cardiovascular disease. The unprecedented improvement in hypert...
Background
The shifting landscape of abortion care from a hospital-only to a distributed service including primary care has implications for how to identify abortion cohorts for research and surveillance. The objectives of this study were to 1) create an improved approach to define abortion cohorts using linked administrative data sets and 2) evalu...
Type 2 diabetes is a complex chronic disease that requires ongoing monitoring by an interprofessional team to prevent complications. The INMED (INterprofessional Management and Education in Diabetes) care pathway was developed by our team to optimize primary care services for these patients and their families. The objective of this study is to desc...
(Abstracted from N Engl J Med 2022;386:57–67) A medical abortion regimen of mifepristone and misoprostol is safe. In the United States, mifepristone is approved for use only with onerous Risk Evaluation and Mitigation Strategy (REMS) restrictions, which include mandatory prescriber certification, observed dispensing of doses by the prescriber or me...
Background
Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since a 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPs 2019 to explore changes of the abortion provider workforce, their clinical care as well as experiences with stigm...
Objective:
This study documents the adoption of telehealth by various types of primary healthcare (PHC) providers working in teaching PHC clinics in Quebec during the COVID-19 pandemic. It also identifies the perceived advantages and disadvantages of telehealth.
Method:
A cross-sectional study was conducted between May and August 2020. The e-sur...
Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency.
We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine cer...
Aim:
To capture pandemic experiences of people with opioid use disorder (OUD) to better inform the programs that serve them.
Design:
We designed, conducted, and analyzed semi-structured qualitative interviews using grounded theory. We conducted interviews until theme saturation was reached and we iteratively developed a codebook of emerging them...
Background:
Buprenorphine-naloxone (BUP) initiation in emergency departments improves follow-up and survival among patients with opioid use disorder. We aimed to assess self-reported BUP-related practices and attitudes among emergency physicians.
Methods:
We designed a cross-sectional physician survey by adapting a validated questionnaire on opi...
Background
Up to 74 % of people with an opioid use disorder (OUD) will experience depression in their lifetime. Understanding and addressing the concept of preference for depression treatments and clinical trial designs may serve as an important milestone in enhancing treatment and research outcomes. Our goal is to evaluate preferences for depressi...
Objectives
The objective of this study was to examine the perspectives of Canadian emergency physicians on the care of patients with opioid use disorders in the emergency department (ED), in particular the real‐world facilitators to prescribing buprenorphine/naloxone (BUP) in the ED.
Methods
We conducted semistructured qualitative interviews using...
Background
Chronic diseases are responsible for over 70% of all deaths globally. While some self-management programs have been shown to be efficacious in preventing or altering trajectories for some chronic conditions, scaling-up and sustaining such programs beyond tightly-controlled study conditions remain a major challenge. CISSS-Laval partnered...
Background
The Cardiovascular Health Awareness Program (CHAP) is as a community-based cardiovascular disease prevention program recently adapted to target older adults living in 14 social housing buildings in Ontario (7) and Quebec (7). Social network analysis (SNA) has been used successfully to assess and strengthen participation in health promoti...
Introduction:
The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular diseases (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary care. Centralized waiti...
Background: The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in small to medium size communities in Ontario. Recently, CHAP has been adapted to target older individuals living in 14 social housing buildings in Ontario (7) and Quebec (7). Th...
Background: Locally recruited and trained volunteers are a vital component of the Cardiovascular Health Awareness Program (CHAP), a community-based cardiovascular disease prevention program that has been implemented across different settings and targeting different populations. As part of expanding and adapting CHAP to new settings, we conducted a...
Background: Locally recruited and trained volunteers are a vital component of the Cardiovascular Health Awareness Program (CHAP), a community-based cardiovascular disease prevention program that has been implemented across different settings and targeting different populations. As part of expanding and adapting CHAP to new settings, we conducted a...
Objectives
The opioid crisis has risen dramatically in North America in the new millennium, due to both illegal and prescription opioid use. While emergency departments (EDs) represent a potentially strategic setting for interventions to reduce harm from opioid use disorder (OUD), the absence of a recent synthesis of literature limits implementatio...
Background : Chronic diseases are responsible for over 70% of all deaths globally. While some self-management programs have been shown to be efficacious in preventing or altering trajectories for some chronic conditions, scaling-up and sustaining such programs beyond tightly-controlled study conditions remain a major challenge. The objective of the...
Hypertension Canada’s 2020 guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children provide comprehensive, evidence-based guidance for health care professionals and patients. Hypertension Canada develops the guidelines using rigourous methodology, carefully mitigating the risk of bias in our pr...
Background:
Health systems in Canada and elsewhere are at a crossroads of reform in response to rising economic and societal pressures. The Quadruple Aim advocates for: improving patient experience, reducing cost, advancing population health and improving the provider experience. It is at the forefront of Canadian reform debates aimed to improve a...
Background The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary healthcare. Centralised wait...
Background: The Cardiovascular Health Awareness Program (CHAP) was originally developed and evaluated as a community-based cardiovascular disease (CVD) prevention program in communities where access to family physicians was not a significant issue. Many Canadians now face sub-optimal access to a regular source of primary healthcare. Centralised wai...
: The main advantage of automated office (AO)BP in hypertension screening is that it eliminates white-coat effect seen in routine office practice, with readings similar to awake ambulatory (A)BP. Recent studies examining the possible equivalence between AOBP recorded with and without research staff present have reported attended systolic AOBP to be...
A recent report from the American Heart Association stated that automated office blood pressure (AOBP) is preferred for evaluating office blood pressure (BP) because it is more accurate and devoid of white coat effect, which is mostly caused by higher systolic BP readings. However, AOBP has been criticized for being too variable to be used for iden...
Volunteers have been extensively used in health promotion programmes. However, they have been less frequently involved in the research process. In its most recent iterations, the Cardiovascular Health Awareness Program (CHAP) integrated volunteers (i) to facilitate CHAP sessions with participating patients for data collection and (ii) to evaluate t...
Background:
Chronic conditions such as diabetes and chronic obstructive pulmonary disease (COPD) are common and burdensome diseases primarily managed in primary care. Yet, evidence points to suboptimal quality of care for these conditions in primary care settings. Quality improvement collaboratives (QICs) are organized, multifaceted interventions...
Background:
The Cardiovascular Health Awareness Program (CHAP) uses volunteers to provide cardiovascular disease (CVD) and diabetes screening in a community setting, referrals to primary care providers, and locally available programs targeting lifestyle modification. CHAP has been adapted to target older adults residing in social housing, a vulner...
Nearly two-thirds of all deaths worldwide are from non-communicable chronic diseases, with a similar proportion in Canada. According to the Global Burden of Disease Study, unhealthy eating is the leading risk for death and the second leading risk for disability in Canada. It is clear that to adequately address this major health issue, we need a com...
Background
Type 2 diabetes is increasing globally, with the highest burden in low- to middle-income countries (LMICs) such as the Philippines. Developing effective interventions could improve detection, prevention, and treatment of diabetes. The Cardiovascular Health Awareness Program (CHAP), an evidence-based Canadian intervention, may be an appro...
In Reply We agree with Etyang’s assertion that the accurate assessment of blood pressure (BP) is an important step in determining cardiovascular risk and that efforts to improve the accuracy of BP measurement should be encouraged. This accuracy is equally important for screening, diagnosis, and ongoing management of patients because the consequence...
Objective
Biliary atresia, a rare newborn liver disease, is the most common cause of liver-related death in children and the main indication for paediatric liver transplantation. Early detection and surgical intervention with a Kasai portoenterostomy offers the best chance for long-term patient survival. We conducted a cost-effectiveness analysis t...
Importance
Automated office blood pressure (AOBP) measurement involves recording several blood pressure (BP) readings using a fully automated oscillometric sphygmomanometer with the patient resting alone in a quiet place. Although several studies have shown AOBP measurement to be more accurate than routine office BP measurement and not subject to a...
The recent American hypertension guidelines recommended a threshold of 130/80 mmHg to define hypertension on the basis of office, home or ambulatory blood pressure (BP). Despite recognizing the potential advantages of automated office (AO)BP, the recommendations only considered conventional office BP, without providing supporting evidence and witho...
Study objective:
Lack of oral anticoagulation prescription in the emergency department (ED) has been identified as a care gap in atrial fibrillation patients. This study seeks to determine whether the use of a tool kit for emergency physicians with a follow-up community-based atrial fibrillation clinic resulted in greater oral anticoagulation pres...
Study question
The Cardiovascular Health Awareness Program (CHAP) cardiovascular risk reduction program consisted of sessions run by local volunteers in local pharmacies during which cardiovascular risk was assessed, healthy lifestyle and preventive care was promoted, and the participants were oriented to local resources to support changes in modif...
Background:
Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear.
Methods and results:
We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of h...
Background:
The efficacy of internet-based interventions to improve hypertension management is not established. We evaluated the therapeutic benefit of e-counseling by adapting best evidence guidelines for behavioral counseling.
Methods and results:
This multicenter double-blind randomized controlled trial included assessments at baseline, 4 mon...
Table S1. Search Strategy for Medline(R) (1946–Most Recent) and Embase (Embase+Embase Classic)
Table S2. Risk of Bias in Nonrandomized Studies—of Interventions (ROBINS‐I) Assessment Tool, Modified Version
Figure S1. Incidence of hypertension in former drinkers compared with lifetime abstainers at baseline by sex, 1989–2017.
Figure S2. Incidence...
Background
Biliary atresia (BA), a rare newborn liver disease (1:19,000 births in Canada), is the leading cause of cirrhosis and liver related mortality in children. Early referral and timely surgical intervention (≤60 days of age) with a Kasai procedure (KP) offers the best chance for long-term survival without liver transplant. Taiwan has a unive...
Hypertension Canada provides annually-updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately.
For 2018, 5 new guidel...
Background:
Biliary atresia (BA), a rare newborn liver disease, is the leading cause of liver-related death in children. Early disease recognition and timely surgical Kasai hepatoportoenterostomy (KP) offers long-term survival without liver transplant. Universal BA screening in Taiwan using infant stool color cards (ISCCs) has proven effectiveness...
Purpose:
The use of potentially inappropriate medications (PIMs) in hospitalized older adults is a complex problem, but the use of computerized alert systems (CAS) has shown some potential. The study's objective is to assess the change in PIM use with a CAS-based pharmacist-physician intervention model compared to usual clinical care.
Methods:
P...
Background:
The benefits of "spaced education" have been documented for residents in highly focused specialties. We found no published studies of spaced education in family medicine. In this study, we report on the feasibility of delivering weekly alerts from a mobile application (app) developed for exam preparation, to increase the reading of cli...
PURPOSE: In 2009, pharmacists in British Columbia were given the right to become certified in vaccine-administration. While the uptake of this new activity was impressive, there is still a need to better understand current and expected involvement of pharmacists in immunization activities. Our objective was to identify pharmacist and pharmacy chara...
BACKGROUND: Biliary atresia (BA), a rare newborn liver disease (1:19,000 births in Canada), is the leading cause of cirrhosis and liver related mortality in children. Early referral and timely surgical intervention (≤60 days of age) with a Kasai procedure (KP) offers the best chance for long-term survival without liver transplant. Taiwan has a univ...
The Community Health Assessment Program-Philippines (CHAP-P) is an international collaboration of investigators whose aim is to adapt a previously proven Canadian community-based cardiovascular awareness and prevention intervention to the Philippines and other low-middle-income countries. Choosing a method of blood pressure measurement for the rese...
Hypertension Canada provides annually-updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed. Previous age and frailty distinctions have been removed as considerations for when to initi...
Objective:
To describe the techniques currently used by family physicians in Canada to measure blood pressure (BP) for screening for, diagnosing, and treating hypertension.
Design:
A Web-based cross-sectional survey distributed by e-mail.
Setting:
Stratified random sample of family physicians in Canada.
Participants:
Family physician members...
Background: Although it is well established that heavy alcohol consumption increases the risk of hypertension, little is known about the effect of a reduction of alcohol intake on blood pressure. We aimed to assess the effect of a reduction in alcohol consumption on change in blood pressure stratified by initial amount of alcohol consumption and se...
Research is needed to understand refugees’ health challenges and barriers to accessing health services during settlement. However, there are practical and ethical challenges for engaging refugees as participants. Despite this, there have been no studies to date specifically investigating refugee perspectives on factors affecting engagement in healt...
