Marie-Thérèse Lussier

• MD,BSc,MSc
• Professor (Associate) at Université de Montréal

132 e x e r c e r # 2 1 1-M a r s 2 0 2 5. Communiquer pour exercer sous la responsabilité de C. Richard et M.-T. Lussier. Chère ARMANDE ! La TCC et la TCD mettent l'accent sur le changement des schémas de pensée et des comportements qui contribuent aux difficultés émotionnelles et comportementales. La TCD a été développée initialement plus spécifi...

Background Nearly 20% of women will be confronted with anxiety or depressive disorders during the perinatal period and this may lead to adverse outcomes for both mother and child. Cognitive behavioural therapy (CBT) is the psychological intervention with the most empirical support for the clinical management of anxiety and depressive disorders. Anx...

1. Background o Walk-in clinics offer medical consultations for semi-urgent primary care, in the context of poor access to family doctors and emergency departments. o In walk-in clinics, patients may not be sufficiently prepared to provide information about their health problems, while doctors have limited time with them. o A consultation preparati...

MEDICODE is a validated medical encounter coding system. Content exchanged is described in terms of the occurrence of predefined topics for the discussion of health problems and treatments. For each topic broached, participation is described in terms of initiative, monologue, dyad or dialogue. In previous studies using MEDICODE, attitudes or emoti...

The goal of the DS-MCP form is to support improved professional-patient communication by GUIDING patients in describing their problem in terms of : 1) Its biomedical (symptom/problem characteristics) aspects 2) The patient’s experience (ideas, concerns, expectations, impact) Empowering patients to optimize their short medical consultation

Introduction: While effective vaccines and natural immunity have significantly reduced hospitalizations and the need for critical care, SARS-CoV-2 is now endemic and is expected to continue to pose a threat to health. New variants are expected to continue to emerge, and vaccines may become less effective. Effective and affordable therapeutics for S...

BACKGROUND Pre-consultation tools have been proposed as a solution to support primary care providers in effectively managing the growing number of older adults. Despite older adults making up 25% of primary care consultations, few tools are specifically adapted for them, and most only assess their physical health. The Evaluation SOcio-GERiatrique (...

Ce communiqué pour exercer vous présente le dernier consensus sur la communication professionnelle en santé publié en mai 2024. Dans cette présentation est également incluse une critique à propos de certains aspects du consensus.

“In Quebec and Canada, we have a public health system. Primary health care is the gateway to the health system. An individual who has a health problem consults his or her family doctor to receive the care and services he or she needs. When the health problem requires urgent care, this patient can consult a hospital emergency department. This system...

Objective The objective was to analyse how the pandemic affected primary care access and comprehensiveness in chronic disease management by comparing primary care patterns before and during the early COVID-19 pandemic. Design We conducted a quasi-experimental pre–post design cohort study and reported indicators for the 21 months before and after t...

Diabetes is a global public health issue. The Public Health Agency of Canada published a Diabetes Framework 2022 which recommends collaborative work across sectors to mitigate the impact of diabetes on health and quality of life. Since 2020, the INMED-COMMUNITY pathway has been implemented in Laval, Québec developing collaboration between healthcar...

« Docteur, vous dites que mes maux de tête sont bénins, sans une IRM ? Il me faut une IRM », « Vous parlez de bronchite, une radio me rassurerait, j’ai peur d’une pneumonie… », « Je n’en peux plus de mon patron ! Je suis à bout, il me faut un arrêt de travail ! » Ces énoncés rappellent probablement aux médecins certaines de leurs consultations. Com...

Background The Laval-ROSA Transilab is a living lab that aims to support the Laval Integrated Health and Social Services Centres (Quebec, Canada) in consolidating the Quebec Alzheimer Plan. It aims to improve care transitions between different settings (Family Medicine Groups, home care, and community services) and as such improve the care of peopl...

Cet article vous propose une vision holistique de la communication patient-médecin que nous nommons « écologie psychosociologique de la communication ». Nous explorons l’intérêt de transposer à la communication professionnelle dans le domaine de la santé le modèle d’écologie sociale du développement humain développé à l’origine par le psychologue B...

Il n’est pas nouveau de s’interroger sur l’impact que représente l’utilisation des nouvelles technologies sur le métier de médecin. Si au niveau technique, les machines semblent pouvoir nous dépasser, les compétences communicationnelles et relationnelles semblaient jusqu’ici rester le propre de l’être humain. Récemment, plusieurs logiciels d’intell...

Background Primary care and other health services have been disrupted during the COVID-19 pandemic, yet the consequences of these service disruptions on patients’ care experiences remain largely unstudied. People with mental-physical multimorbidity are vulnerable to the effects of the pandemic, and to sudden service disruptions. It is thus essentia...

Background: Since the COVID-19 pandemic began, there have been concerns that interruptions to the health care system may have led to changes in primary care, especially for care of chronic conditions such as diabetes and heart failure. Such changes may have longer term implications for population health. Objective: This study aims to describe th...

La santé est un sujet qui nous concerne tous, quel que soit notre âge. Selon les données combinées des deux cycles de l’Enquête canadienne sur les mesures de la santé (ECMS) de 2017 et 2019, 55 % des Canadiens âgés de 18 à 79 ans avaient pris au moins un médicament prescrit par un professionnel de la santé, 36 % en avaient pris deux ou plus, et 24...

Introduction: Measuring the performance of interprofessional primary care is needed to examine whether this model of care is achieving its desired outcomes on patient care and health system effectiveness as well as to guide quality improvement initiatives. The aim of this scoping review is to map the literature on primary care performance measurem...

BACKGROUND Since the COVID-19 pandemic began, there have been concerns that interruptions to the health care system may have led to changes in primary care, especially for care of chronic conditions such as diabetes and heart failure. Such changes may have longer term implications for population health. OBJECTIVE This study aims to describe the im...

A proper understanding of the relationship between people living with dementia (PLWD) and their care partners across the dementia trajectory provides an opportunity to better meet their healthcare needs. However, few studies in Canada have explored the nature of this relationship, considering the well-being of both parties simultaneously. There is...

Design Analyst blinded, parallel, multi-centre, randomised controlled trial (RCT). Participants People with confirmed diagnoses of cancer (head and neck, skin or colorectal) attending follow-up consultation 3 months post-treatment between 2015 and 2020. Intervention Holistic needs assessment (HNA) or care as usual during consultation. Objective...

Professional assertiveness can enable the healthcare provider to confidently share their expertise without seeming authoritarian to the patient. Professional assertiveness is an interpersonal communication skill that helps express opinions or knowledge while respecting similar competencies in others. For healthcare providers, this compares to shari...

Les émotions font partie intégrante de nos vies. Qu’elles soient positives ou négatives, d’une faible ou forte intensité, elles colorent nos journées. Lorsque nous quittons notre domicile pour arriver sur notre lieu de travail, elles nous accompagnent (tristesse émanant d’une discussion compliquée avec son partenaire au petit déjeuner, joie en repe...

La communication interpersonnelle est probablement une des activités humaines parmi les plus complexes, sinon la plus complexe. Elle est à la fois source et produit de la relation. Nous présentons ses différentes dimensions de contenu, d’interaction, de logique et d’argumentation. Nous abordons la capacité d’évocation inhérente à la communication p...

The advanced access (AA) model is among the most recommended innovations for improving timely access in primary health care (PHC). Originally developed for physicians, it is now relevant to evaluate the model's implementation in more interprofessional practices. We compared AA implementation among family physicians, nurse practitioners, and nurses....

Dans un moment de nostalgie, nous avons revisionner des épisodes de la série Dr House (2004-2012). Première constatation, ce diagnosticien arrogant nous permet de mesurer comment ce qui était acceptable comme comportement a évolué. Il y a une phrase qui revient régulièrement chez House : « Tout le monde ment. » Ce qui justifie à ses yeux des compor...

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist - AYP) to a universal...

Context: Virtual pre-consultation screening of patient needs may offer opportunities to improve the care and health outcomes of older patients in primary care, especially those with multiple care needs. Objective: We sought to implement and evaluate the effectiveness of a multidimensional virtual pre-consultation tool in the primary care setting to...

Dans ce premier article, nous vous présentons une nouvelle chronique qui, nous l’espérons, sera utile aux cliniciens : communiquer pour exercer. Notre point de vue pour discuter de communication en santé est celui d’un chercheur et d’une médecin de famille-chercheuse canadiens. Nous nous associerons le plus souvent possible à d’autres auteurs issus...

Background In primary care, patients increasingly face difficult decisions related to complex care needs (multimorbidity, polypharmacy, mental health issues, social vulnerability and structural barriers). There is a need for a pragmatic conceptual model to understand decisional needs among patients with complex care needs and outcomes related to de...

e x e r c e r # 1 8 4-J u i n 2 0 2 2 276 Soins I Communication L'assertivité professionnelle Professional assertiveness née. Cette vérité méthodologique est toujours remise en question par l'ap-parition et l'évolution des technologies permettant de nouvelles mesures, le développement de nouveaux points de vue théoriques, etc. La surabondance d'inf...

Many patients with Type 2 Diabetes (T2D) have difficulty in controlling their disease despite wide-spread availability of high-quality guidelines, T2D education programs and primary care follow-up programs. Current diabetes education and treatment programs translate knowledge from bench to bedside well, but underperform on the ‘last-mile’ of conver...

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...

Objective To describe and evaluate the contribution of multiple coding approaches applied to a clinical conversation on deprescribing in primary care (PC). Methods Seven distinct coding approaches were applied to one audiotaped consultation. Only exchanges related to deprescribing a benzodiazepine (BZD) were coded for: content, interaction, argume...

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...

New version of MEDICODE including treatments and problems

Analyse multiméthode d'un extrait d'une consultation portant sur la déprescription d'un benzodiazépine

A tool to help patients prepare for their consultation

Coding with several coding methods of the communication of an exchange on the deprescribing of a benzodiazepine

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...

Background Let's Discuss Health (LDH) is a website that encourages patients to prepare their health‐care encounters by providing communication training, review of topics and questions that are important to them. Objective To describe LDH implementation during primary care (PC) visits for chronic illnesses. Methods Design: Descriptive mixed‐method...

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...

1- La nécessité et les défis liés à la communication 2- Discussion des différentes formes de communication en fonction des participants, des lieux et du problème. 3- Présentation d'un innovation "Discutons Santé"

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...

Description of the use of MEDICODE and presentations of the type of results we can have.

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...

La communication thérapeutique, dont l’hypnose en représente une variété, est une forme particulière de communication interpersonnelle (entre des personnes) et de communication professionnelle. Examiner ce qu’est la communication professionnelle dans le domaine de la santé constitue un premier temps essentiel pour préciser ce que peut être une comm...

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...

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...

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: Timely access in primary health care is one of the key issues facing health systems. Among many interventions developed around the world, advanced access is the most highly recommended intervention designed specifically to improve timely access in primary care settings. Based on greater accessibility linked with patients' relational co...

Background Patients are often non-adherent to topical corticosteroids (TCS). This may be in part due to poor communication between patients and dermatologists. Objectives This quality improvement (QI) study aims to describe dermatologist–patient communication about TCS treatments and to compare communication before and after the implementation of...

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...

Dans le premier de ces deux articles portant sur l’assertivité professionnelle, nous nous sommes efforcés de replacer la relation médecin-patient dans son cadre légal et déontologique1. Nous avons aussi analysé divers arguments fréquemment invoqués pour réduire l’influence du médecin. Ce faisant, nous avons tenté d’apporter un nouvel éclairage sur...

Dans cet article, scindé en deux parties, nous discuterons de l’« assertivité » et du « comportement assertif », concepts introduits principalement par les psychologues pour décrire une façon d’interagir dans ses relations interpersonnelles. Succinctement, la fonction de l’assertivité est d’affirmer son point de vue tout en respectant son interlocu...

Effective communication between patients and healthcare providers (HCP) is the foundation of Wagner's Chronic Care Model. Few self-learning educational websites focus on improving both patient and HCP communication. To our knowledge, none are available in French. The aim of this project is to develop and validate a French language website intended...

Codification of themes about medication and health condition. For each theme identification of dialog, diad or monolog.

Communication avec un collègue

Un site pour activer le patient et le motiver.

Background: Elders living with polypharmacy may be taking medications that do not benefit them. Polypharmacy can be associated with elevated risks of poor health, reduced quality of life, high care costs, and persistently complex care needs. While many medications could be problematic, this project targets medications that should be deprescribed f...

Analyse d'une entrevue médicale où le MD discute de déprescription d'un benzodiazépine (cesser le RX). Les énoncés sont à la fois codés en fonction de : l'algorithme de déprescription, des codes MEDICODE (contenu), des arguments utilisés, de l'interaction (Roter) et les liens logiques entre propositions. Nous procédons également à une analyse criti...

Registered Protocol for a scoping review. Registered on OSF here: https://osf.io/8ufpd/

Objective: To draw a portrait of drug sample distribution and to assess the concordance between drug samples distributed and the medical problems encountered in the ambulatory primary health care setting. Design: Descriptive cross-sectional survey. A self-administered questionnaire was distributed to all health care professionals (HCPs) in famil...

Objective To determine the existence and the level of health care professional (HCP) knowledge of local policies regarding drug sample use and the relationship between residents and the pharmaceutical industry in academic primary health care settings. Design Descriptive cross-sectional survey. Health care providers were invited to complete a self-a...

Objective: To draw a portrait of drug sample management in academic primary health care settings and assess conformity to existing Canadian guidelines. Design: Descriptive cross-sectional survey. Setting: All 33 family medicine teaching units (FMTUs) in Quebec that kept drug samples. Participants: Health care professionals or FMTU staff who...

Objective: To determine the existence and the level of health care professional (HCP) knowledge of local policies regarding drug sample use and the relationship between residents and the pharmaceutical industry in academic primary health care settings. Design: Descriptive cross-sectional survey. Health care providers were invited to complete a s...

Background: Cardiovascular disease morbidity and mortality are largely influenced by poor control of hypertension, dyslipidemia, and diabetes. Process indicators are essential to monitor the effectiveness of quality improvement strategies. However, process indicators should be validated by demonstrating their ability to predict desirable outcomes....

Résumé Contexte : Les interventions web sont proposées pour engager les patients dans leurs auto-soins et soutenir la collaboration avec leurs soignants. Objectif : Décrire la conception, la validation et l’utilisation du site web Discutons Santé (DS) en vue de soutenir le partenariat patients-soignants. Méthode : Le développement de DS s’est basé...

Background Little is known about the initiation, style and content of patient and healthcare provider communication around deprescribing. We report the findings from a content analysis of audio-recorded discussions of proton pump inhibitor (PPI) and benzodiazepine deprescribing in primary care. Methods Participants were healthcare providers ( n =...

Participants: 5 radio-oncologists 30 prostate cancer patients ! Intervention: DS use to prepare RO consultation o Usual Care (N=15) o DS Care (N=15) ! Study schedule: 1. Assess the feasibility of referring prostate cancer patients to DS before initial radiation oncology consultations; 2. Explore the impact of DS use on radiation oncologists (RO)-pa...

To explore whether receipt of a patient educational brochure prior to the healthcare provider (HCP)-patient encounter changed the topics discussed and the discussion style during deprescribing conversations in primary care (PC).

Active DS implementation phase strategies-DS bookmarks distribution to patients;-DS posters and video display in waiting room;-DS information in clinic voice message and e-mails;-DS demonstrations by trained volunteers Instrument: Questionnaire distributed to adults in the clinic waiting room during January 2018. Outcomes:-DS implementation reach:...

NAPCRG poster

Objective: To assess a selection of psychometric properties of the TRANSIT indicators. Design: Using medical records, indicators were documented retrospectively during the 14 months preceding the end of the TRANSIT study. Setting: Primary care in Quebec, Canada. Participants: Indicators were documented in a random subsample (n = 123 patients...

Présentation de C.I.M. Convaincre et éduquer, Implanter, Maintenir

Présentation du modèle descriptif des usages de la communication professionnelle et la roulette combinatoire

Communication professionnel client

Objective: Examine the impact of a PACE (Prepare, Ask, Check, Express) inspired web-based communication intervention alone or combined with a workshop on reaching treatment goals for patients suffering from chronic diseases (CDs), compared to usual care. Methods: Three arm single-blind RCT in community primary care (PC) practices. PC practitione...

Website interventions directed at patients can increase patient participation in healthcare encounters Easy, accessible As effective as face-to-face interventions and less resource intensive

Let’s Discuss Health-Discutons Santé (DS) is a unique French language free PHR intended to activate chronic disease patients help them prepare for healthcare encounters It was modeled after the THT website that showed significant changes in Communication patterns Post encounter recall of information Proportion of patients reaching clinical targets