Nadia Sourial

Nadia Sourial
Université de Montréal | UdeM · Département de médecine de famille et de médecine d'urgence

Doctor of Medicine

About

95
Publications
8,573
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1,827
Citations
Citations since 2017
56 Research Items
1082 Citations
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2017201820192020202120222023050100150200

Publications

Publications (95)
Preprint
BACKGROUND The latest global figures show that 55 million persons lived with major neurocognitive disorders (MNCDs) worldwide in 2021. In Quebec, Canada, most of these seniors are cared for by family physicians in interdisciplinary primary care clinics such as family medicine groups (FMG). When a person suffers from a MNCD, taking potentially inapp...
Article
Background: The latest global figures show that 55 million persons lived with major neurocognitive disorders (MNCDs) worldwide in 2021. In Quebec, Canada, most of these seniors are cared for by family physicians in interdisciplinary primary care clinics such as family medicine groups (FMG). When a person suffers from a MNCD, taking potentially ina...
Article
Objective: To develop a framework of population-based primary care quality indicators adapted to patients with dementia and to identify a subset of stakeholder-driven priority indicators. Design: Framework development was carried out through the selection of an initial framework based on a rapid review and identification of relevant indicators a...
Article
Objective: The objective of the present study is to measure the impact of the intervention of combining a medication review with an integrated care approach on potentially inappropriate medications and hospital readmissions in frail older adults. Methods: A cohort of hospitalized older adults enrolled in the PAERPA integrated care pathway (the e...
Article
During the COVID-19 pandemic, policymakers had to quickly offer telehealth services to address older adults’ needs. This study aimed to understand the experiences of providers who implemented a telephone-based telehealth tool named Socio-Geriatric Evaluation (ESOGER), which assessed health and social isolation risks in community-dwelling older adul...
Article
Background: Community-dwelling people with dementia have been affected by COVID-19 pandemic health risks and control measures that resulted in worsened access to health care and service cancellation. One critical access point in health systems is the emergency department. We aimed to determine the change in weekly rates of visits to the emergency...
Article
Full-text available
Background COVID-19 catalyzed a rapid and substantial reorganization of primary care, accelerating the spread of existing strategies and fostering a proliferation of innovations. Access to primary care is an essential component of a healthcare system, particularly during a pandemic. We describe organizational innovations aiming to improve access to...
Article
Full-text available
Background Organizational and clinician characteristics are important considerations for the implementation of evidence-based recommendations into primary care practice. The introduction of Canadian dementia practice guidelines and Alzheimer strategies offers a unique context to study which of the organizational and clinician characteristics align...
Article
There is growing consensus that interprofessional primary care is key to delivering timely, coordinated, and comprehensive care, especially in the older patient population who often live with complex and chronic needs. Despite significant investments in reforming health systems toward interprofessional primary care, there is a paucity of evidence d...
Article
Full-text available
Introduction Institutional support, encompassing financial and training support, as well as interdisciplinary teams, may be important for the quality of dementia primary care for persons living with dementia. The aim of this study was to measure the association between the level of institutional support provided to primary care practices and the qu...
Article
Importance: Persons with dementia and Parkinson disease (PD) are vulnerable to disruptions in health care and services. Objective: To examine changes in health service use among community-dwelling persons with dementia, persons with PD, and older adults without neurodegenerative disease during the first wave of the COVID-19 pandemic. Design set...
Article
Purpose: Interprofessional primary care has the potential to optimize hospital use for acute care among people with dementia. We compared 1-year emergency department (ED) visits and hospitalizations among people with dementia enrolled in a practice having an interprofessional primary care team with those enrolled in a physician-only group practice...
Preprint
Objective: Our hypothesis was that the intervention would decrease (or at least not increase) the number of potentially inappropriate medications (PIMs) and the number of hospital readmissions within 30 days of discharge per hospital stay. Methods: A cohort of hospitalized older adults enrolled in the PAERPA integrated care pathway (the exposed coh...
Article
Full-text available
Antiretroviral therapy effectively prevents sexual and vertical transmission of HIV. Yet, some women living with HIV report having unmet needs for reproductive health care. This study measured the prevalence of women discussing reproductive goals with any current healthcare provider and assessed the effect of the current HIV care provider’s gender...
Article
Little has been quantified, at a population‐level, about the magnitude of heath service disruption to persons living with dementia in community settings during the COVID‐19 pandemic. Sustained access to health care services is particularly important for persons with dementia and other neurodegenerative diseases as they are vulnerable to decline. He...
Preprint
Full-text available
Background COVID-19 catalyzed a rapid and substantial reorganization of primary care, accelerating the spread of existing strategies and fostering a proliferation of innovations. Access to primary care is an essential component of a health care system, particularly during a pandemic. We describe organizational innovations aiming to improve access t...
Article
Full-text available
Background: Whether avoidable hospitalizations in community-dwelling persons with dementia have decreased during primary care reforms is unknown. Methods: We described the prevalence and trends in avoidable hospitalizations in population-based repeated yearly cohorts of 192,144 community-dwelling persons with incident dementia (Quebec, 2000-2015...
Article
Introduction: The implications of the COVID-19 pandemic are far reaching for persons living with dementia (PLWD) in the community and in long-term care (LTC), as they are among the most vulnerable. PLWD are at risk for severe COVID-19 and a disruption in accessing supportive and health care due to the confinement measures. Objectives: 1) To measur...
Preprint
Full-text available
Background Older adults are more vulnerable to severe infection and mortality due to COVID-19. They often have atypical presentations of the disease without respiratory symptoms, which makes early diagnosis clinically challenging. We aimed to compare the baseline characteristics, presentation, and disease course of older and younger patients hospit...
Article
Background/objective: To measure the association between high primary care continuity and potentially avoidable hospitalization in community-dwelling persons with dementia. Our hypothesis was that high primary care continuity is associated with fewer potentially avoidable hospitalizations. Design: Population-based retrospective cohort (2012-2016...
Conference Paper
As the Canadian population ages, challenges have emerged with the quality and healthcare utilization of services for persons living with dementia (PWD). These challenges may be exacerbated when we consider the sex inequalities. A disconcerting trend in sex differences has arisen among older adult women, where they are more disadvantaged compared to...
Article
Many countries have answered the call from the World Health Organization, and developed or implemented Alzheimer Plans. Some plans anchored the majority of the care for persons living with dementia in specialized care settings, while others anchored it in primary care. In this article we present the Quebec Alzheimer Plan, which is being implemented...
Article
Full-text available
Background: The influence of sex and gender on the risk of dementia, its clinical presentation and progression is increasingly being recognized. However, current dementia strategies have not explicitly considered sex and gender differences in the management of dementia to ensure equitable care. The objective of this study was to examine the modera...
Article
Our study objective was to develop and validate a questionnaire assessing the knowledge, attitude, and practice (KAP) of family physicians regarding dementia care and dementia strategies in Canada. Using a multistage process with a panel of experts, we developed and distributed an 83-item questionnaire to 542 eligible family physicians in 42 interd...
Article
Full-text available
Introduction Dementia is on the rise in Canada and globally. Ensuring accessibility to diagnosis, treatment and management throughout the course of the disease is a very significant problem worldwide. In order to provide comprehensive care to patients and their caregivers, enhancing primary care-based dementia care is seen as the way forward. In ma...
Article
Full-text available
Transitional care interventions, often led by hospital specialists, have mixed impact on reducing readmissions. Interventions led by family physicians may be more promising. The objective of this study was to evaluate the impact of a family-medicine-based intervention in reducing the incidence of emergency department (ED) visits, hospital readmissi...
Article
Objectives: Growing evidence points to underlying sex differences in the risk factors and clinical presentation of dementia. It is unclear, however, whether sex differences also exist in the management and healthcare utilization of persons with dementia. We compared primary care performance and health service use indicators for newly identified me...
Article
Full-text available
Background: The Quebec Alzheimer Plan aims to improve care provided to patients with neurocognitive disorders in Family Medicine Groups (FMGs) (multidisciplinary team-based primary care practices). The objective of this study was to determine changes in the detection and management of neurocognitive disorders following implementation of the plan,...
Poster
Context: Many provinces are implementing initiatives to better prepare primary care to tackle dementia care. In Quebec, a provincial plan was implemented in 2014. In Ontario, many local initiatives have been put in place since 1999 and similar initiatives are under consideration in New Brunswick. Knowledge, attitudes, and practices of the family ph...
Conference Paper
Context: In 2014, the Quebec Alzheimer Plan (AP) was launched in 38 family medicine groups (FMGs) to improve the ability of primary care professionals to detect and care for patients with Alzheimer’s disease and their caregivers. Objective: Describe the fidelity of implementation of the AP in participating FMGs Method: 42-item questionnaire measuri...
Article
Full-text available
Background Passive dissemination of information in healthcare refers to the publication or mailing of newly established guidelines or recommendations. It is one of the least costly knowledge translation activities. This approach is generally considered to be ineffective or to result in only small changes in practice. Recent research, however, sugge...
Article
Background The objective of this study is to explore the association between frailty and surgical recovery over a 6-month period, in elderly patients undergoing elective abdominal surgery. Methods A total of 144 patients were categorized as frail, pre-frail, and non-frail based on five criteria: weight loss, exhaustion, weakness, slowness, and low...
Conference Paper
In 2013, the Quebec Ministry of Health implemented a reform called the ‘Alzheimer Plan’ in 42 family medicine groups (FMG) to better manage dementia patients in primary care. We created and validated two questionnaires to measure the clinicians’ knowledge, attitudes, and practices regarding dementia care in each FMG. Based on the literature and con...
Conference Paper
In 2013, the Quebec government implemented an Alzheimer Plan (AP) to improve dementia patients’ management in primary care. We aimed to evaluate the impact of this intervention on the clinicians’ knowledge, attitudes, and practices (KAP) and their association with the quality of dementia care. To this end, clinicians’ questionnaires were distribute...
Article
Nonrandomized studies are increasingly used to evaluate interventions where randomization is not feasible or desired such as with policy reforms or practice change. A common practice is to statistically compare baseline characteristics between the control and intervention group to determine imbalances and confounders for model adjustment. This prac...
Article
Healthcare systems are facing an increasing number of vulnerable older patients with chronic diseases (CD). Transitions in care from hospital to primary care for this population are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented to increase...
Conference Paper
The Alzheimer Plan, focusing on primary health care as the hub of networked care for patients with dementia, is being implemented in 40 selected Family Medicine Groups in Quebec, Canada. Our objectives were to: 1) assess the impact of the plan on detection, diagnosis, treatment and quality of dementia care management, 2) describe the implementation...
Conference Paper
The Quebec government has started implementing an Alzheimer Plan (AP) in 42 family medicine groups (FMGs) to improve the management of patients with dementia. We aimed to evaluate the change in the quality of dementia care management and the rate of cognitive testing and diagnosis after the implementation of this reform. Two independent sets of cha...
Article
Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self-management, discharge planning, structured follow-up and coo...
Article
Background: Malnutrition among elderly surgical patients has been associated with poor postoperative outcomes and reduced functional status. Although previous studies have shown that nutrition contributes to patient outcomes, its long-term impact on functional status requires better characterization. This study examines the effect of nutrition on...
Article
While the negative impact of postoperative complications on hospital costs, survival, and cancer recurrence is well known, few studies have quantified the impact of postoperative complications on patient-centered outcomes such as functional status. The objective of this study was to estimate the impact of postoperative complications on recovery of...
Article
Full-text available
The purpose of this study was to determine the proportion of symptomatic recurrence following initial non-operative management of gallstone disease in the elderly and to test possible predictors. This is a single institution retrospective chart review of patients 65 years and older with an initial hospital visit (V1) for symptomatic gallstone disea...
Article
Full-text available
The effect of an educational program on antipsychotic prescribing was assessed in two Canadian long-term care centers (LTCC). In each center (Center A residents, n = 258 and Center B residents, n = 191, with dementia at program inception), the rate of change in the odds of using antipsychotics in residents was estimated using mixed-effects logistic...
Article
Objectives To determine the association between self-rated health (SRH) and functional status, comorbidity, toxicity of treatment and mortality in older patients with newly-diagnosed cancer. Materials and Methods Patients aged 65 and over, newly diagnosed were recruited at the Jewish General Hospital, Montreal, Canada. SRH and functional status [i...
Article
The ability to measure surgical quality of care is important and can lead to improvements in patient safety. As such, processes should be carried out in an identical fashion for all patients, regardless of how vulnerable or complex they are. Our objectives were to assess quality of surgical care delivered to elderly patients and to determine the as...
Article
Full-text available
Background: Little is known about the contribution of frailty in improving patient-level prediction beyond readily available clinical information. The objective of this study is to compare the predictive ability of 129 combinations of seven frailty markers (cognition, energy, mobility, mood, nutrition, physical activity, and strength) and quantify...
Article
Background Measuring quality of surgical care is essential to identifying areas of weakness in the delivery of effective surgical care and to improving patient outcomes. Our objectives were 1) to assess the quality of surgical care delivered to adult patients and 2) to determine the association between quality of surgical care and post-operative co...
Article
Full-text available
There has been little research on the relative importance of frailty markers. The objective was to investigate the association among seven frailty domains (nutrition, physical activity, mobility, strength, energy, cognition, and mood) and their relative contribution in explaining differences among individuals in five samples of older persons. Data...
Article
RÉSUMÉ La fragilité met les individus à un risque accru de mauvaise santé. Les personnes âgées consomment une quantité disproportionnée des ressources du service des urgence [SU]. Afin d’étudier la relation entre les marqueurs de fragilité et l’effet sur l’utilisation des services des urgence par les personnes âgées vivant dans les communautés, nou...
Article
Background: While antipsychotic (AP) medications are frequently used in long-term care, current evidence suggests that the risks may offset the benefits, necessitating periodic reassessment of their use. The aims of this present study were: (1) to assess rates of AP use five years after our first intervention to determine the long-term impact; and...
Article
Inappropriate and widespread prescribing of antipsychotics in LTCF is of concern. This study aimed to explore the association of resident and room characteristics with antipsychotic use in this setting. This is cross-sectional secondary analysis of the baseline data of 280 residents ≥ 65 years old, from a prospective, observational, LTCF multi-site...
Article
Full-text available
This study aimed to describe the differences in the management of symptomatic gallstone disease within different elderly groups and to evaluate the association between older age and surgical treatment. This single-institution retrospective chart review included all patients 65 years old and older with an initial hospital visit for symptomatic galls...
Article
Background Physical performance may predict survival independently of other current predictors in non selected elderly subjects. We determined if poor balance and decreased gait speed may predict mortality after adjustment for both baseline and follow-up confounders in well-functioning elderly women. Methods A subgroup of participants in the Epidem...
Article
The management of older cancer patients is often suboptimal. This study aims to understand the management of older cancer patients who may receive chemotherapy. A questionnaire was mailed in 2006-2007 to 181 medical oncologists and hematologists practicing in the Province of Quebec, Canada. Physicians, involved in treatment decisions regarding chem...
Article
Full-text available
Correspondence analysis (CA) is a multivariate graphical technique designed to explore the relationships among categorical variables. Epidemiologists frequently collect data on multiple categorical variables with the goal of examining associations among these variables. Nevertheless, CA appears to be an underused technique in epidemiology. The obje...
Article
The term frailty is used to describe older persons at high risk for adverse health outcomes. In 2001, Fried et al. proposed a now widely cited definition which suggests that frailty is a clinical entity related to, but distinct from, ADL disability and comorbidity. Frailty status was assessed based on the presence of any three of the following five...
Article
To examine the relationships among seven frailty domains: nutrition, physical activity, mobility, strength, energy, cognition, and mood, using data from three studies. Data from three studies were separately analyzed using multiple correspondence analysis (MCA). The graphical output of MCA was used to assess (1) if the presence of deficits in the f...
Article
Full-text available
Cognition and mobility in older adults are closely associated and they decline together with aging. Studies evaluating associations between cognitive factors and gait performance in people with Mild Cognitive Impairment (MCI) are scarce. In this study, our aim was to determine whether specific cognitive factors have a more identifiable effect on ga...
Data
Linear regression analysis of the associations of cognitive tests and GV with single and dual-task conditions. Data provided represents results of a linear regression analysis of the associations of cognitive tests and GV with single and dual-task conditions.
Article
There is a growing consensus on the relevance of a palliative care approach in end-stage dementia. The objective of this study was to assess the impact, in terms of family satisfaction with end-of-life care, of a nursing home (NH) pilot educational program for nursing staff and physicians on comfort care and advanced dementia. The intervention, imp...
Article
Frail older adults sustain mobility limitations; however, clinical experience suggests that their mobility characteristics are far from being homogeneous. We conducted a prospective analysis to identify mobility heterogeneity in 1160 very frail older adults and we investigated the associations between mobility limitation profiles and further instit...