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Background Posttraumatic stress disorder (PTSD) has significant morbidity and economic costs. This study describes the prevalence and characteristics of patients with PTSD using primary care electronic medical record (EMR) data. Methods This retrospective cross-sectional study used EMR data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). This study included 1,574 primary care providers located in 7 Canadian provinces. There were 689,301 patients that visited a CPCSSN provider between 1 January 2017 and 31 December 2019. We describe associations between PTSD and patient characteristics using descriptive statistics, chi-square, and multiple logistic regression models. Results Among the 689,301 patients included, 8,817 (1.3%, 95% CI 1.2–1.3) had a diagnosis of PTSD. On multiple logistic regression analysis, patients with depression (OR 4.4, 95% CI 4.2–4.7, P < 0.001), alcohol abuse/dependence (OR 1.7, 95% CI 1.6–1.9, P < 0.001), and/or drug abuse/dependence (OR 2.6, 95% CI 2.5–2.8, P < 0.001) had significantly higher odds of PTSD compared with patients without those conditions. Patients residing in community areas considered the most material deprived (OR 2.1, 95% CI 1.5–2.1, P < 0.001) or the most socially deprived (OR 2.8, 95% CI 2.7–5.3, P < 0.001) had higher odds of being diagnosed with PTSD compared with patients in the least deprived areas. Conclusions The prevalence of PTSD in Canadian primary care is 1.3% (95% CI 1.25–1.31). Using EMR records we confirmed the co-occurrence of PTSD with other mental health conditions within primary care settings suggesting benefit for improved screening and evidence-based resources to manage PTSD. [ABSTRACT FROM AUTHOR]

Context: The high dose flu vaccination is newly available to Canadians and recommended for adults aged 65 years and older. Describing patterns of flu vaccination in Canadian primary care using electronic medical records (EMR) is challenging. However, we have established that by using a combination of the ATC code and the lot number of the product administered, we can differentiate between high and standard dose flu vaccination using routinely collected structured EMR data. Objectives: 1) Construct a baseline cohort of patients who received a flu vaccine during the 2018- 2019 and 2019-2020 flu seasons. 2) Describe age, SES and comorbidity related patterns of standard vs. high dose flu vaccination. Design: Baseline cohort pilot study Dataset: Data from the Eastern Ontario Network (EON), a repository of EMR data drawn from primary care practices in south-eastern Ontario. Population Studied: Patients aged 65 and older who received a flu vaccination in a primary care setting during the 2018-2019 and/or 2019-2020 flu seasons (June 1 2018-May 31 2020). Outcome Measures: Flu vaccinations were determined by ATC code (J07BB). All patients who were vaccinated with a high dose lot number product were classified as 'high dose', all others were classified as 'standard dose'. Logistic regression was used to describe odds of high vs standard dose flu vaccinations related to age, sex, location, socioeconomic status, and comorbidity. Results: Baseline cohorts of patients aged 65 and older who received flu vaccinations during the 2018-2019 (n=19,037) and 2019-2020 (n=18,908) flu seasons were constructed. Over one-third of patients 65 and older received a high dose flu vaccination in the 2018- 2019 (36.6%) and 2019-2020 (35.4%) flu seasons. Both cohorts (2019-2019 vs 2019-2020) were also similar in age (75.8 [+ or -] 7.6 vs. 75.9 [+ or -] 7.6 years old), sex (54.6% vs. 54.2% female), and location (65.2% vs 64.2% live in an urban setting). Age was the strongest predictor of having received a high dose flu vaccine for both cohorts. Patients aged 85 years and older were 1.44x (95% CI 1.29-162; 2018-2019) and 1.86x (95% CI 1.65-2.08; 2019-2020) more likely to have received a high dose flu vaccine compared to patients aged 65 to 69. Conclusion: Overall, Canadian primary care EMR data was effectively used to compare patterns of high and standard dose flu vaccinations in patients aged 65+. Future work will describe patterns of subsequent respiratory infections stratified by flu vaccine dose., Presenters Rebecca Theal, Rachael Morkem, MSc, David Barber, MD, BSc, John Queenan, PhD, BA, MSc, Lorne [...]

IntroductionEffective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery.Methods and analysisThe CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients' demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3-5 will be presented as age-sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age-sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods.Ethics and disseminationThe CPCSSN is committed to high ethical standards when dealing with individual data collected, and this work is reviewed and approved by the Network Scientific Committee. The results will be published in peer-reviewed journals and presented at relevant national and international scientific meetings.