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6. Opioid reduction and enhanced recovery in orthopaedic surgery (OREOS): a protocol for a feasibility randomised controlled trial in patients undergoing total knee arthroplasty

Author

Madden, Kim, Pallapothu, Sushmitha, Young Shing, Darren, Adili, Anthony, Bhandari, Mohit, Carlesso, Lisa, Khan, Moin, Kleinlugtenbelt, Ydo V., Krsmanovic, Adrijana, Nowakowski, Matilda, Packham, Tara, Romeril, Eric, Tarride, Jean-Eric, Thabane, Lehana, Tushinski, Daniel M., Wallace, Christine, Winemaker, Mitchell, and Shanthanna, Harsha

Published
2024
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7. Health care utilization and outcomes of patients seen by virtual urgent care versus in-person emergency department care

Author

McLeod, Shelley L., Tarride, Jean-Eric, Mondoux, Shawn, Paterson, J. Michael, Plumptre, Lesley, Borgundvaag, Emily, Dainty, Katie N., McCarron, Joy, Ovens, Howard, and Hall, Justin N.

Subjects
Medical care -- Utilization, Hospitals -- Emergency service, Health
Abstract

Background: Virtual urgent care (VUC) is intended to support diversion of patients with low-acuity complaints and reduce the need for in-person emergency department visits. We aimed to describe subsequent health care utilization and outcomes of patients who used VUC compared with similar patients who had an in-person emergency department visit. Methods: We used patient-level encounter data that were prospectively collected for patients using VUC services provided by 14 pilot programs in Ontario, Canada. We linked the data to provincial administrative databases to identify subsequent 30-day health care utilization and outcomes. We defined 2 subgroups of VUC users; those with a documented prompt referral to an emergency department by a VUC provider, and those without. We matched patients in each cohort to an equal number of patients presenting to an emergency department in person, based on encounter date, medical concern and the logit of a propensity score. For the subgroup of patients not promptly referred to an emergency department, we matched patients to those who were seen in an emergency department and then discharged home. Results: Of the 19 595 patient VUC visits linked to administrative data, we matched 2129 patients promptly referred to the emergency department by a VUC provider to patients presenting to the emergency department in person. Index visit hospital admissions (9.4% v. 8.7%), 30-day emergency department visits (17.0% v. 17.5%), and hospital admissions (12.9% v. 11.0%) were similar between the groups. We matched 14 179 patients who were seen by a VUC provider with no documented referral to the emergency department. Patients seen by VUC were more likely to have a subsequent in-person emergency department visit within 72 hours (13.7% v. 7.0%), 7 days (16.5% v. 10.3%) and 30 days (21.9% v. 17.9%), but hospital admissions were similar within 72 hours (1.1% v. 1.3%), and higher within 30 days for patients who were discharged home from the emergency department (2.6% v. 3.4%). Interpretation: The impact of the provincial VUC pilot program on subsequent health care utilization was limited. There is a need to better understand the inherent limitations of virtual care and ensure future virtual providers have timely access to in-person outpatient resources, to prevent subsequent emergency department visits., The COVID-19 pandemic has had a substantial impact on the way people in Canada interact with health care systems. (1,2) In the early stages of the pandemic, when physical distancing [...]

Published
2023
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9. A multi-center, randomized, 12-month, parallel-group, feasibility study to assess the acceptability and preliminary impact of family navigation plus usual care versus usual care on attrition in managing pediatric obesity: a study protocol

Author

Ball, Geoff D. C., O’Neill, Marcus G., Noor, Rafat, Alberga, Angela, Azar, Rima, Buchholz, Annick, Enright, Michelle, Geller, Josie, Ho, Josephine, Holt, Nicholas L., Lebel, Tracy, Rosychuk, Rhonda J., Tarride, Jean-Eric, and Zenlea, Ian

Published
2023
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11. Health TAPESTRY Ontario: A Multi-Site Randomized Controlled Trial Testing Implementation and Reproducibility

Author

Mangin, Dee, Lamarche, Larkin, Oliver, Doug, Blackhouse, Gord, Bomze, Sivan, Borhan, Sayem, Carr, Tracey, Clark, Rebecca, Datta, Julie, Dolovich, Lisa, Gaber, Jessica, Forsyth, Pamela, Howard, Michelle, Marentette-Brown, Sarah, Risdon, Cathy, Talat, Samina, Tarride, Jean-Eric, Thabane, Lehana, Valaitis, Ruta, and Price, David

Subjects
Aged patients -- Care and treatment, Primary health care -- Methods -- Quality management, Health, Science and technology
Abstract

PURPOSE Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a complex primary care program aimed at assisting older adults to stay healthier for longer. This study evaluated the feasibility of implementation across multiple sites, and the reproducibility of the effects found in the previous randomized controlled trial. METHODS This was a pragmatic, unblinded, 6-month parallel group randomized controlled trial. Participants were randomized (intervention or control) using a computer-generated system. Eligible patients, aged 70 years and older, were rostered to 1 of 6 participating interprofessional primary care practices (urban and rural). In total, 599 (301 intervention, 298 control) patients were recruited from March 2018 through August 2019. Intervention participants received a home visit from volunteers to collect information on physical and mental health, and social context. An interprofessional care team created and implemented a plan of care. The primary outcomes were physical activity and number of hospitalizations. RESULTS Based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (REAIM) framework, Health TAPESTRY had widespread reach and adoption. In the intention-to-treat analysis (257 intervention, 255 control), there were no statistically significant between-group differences for hospitalizations (incidence rate ratio = 0.79; 95% CI, 0.48-1.30; P= .35) or total physical activity (mean difference = -0.26; 95% CI, -1.18 to 0.67; P= .58). There were 37 non-study related serious adverse events (19 intervention, 18 control). CONCLUSIONS We found Health TAPESTRY was successfully implemented for patients in diverse primary care practices; however, implementation did not reproduce the effect on hospitalizations and physical activity found in the initial randomized controlled trial. Key words: aged; health plan implementation; multimorbidity; primary health care; randomized controlled trial https://doi.org/10.1370/afm.2944, INTRODUCTION As the proportion of older adults increases, health care systems try to meet their complex needs more efficiently and effectively. Strengthening primary care is a system-level strategy to address [...]

Published
2023
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18. Demographic characteristics, outcomes and experience of patients using virtual urgent care services from 14 emergency department led sites in Ontario

Author

McLeod, Shelley L., Mondoux, Shawn, Hall, Justin N., Dainty, Katie, McCarron, Joy, Tarride, Jean-Eric, Abraham, Lency, Tse, Sandy, Lim, Rodrick, Fitzgibbon, Megan, Montpellier, Renee-Anne, Rivlin, Leon, Rodriguez, Carla, Beck, Lisa, McLean, Lianne, Rosenfield, Daniel, Mehta, Shaun, Welsford, Michelle, Thompson, Cameron, and Ovens, Howard

Published
2023
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20. Early In-Bed Cycle Ergometry in Mechanically Ventilated Patients

Author

Kho, Michelle E., primary, Berney, Susan, additional, Pastva, Amy M., additional, Kelly, Laurel, additional, Reid, Julie C., additional, Burns, Karen E. A., additional, Seely, Andrew J., additional, D’Aragon, Frédérick, additional, Rochwerg, Bram, additional, Ball, Ian, additional, Fox-Robichaud, Alison E., additional, Karachi, Tim, additional, Lamontagne, Francois, additional, Archambault, Patrick M., additional, Tsang, Jennifer L., additional, Duan, Erick H., additional, Muscedere, John, additional, Verceles, Avelino C., additional, Serri, Karim, additional, English, Shane W., additional, Reeve, Brenda K., additional, Mehta, Sangeeta, additional, Rudkowski, Jill C., additional, Heels-Ansdell, Diane, additional, O’Grady, Heather K., additional, Strong, Geoff, additional, Obrovac, Kristy, additional, Ajami, Daana, additional, Camposilvan, Laura, additional, Tarride, Jean-Eric, additional, Thabane, Lehana, additional, Herridge, Margaret S., additional, and Cook, Deborah J., additional

Published
2024
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25. Correction: Clinical utility of combinatorial pharmacogenomic testing in depression: A Canadian patient- and rater-blinded, randomized, controlled trial

Author

Tiwari, Arun K., Zai, Clement C., Altar, C. Anthony, Tanner, Julie-Anne, Davies, Paige E., Traxler, Paul, Li, James, Cogan, Elizabeth S., Kucera, Matthew T., Gugila, Ana, Braganza, Nicole, Emmerson, Heather, Zai, Gwyneth, Müller, Daniel J., Levitan, Robert, Kloiber, Stefan, Daskalakis, Zafiris J., Frey, Benicio N., Bowen, James M., Tarride, Jean-Eric, Tytus, Richard, Chandrasena, Ranjith, Voudouris, Nicholas, Taylor, Valerie H., Tempier, Raymond, Sharma, Verinder, Vasudev, Akshya, Dzongowski, Peter, Pliamm, Lew, Greenspoon, Todd, Dechairo, Bryan M., and Kennedy, James L.

Published
2022
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26. Clinical utility of combinatorial pharmacogenomic testing in depression: A Canadian patient- and rater-blinded, randomized, controlled trial

Author

Tiwari, Arun K., Zai, Clement C., Altar, C. Anthony, Tanner, Julie-Anne, Davies, Paige E., Traxler, Paul, Li, James, Cogan, Elizabeth S., Kucera, Matthew T., Gugila, Ana, Braganza, Nicole, Emmerson, Heather, Zai, Gwyneth, Müller, Daniel J., Levitan, Robert, Kloiber, Stefan, Daskalakis, Zafiris J., Frey, Benicio N., Bowen, James M., Tarride, Jean-Eric, Tytus, Richard, Chandrasena, Ranjith, Voudouris, Nicholas, Taylor, Valerie H., Tempier, Raymond, Sharma, Verinder, Vasudev, Akshya, Dzongowski, Peter, Pliamm, Lew, Greenspoon, Todd, Dechairo, Bryan M., and Kennedy, James L.

Published
2022
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27. Rates of health services use among residents of retirement homes in Ontario: a population-based cohort study

Author

Manis, Derek R., Poss, Jeffrey W., Jones, Aaron, Rochon, Paula A., Bronskill, Susan E., Campitelli, Michael A., Perez, Richard, Stall, Nathan M., Rahim, Ahmad, Babe, Glenda, Tarride, Jean-Eric, Abelson, Julia, and Costa, Andrew P.

Subjects
Medical care -- Utilization, Aged patients -- Statistics -- Care and treatment, Nursing home patients -- Statistics -- Care and treatment, Health
Abstract

Background: Because there are no standardized reporting systems specific to residents of retirement homes in North America, little is known about the health of this distinct population of older adults. We evaluated rates of health services use by residents of retirement homes relative to those of residents of long-term care homes and other populations of older adults. Methods: We conducted a retrospective cohort study using population health administrative data from 2018 on adults 65 years or older in Ontario. We matched the postal codes of individuals to those of licensed retirement homes to identify residents of retirement homes. Outcomes included rates of hospital-based care and physician visits. Results: We identified 54 733 residents of 757 retirement homes (mean age 86.7 years, 69.0% female) and 2 354 385 residents of other settings. Compared to residents of long-term care homes, residents of retirement homes had significantly higher rates per 1000 person months of emergency department visits (10.62 v. 4.48, adjusted relative rate [RR] 2.61, 95% confidence interval [CI] 2.55 to 2.67), hospital admissions (5.42 v. 2.08, adjusted RR 2.77, 95% CI 2.71 to 2.82), alternate level of care (ALC) days (6.01 v. 2.96, adjusted RR 1.51, 95% CI 1.48 to 1.54), and specialist physician visits (6.27 v. 3.21, adjusted RR 1.64, 95% CI 1.61 to 1.68), but a significantly lower rate of primary care visits (16.71 v. 108.47, adjusted RR 0.13, 95% CI 0.13 to 0.14). Interpretation: Residents of retirement homes are a distinct population with higher rates of hospital-based care. Our findings can help to inform policy debates about the need for more coordinated primary and supportive health care in privately operated congregate care homes., In the continuum of care services and settings for older adults lies home care at one end and long-term care at the other. (1) Home care services may include, but [...]

Published
2022
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29. Use, Costs, and Predictors of Psychiatric Healthcare Services Following an Autism Spectrum Diagnosis: Population-Based Cohort Study

Author

Croteau, Caroline, Mottron, Laurent, Dorais, Marc, Tarride, Jean-Eric, and Perreault, Sylvie

Abstract

A number of cross-sectional studies report extensive use of psychiatric services and high healthcare costs in autistic youths. However, little is known about how the use of these services evolves from the time of diagnosis, as children grow up. Our objectives were to investigate the use, costs, and predictors of psychiatric services following autism spectrum diagnosis. We built a cohort of 1227 newly diagnosed autism spectrum individuals identified in the Quebec (Canada) "Régie de l'assurance maladie du Québec" administrative database (January 1998 to December 2010). Mean number and cost per individual of psychiatric healthcare use (hospitalizations, medical visits, psychoactive drug use) were calculated yearly for 5 years following autism spectrum diagnosis. Mean number of psychiatric visits decreased over time by more than threefold (7.5 vs 2.1 visits) from year 1 to year 5, whereas psychoactive drug use increased from 16.0 to 25.2 claims. Psychiatric hospitalizations decreased during follow-up, but still represented the greatest costs per individual (CAD9820 for year 1; CAD4628 for year 5). Antipsychotics represented over 50% of drug costs. Mixed-effect model with repeated measures showed that previous psychoactive drug use was the strongest predictor of greater psychiatric healthcare cost during follow-up (odds ratio: 9.96; 95% confidence interval: 7.58-13.10). These trends contrast with guidelines advocating cautious prescribing of antipsychotics with periodical re-assessment of their benefit.

Published
2019
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34. GRADE Guidelines 30: the GRADE approach to assessing the certainty of modeled evidence—An overview in the context of health decision-making

Author

Brozek, Jan L., Canelo-Aybar, Carlos, Akl, Elie A., Bowen, James M., Bucher, John, Chiu, Weihsueh A., Cronin, Mark, Djulbegovic, Benjamin, Falavigna, Maicon, Guyatt, Gordon H., Gordon, Ami A., Hilton Boon, Michele, Hutubessy, Raymond C.W., Joore, Manuela A., Katikireddi, Vittal, LaKind, Judy, Langendam, Miranda, Manja, Veena, Magnuson, Kristen, Mathioudakis, Alexander G., Meerpohl, Joerg, Mertz, Dominik, Mezencev, Roman, Morgan, Rebecca, Morgano, Gian Paolo, Mustafa, Reem, O'Flaherty, Martin, Patlewicz, Grace, Riva, John J., Posso, Margarita, Rooney, Andrew, Schlosser, Paul M., Schwartz, Lisa, Shemilt, Ian, Tarride, Jean-Eric, Thayer, Kristina A., Tsaioun, Katya, Vale, Luke, Wambaugh, John, Wignall, Jessica, Williams, Ashley, Xie, Feng, Zhang, Yuan, and Schünemann, Holger J.

Published
2021
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35. Postfracture survival in a population-based study of adults aged ≥66 yr: a call to action at hospital discharge.

Author

Vincent, Geneviève, Adachi, Jonathan D, Schemitsch, Emil, Tarride, Jean-Eric, Ho, Nathan, Wani, Rajvi J, and Brown, Jacques P

Subjects
OLDER patients, HOSPITAL admission & discharge, HIP fractures, ADULTS, OVERALL survival, VERTEBRAL fractures
Abstract

Postfracture survival rates provide prognostic information but are rarely reported along with other mortality outcomes in adults aged ≥50 yr. The timing of survival change following a fracture also needs to be further elucidated. This population-based, matched-cohort, retrospective database study examined 98 474 patients (73% women) aged ≥66 yr with an index fracture occurring at an osteoporotic site (hip, clinical vertebral, proximal non-hip non-vertebral [pNHNV], and distal non-hip non-vertebral [dNHNV]) from 2011 to 2015, who were matched (1:1) to nonfracture individuals based on sex, age, and comorbidities. All-cause 1- and 5-yr overall survival and relative survival ratios (RSRs) were assessed, and time trends in survival changes were characterized starting immediately after a fracture. In both sexes, overall survival was markedly decreased over 6 yr of follow-up after hip, vertebral, and pNHNV fractures, and as expected, worse survival rates were observed in older patients and males. The lowest 5-yr RSRs were observed after hip fractures in males (66–85 yr, 51.9%–63.9%; ≥86 yr, 34.5%), followed by vertebral fractures in males (66–85 yr, 53.2%–69.4%; ≥86 yr, 35.5%), and hip fractures in females (66–85 yr, 69.8%–79.0%; ≥86 yr, 52.8%). Although RSRs did not decrease as markedly after dNHNV fractures in younger patients, relatively low 5-yr RSRs were observed in females (75.9%) and males (69.5%) aged ≥86 yr. The greatest reduction in survival occurred within the initial month after hip, vertebral, and pNHNV fractures, indicating a high relative impact of short-term factors, with survival-reduction effects persisting over time. Therefore, the most critical period for implementing interventions aimed at improving post-fracture prognosis appears to be immediately after a fracture; however, considering the immediate need for introducing such interventions, primary fracture prevention is also crucial to prevent the occurrence of the initial fracture in high-risk patients. [ABSTRACT FROM AUTHOR]

Published
2024
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38. What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency?

Author

Neil-Sztramko, Sarah E., primary, Belita, Emily, additional, Hopkins, Stephanie, additional, Sherifali, Diana, additional, Anderson, Laura, additional, Apatu, Emma, additional, Kapiriri, Lydia, additional, Tarride, Jean Eric, additional, Bellefleur, Olivier, additional, Kaasalainen, Sharon, additional, Marr, Sharon, additional, and Dobbins, Maureen, additional

Published
2023
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45. Economic evaluation of non-invasive liver tests for the diagnosis of liver fibrosis in chronic liver diseases: a systematic review protocol

Author

de Almeida Cardoso, Marilia Mastrocolla, primary, Thabane, Lehana, additional, Romeiro, Fernando Gomes, additional, Silva, Giovanni Faria, additional, Machado-Rugolo, Juliana, additional, Fonseca, Alan Francisco, additional, dos Santos, Wendel Mombaque, additional, de Almeida, Juliana Tereza Coneglian, additional, Thavorn, Kednapa, additional, and Tarride, Jean-Eric, additional

Published
2023
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