Annals of family medicine
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Annals of family medicine · Apr 2022
Demonstrating the complexity of patient-partnered research in primary care: a snapshot of patient-partners.
Background: In Canada, we are still struggling to achieve the critical goal of enabling performant health care systems that moves research results to real-world impact particularly for primary care. To address this, we have created a primary care research network where patient partners are involved in all levels of decision making for governance, research, and innovation. For many researchers, however, it is unclear what primary care patient-partners 'brings to the table.' As the Pan-Canadian Patient Council of the Primary and Integrated Health Care Innovations Network, we wanted to provide insight into the richness of expertise and experience patient partners contribute. ⋯ Conclusion: Diversity of life experience, extensive exposure to the health care system and strong engagement with multiple organizations for primary care research characterized us as patient-partners. This lived expertise represents a significant asset for researchers. This work should encourage researchers to starting thinking about how to include primary care patient-partners as a crucial resource in health research.
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Annals of family medicine · Apr 2022
Implementation analysis of case management interventions for frequent users of healthcare services: A multiple-case study.
Context. Case management interventions (CMIs) are recognized to improve patients' experience of integrated care, to promote better utilization of healthcare resources, and to reduce emergency department visits, hospitalizations and health care costs. However, contextual factors influencing implementation of CMIs in primary care settings in Canada still need to be studied. ⋯ On the other hand, a culture of patient-centredness and collaboration; managerial and clinical leadership and support; and a positive perception of the CMI alongside provider engagement helps to overcome these barriers. Conclusions. This study may help researchers, decision-makers and clinicians plan the implementation of CMIs in primary care settings for frequent users of healthcare services with chronic diseases and complex care needs.
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Annals of family medicine · Apr 2022
Multimorbidity in a selected cohort compared to a representative sample: Does selection bias influence outcomes?
Context: UK Biobank is increasingly used to study causes, associations, and implications of multimorbidity. However, UK Biobank is criticised for lack of representativeness and 'healthy volunteer bias'. Selection bias can lead to spurious or biased estimates of associations between exposures and outcomes. ⋯ Similarly hazard ratios for some LTC combinations were similar between the cohorts (e.g. cardiovascular, respiratory conditions), UK Biobank underestimated the risk for combinations including pain or mental health conditions. Conclusions: UK Biobank accurately estimates risk of outcomes associated with LTC counts ≤3. However, for counts ≥4 estimates of magnitude of association from UK Biobank are likely to be conservative.
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Annals of family medicine · Apr 2022
A qualitative study of adolescent perspectives on COVID-19 pandemic: considerations in the provision of primary virtual care.
Context: Amidst school shutdowns, sheltering in place, and social distancing, the COVID-19 pandemic uniquely affected adolescents. Understanding the experiences of adolescents with respect to social distancing, health changes, information sources and virtual care can inform effective health care for adolescents both during and after the pandemic. Objective: An exploration into their health care experiences during the beginning stage of the pandemic was undertaken to increase knowledge among family physicians to enable adjustments to the provision of care, primarily done virtually. ⋯ Parents were described as the most trusted source of information about the pandemic. Conclusions: Adolescents primarily look to parents for guidance and the increased family time promoted well-being. Physicians that are able to help adolescents negotiate privacy and mitigate communication challenges are able to provide effective virtual care.
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Annals of family medicine · Apr 2022
Identifying priorities for artificial intelligence and primary care in ontario: A multi-stakeholder engagement event.
To identify current priority areas for AI and PC in Ontario, Canada. STUDY DESIGN: Multi-stakeholder engagement event with facilitated small and large group discussions. A nominal group technique process was used to identify and rank challenges in PC that AI may be able to support. Mentimeter software was used to allow real-time, anonymous and independent ranking from all participants. A final list of priority areas for AI and PC, with key considerations, was derived based on ranked items and small group discussion notes. SETTING: Ontario, Canada. POPULATION STUDIED: Digital health and PC stakeholders. OUTCOME MEASURES: N/A. ⋯ A one-day multi-stakeholder event identified priority areas for AI and PC in Ontario. These priorities can serve as guideposts to focus near-term efforts on the planning, development, and evaluation of AI for PC.