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https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#1
Lillian Lai, Clare Liddy, Erin Keely, Amir Afkham, Julia Kurzawa, Nishard Abdeen, Tobey Audcent, Matthew Bromwich, Jason Brophy, Sasha Carsen, Annick Fournier, Leigh Fraser-Roberts, Hazen Gandy, Charles Hui, Donna Johnston, Kathryn Keely, Ken Kontio, Christine Lamontagne, Nathalie Major, Michael O'Connor, Dhenuka Radhakrishnan, Joe Reisman, Marjorie Robb, Lindy Samson, Erick Sell, William Splinter, Judy van Stralen, Sunita Venkateswaran, Kimmo Murto
BACKGROUND: Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction. OBJECTIVE: To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults...
2018: PloS One
https://www.readbyqxmd.com/read/29314035/economic-evaluation-of-floseal-compared-to-nasal-packing-for-the-management-of-anterior-epistaxis
#2
Andre Le, Kednapa Thavorn, Andrea Lasso, Shaun J Kilty
OBJECTIVES/HYPOTHESIS: To evaluate the cost-effectiveness of Floseal, a topically applied hemostatic agent, and nasal packing for the management of epistaxis in Canada. STUDY DESIGN: Outcomes research, a cost-utility analysis. METHODS: We developed a Markov model to compare the costs and health outcomes of Floseal with nasal packing over a lifetime horizon from the perspective of a publicly funded healthcare system. A cycle length of 1 year was used...
January 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29310674/ezetimibe-prescriptions-in-older-canadian-adults-after-an-acute-myocardial-infarction-a-population-based-cohort-study
#3
Kristin K Clemens, Salimah Z Shariff, Eric McArthur, Robert A Hegele
BACKGROUND: The utility of ezetimibe in preventing cardiovascular outcomes remains controversial. To guide future assessments of the effectiveness of ezetimibe in routine care, we evaluated how this medication has been prescribed to high-risk older adults in Ontario, Canada. METHODS: Using linked healthcare databases, we carried out a population-based cohort study of older adults who were discharged from hospital following an acute myocardial infarction from 2005 until 2014...
January 8, 2018: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29284273/a-double-whammy-new-baccalaureate-registered-nurses-transitions-into-rural-acute-care
#4
Jean Smith, Virginia Vandall-Walker
INTRODUCTION: Transitioning into the Canadian rural acute care environment can be challenging for new RNs, and so retention is of concern. Currently, few seasoned registered nurses (RNs) are available to support new RNs during transition because (a) the Canadian RN workforce countrywide is aging and significant numbers are retiring, and (b) the number of Canadian RNs working rurally has plummeted in the past 10 years. Investigations into the phenomenon of new RNs\' transitions into the workforce have been conducted, but little is known about this phenomenon as it relates to Canadian rural acute care hospitals...
December 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29283877/canadians-views-on-palliative-care
#5
Erin Roulston
Palliative Care Matters is a national initiative designed to develop consensus on the steps that need to be taken now to ensure Canadians can access high-quality palliative care services as part of Canada's universal healthcare model. Covenant Health and the Canadian Partnership Against Cancer joined with leading national health organizations to lead this initiative, resulting in a Consensus Development Conference in November 2016. Six questions were identified by experts in the field to form the basis of the conference...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29283875/consensus-development-conference-promoting-access-to-quality-palliative-care-in-canada
#6
Konrad Fassbender
OBJECTIVE: This article outlines the development and implementation of a consensus development conference (CDC). BACKGROUND: As a rapid method for data synthesis, a CDC affords a timely and methodic means of evaluating data to effect change in healthcare policy. METHODS: The CDC methodology was adopted for the Palliative Care Matters initiative due to its engagement with the public, scientific community, and palliative care stakeholders. RESULTS: It requires the involvement of seven key groups/roles to successfully effect change: a manager, steering committee, scientific expert panel, public lay panel, a lay-panel facilitator, a public audience, and the media for dissemination...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29283874/a-call-for-integrated-and-coordinated-palliative-care
#7
Kevin Brazil
Integrated palliative care is viewed as having the potential to improve service coordination, efficiency, and quality outcomes for patients and family carers. However, the majority of Canadians do not have access to regional, comprehensive, integrated palliative care. Work needs to be directed toward planning palliative care services that is integrated into the healthcare and social care system. To further this goal, it is important to have a conceptual understanding of the meaning of integrated care and its expression in organizational models for the provision of palliative care...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29283869/evaluating-public-engagement-for-a-consensus-development-conference
#8
Michelle Chan, Konrad Fassbender
BACKGROUND: Effectively engaging Canadians to help improve the quality and delivery of healthcare to dying Canadians is a priority for healthcare administrators and policy makers. This report shares our evaluation and learnings, applying a series of strategies to encourage policy formation. The Palliative Care Matters consensus development conference held in Ottawa on November 7-9, 2016 brought together members of the public, stakeholders, scientific experts, and a lay panel of interested Canadians to examine Canadian public opinions on palliative care and question experts on how palliative care could be enhanced...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29283088/compliance-of-the-recurrent-renal-stone-former-with-current-best-practice-guidelines
#9
Derek Bos, Kevin Kim, Jen Hoogenes, Shahid Lambe, Bobby Shayegan, Edward D Matsumoto
INTRODUCTION: Patient compliance to best practice guidelines is a significant factor in preventing renal stone recurrence. While patient compliance has been historically poor, there remains a paucity of data in the renal stone setting. We evaluated compliance of the recurrent renal stone former with current Canadian Urological Association (CUA) best practice guidelines. METHODS: A prospective, cross-sectional study design was used to evaluate patient compliance...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29282272/our-health-counts-toronto-using-respondent-driven-sampling-to-unmask-census-undercounts-of-an-urban-indigenous-population-in-toronto-canada
#10
Michael A Rotondi, Patricia O'Campo, Kristen O'Brien, Michelle Firestone, Sara H Wolfe, Cheryllee Bourgeois, Janet K Smylie
OBJECTIVES: To provide evidence of the magnitude of census undercounts of 'hard-to-reach' subpopulations and to improve estimation of the size of the urban indigenous population in Toronto, Canada, using respondent-driven sampling (RDS). DESIGN: Respondent-driven sampling. SETTING: The study took place in the urban indigenous community in Toronto, Canada. Three locations within the city were used to recruit study participants. PARTICIPANTS: 908 adult participants (15+) who self-identified as indigenous (First Nation, Inuit or Métis) and lived in the city of Toronto...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29274226/what-s-involved-with-wanting-to-be-involved-comparing-expectations-for-public-engagement-in-health-policy-across-research-and-care-contexts
#11
Carolyn J Barg, Fiona A Miller, Robin Z Hayeems, Yvonne Bombard, Céline Cressman, Michael Painter-Main
OBJECTIVES: We explored public preferences for involvement in health policy decisions, across the contexts of medical research and healthcare. APPROACH: We e-surveyed a sample of Canadians, categorizing respondents by preferences for decision control: (1) more authority; (2) more input; (3) status quo. Two generalized ordered logistic regressions assessed influences on preferences. RESULTS: The participation rate was 94%; 1,102 completed responses met quality criteria...
November 2017: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/29274224/what-is-bending-the-cost-curve-an-exploration-of-possible-drivers-and-unintended-consequences
#12
Kimberlyn McGrail, Megan Ahuja
Health expenditures in most OECD countries have increased at a slower rate since 2008/2009. Potential drivers of this bending of the cost curve include: (1) changes in pharmaceuticals and technology innovations; (2) healthcare reforms, and specifically those focusing on care for complex and high-user patients and (3) government expenditure controls resulting from general economic conditions. We use publicly available National Health Expenditure data from the Canadian Institute for Health Information to assess the merits of each of these drivers, with a focus on British Columbia...
November 2017: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/29273068/exploring-patient-and-family-involvement-in-the-lifecycle-of-an-orphan-drug-a-scoping-review
#13
REVIEW
Andrea Young, Devidas Menon, Jackie Street, Walla Al-Hertani, Tania Stafinski
BACKGROUND: Patients and their families have become more active in healthcare systems and research. The value of patient involvement is particularly relevant in the area of rare diseases, where patients face delayed diagnoses and limited access to effective therapies due to the high level of uncertainty in market approval and reimbursement decisions. It has been suggested that patient involvement may help to reduce some of these uncertainties. This review explored existing and proposed roles for patients, families, and patient organizations at each stage of the lifecycle of therapies for rare diseases (i...
December 22, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29258628/cost-analysis-of-peripherally-inserted-central-catheter-in-pediatric-patients
#14
Zhaoxin Dong, Bairbre L Connolly, Wendy J Ungar, Peter C Coyte
PURPOSE: A peripherally inserted central catheter (PICC) is a useful option in providing secure venous access, which enables patients to be discharged earlier with the provision of home care. The objective was to identify the costs associated with having a PICC from a societal perspective, and to identify factors that are associated with total PICC costs. METHODS: Data were obtained from a retrospective cohort of 469 hospitalized pediatric patients with PICCs inserted...
December 20, 2017: International Journal of Technology Assessment in Health Care
https://www.readbyqxmd.com/read/29258568/establishing-core-outcome-sets-for-phenylketonuria-pku-and-medium-chain-acyl-coa-dehydrogenase-mcad-deficiency-in-children-study-protocol-for-systematic-reviews-and-delphi-surveys
#15
Beth K Potter, Brian Hutton, Tammy J Clifford, Nicole Pallone, Maureen Smith, Sylvia Stockler, Pranesh Chakraborty, Pauline Barbeau, Chantelle M Garritty, Michael Pugliese, Alvi Rahman, Becky Skidmore, Laure Tessier, Kylie Tingley, Doug Coyle, Cheryl R Greenberg, Lawrence Korngut, Alex MacKenzie, John J Mitchell, Stuart Nicholls, Martin Offringa, Andreas Schulze, Monica Taljaard
BACKGROUND: Inherited metabolic diseases (IMD) are a large group of rare single-gene disorders that are typically diagnosed early in life. There are important evidence gaps related to the comparative effectiveness of therapies for IMD, which are in part due to challenges in conducting randomized controlled trials (RCTs) for rare diseases. Registry-based RCTs present a unique opportunity to address these challenges provided the registries implement standardized collection of outcomes that are important to patients and their caregivers and to clinical providers and healthcare systems...
December 19, 2017: Trials
https://www.readbyqxmd.com/read/29236230/gene-patents-in-canada-is-there-a-new-legal-landscape
#16
Katherine L Bonter, Carmela De Luca, Christi J Guerrini
In 2016, the Children's Hospital of Eastern Ontario (CHEO) announced the settlement of its patent lawsuit against US-based Transgenomic, Inc. At issue in the case was CHEO's ability to test for gene mutations associated with long QT syndrome (LQTS) that are described in Transgenomic's patents. CHEO challenged the patents as invalid, and Transgenomic ultimately agreed to license them on a royalty-free basis to CHEO and other healthcare institutions for LQTS testing and research. While widely celebrated in the media, the ethical rhetoric surrounding the settlement has at times obscured the practical and legal context in which it was made and will operate...
December 13, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/29226327/medication-use-and-kidney-cancer-survival-a-population-based-study
#17
Madhur Nayan, David N Juurlink, Peter C Austin, Erin M Macdonald, Antonio Finelli, Girish S Kulkarni, Robert J Hamilton
Several studies demonstrate that use of commonly-prescribed medications is associated with improved survival in various malignancies. Methods of classifying medication use in many of these studies, however, do not account for intermittent or cumulative use. Moreover, there are limited data in kidney cancer. Therefore, we performed a population-based cohort study utilizing healthcare databases in Ontario, Canada. We identified patients aged ≥65 with an incident diagnosis of kidney cancer between 1997-2013 and examined use of nine putative anti-neoplastic medications using prescription claims...
December 11, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29223487/implementing-a-province-wide-mandatory-vaccinate-or-mask-policy-at-healthcare-facilities-in-british-columbia-canada
#18
Alexandra Nunn, Audrey C Campbell, Monika Naus, Jeffrey C Kwong, David Puddicombe, Susan Quach, Bonnie Henry
OBJECTIVES: In 2012, British Columbia (BC) became the first Canadian province to implement an influenza prevention policy requiring healthcare workers (HCW) to either be vaccinated annually against influenza or wear a mask in patient care areas during the influenza season. This study describes an evaluation of influenza policy implementation processes and identifies supports and challenges related to successful policy implementation at the level of healthcare facilities, during the second policy year (2013/14)...
December 6, 2017: Vaccine
https://www.readbyqxmd.com/read/29205063/how-should-health-leaders-approach-morally-contentious-policy-issues
#19
Michael Kekewich, Joshua Landry, Virginia Roth
In terms of their expertise, experience, and impact on patient care, health leaders occupy an important position in our health system. These leaders are expected to provide value to their constituents, and this value is connected to moral objectives that are fundamental to the delivery of healthcare. In some cases, leaders may interpret a certain politico-medical decision, policy, or directive to interfere with these moral objectives. In these instances, leaders can either expressly object to a decision or sideline moral views while enacting these policies or directives...
January 1, 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/29193883/economic-evaluation-of-lupus-nephritis-in-the-systemic-lupus-international-collaborating-clinics-inception-cohort-using-a-multistate-model-approach
#20
Megan R W Barber, John G Hanly, Li Su, Murray B Urowitz, Yvan St Pierre, Juanita Romero-Diaz, Caroline Gordon, Sang-Cheol Bae, Sasha Bernatsky, Daniel J Wallace, David A Isenberg, Anisur Rahman, Ellen M Ginzler, Michelle Petri, Ian N Bruce, Paul R Fortin, Dafna D Gladman, Jorge Sanchez-Guerrero, Rosalind Ramsey-Goldman, Munther A Khamashta, Cynthia Aranow, Meggan Mackay, Graciela S Alarcón, Susan Manzi, Ola Nived, Andreas Jönsen, Asad A Zoma, Ronald F van Vollenhoven, Manuel Ramos-Casals, Guillermo Ruiz-Irastorza, S Sam Lim, Kenneth C Kalunian, Murat Inanc, Diane L Kamen, Christine A Peschken, Soren Jacobsen, Anca Askanase, Chris Theriault, Vernon Farewell, Ann E Clarke
OBJECTIVE: Little is known about the long-term costs of lupus nephritis (LN). These were compared between patients with and without LN based on multistate modelling. METHODS: Patients from 32 centres in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis and provided annual data on renal function, hospitalizations, medications, dialysis, and selected procedures. LN was diagnosed by renal biopsy or the American College of Rheumatology classification criteria...
November 28, 2017: Arthritis Care & Research
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