Health Impacts and Characteristics of Deprescribing Interventions in Older Adults: Protocol for a Systematic Review and Meta-analysis.

Background: Deprescribing, a relatively recent concept, has been proposed as a promising solution to the growing issues of polypharmacy and use of medications of questionable benefit among older adults. However, little is known about the health outcomes of deprescribing interventions.

Objective: This paper presents the protocol of a study that aims to contribute to the knowledge on deprescribing by addressing two specific objectives: (1) describe the impact of deprescribing in adults ≥60 years on health outcomes or quality of life; and (2) determine the characteristics of effective interventions in deprescribing.

Discontinuation of bisphosphonates in seniors: a systematic review on health outcomes.

Purpose: Bisphosphonates are used to treat osteoporosis. Despite their benefits on bone mineral density (BMD) and fractures, they have shown adverse effects, sometimes severe, during chronic use. Taken for several years, they achieve long-term bone retention, making deprescribing feasible.

Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey.

Objectives: Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis.

Methods: A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.

Impact of the COVID-19 Pandemic on Older Adults: Rapid Review.

Background: The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.

Continuity of Cancer Care and Collaboration Between Family Physicians and Oncologists: Results of a Randomized Clinical Trial.

Purpose: Collaboration between family physicians (FPs) and oncologists can be challenging. We present the results of a randomized clinical trial of an intervention designed to improve continuity of care and interprofessional collaboration, as perceived by patients with lung cancer and their FPs.

Methods: The intervention included (1) supplying FPs with standardized summaries related to each patient, (2) recommending that patients see their FP after receiving the cancer diagnosis, (3) supplying the oncology team with patient information resulting from FP visits, and (4) providing patients with priority access to FPs as needed.

Outcomes and prognosis of diabetic foot ulcers treated by an interdisciplinary team in Canada.

The aim of this study was to determine the wound healing outcomes of patients with a plantar diabetic foot ulcer (DFU) treated with an interdisciplinary team approach, and to identify associated variables. A retrospective observational cohort study of 140 adult patients, with a plantar DFU, treated between 2012 and 2018 at a wound care clinic of a University affiliated hospital was conducted. Predictive and explicative analyses were conducted with logistic multivariate methods and with a Receiver Operating Characteristics curve.

Vitamin D status, cognitive decline and incident dementia: the Canadian Study of Health and Aging.

Objective: Vitamin D could prevent cognitive decline because of its neuroprotective, anti-inflammatory and antioxidant properties. This study aimed to evaluate the associations of plasma 25-hydroxyvitamin D (25(OH)D) concentrations with global cognitive function and incident dementia, including Alzheimer's disease (AD).

Methods: The Canadian Study of Health and Aging is a 10-year cohort study of a representative sample of individuals aged 65 years or older.

Effect of personalised citizen assistance for social participation (APIC) on older adults' health and social participation: study protocol for a pragmatic multicentre randomised controlled trial (RCT).

Introduction: The challenges of global ageing and the growing burden of chronic diseases require innovative interventions acting on health determinants like social participation. Many older adults do not have equitable opportunities to achieve full social participation, and interventions might underempower their personal and environmental resources and only reach a minority. To optimise current practices, the (APIC), an intervention demonstrated as being feasible and having positive impacts, needs further evaluation.

Mobilizing Local Authorities Around Public Health Priorities.

Large Analysis and Review of European Housing and Health Status (LARES) was conducted in Europe in 2002 to 2003 to study the relationship between citizens' health and built environments. One of its objectives was to put public health priorities on the agenda of local decision-makers to implement solutions for the community. We adapted the LARES protocol as a pilot project in a small French-Canadian town in Quebec Province in 2012.

Personalized citizen assistance for social participation (APIC): A promising intervention for increasing mobility, accomplishment of social activities and frequency of leisure activities in older adults having disabilities.

Background: Social participation, a determinant of health in older adults, requires innovative interventions. The personalised citizen assistance for social participation (APIC) involves weekly three-hour personalised stimulation sessions targeting significant social and leisure activities difficult to accomplish. Recently adapted for older adults, the APIC's impact on this population is unknown.

Preventive Home Visits for Older People: A Systematic Review.

RÉSUMÉ L'augmentation du nombre de personnes âgées présentant des incapacités et ayant des maladies chroniques entraîne une hausse des besoins en services de santé à domicile. Le nombre d'études et de revues systématiques traitant des approches préventives pour cette clientèle a proliféré, générant un besoin de synthèse des connaissances. Nous avons mené une revue systématique de revues systématiques évaluant l'effet des programmes de visite préventive pour les personnes âgées.

Variations in patients' assessment of chronic illness care across organizational models of primary health care: a multilevel cohort analysis.

Purpose: To measure patients' assessment of chronic illness care and its variation across primary healthcare (PHC) models.

Methods: We recruited 776 patients with diabetes, heart failure, arthritis or chronic obstructive pulmonary disease from 33 PHC clinics. Face-to-face interviews, followed by a telephone interview at 12 months, were conducted using the Patient Assessment of Chronic Illness Care (PACIC).

Development of integrated care pathways: toward a care management system to meet the needs of frail and disabled community-dwelling older people.

Introduction: The home care and services provided to older adults with the same needs are often inadequate and highly varied. Integrated care pathways (ICPs) can resolve these issues. The aim of this study was to develop the content of ICPs to follow-up frail and disabled community-dwelling older people.

Primary Healthcare Organization and Quality-of-Life Outcomes for Persons with Chronic Disease.

Purpose: To explore the association between primary healthcare (PHC) organizational model and health-related quality of life (HRQoL) in persons with chronic disease.

Methods: We recruited 776 patients with a primary diagnosis of one of four chronic diseases from 33 PHC clinics. Patients were interviewed at baseline, 6, 12 and 18 months.

Patients' perceptions of the quality of care after primary care reform: Family medicine groups in Quebec.

Objective: To evaluate how a primary care reform, which aimed to promote interprofessional and interorganizational collaborative practices, affected patients' experiences of the core dimensions of primary care.

Design: Before-and-after comparison of patients' perceptions of care at the beginning of family medicine group (FMG) implementation (15 to 20 months after accreditation) and 18 months later.

Setting: Five FMGs in the province of Quebec from various settings and types of practice.

[Assessment of the implementation of an innovative experience: network of integrated services for the elderly in the Bois-Franc region.].

Conscious of problems related to coordination of services for the elderly on its territory, the working group on health and social services of the Bois-Francs in the Mauricie and Centre-du-Québec regions implemented in February 1997, after two years of planning, a new coordination model of services for the frail elderly. This model is innovative because it combines the unique entry, case management, individualized services plan as well as the presence of three levels of concertation : strategic, tactical and clinical. The model also has the characteristic of offering comprehensive services to the elderly.

Selecting process quality indicators for the integrated care of vulnerable older adults affected by cognitive impairment or dementia.

Background: This study aimed at evaluating face and content validity, feasibility and reliability of process quality indicators developed previously in the United States or other countries. The indicators can be used to evaluate care and services for vulnerable older adults affected by cognitive impairment or dementia within an integrated service system in Quebec, Canada.

Methods: A total of 33 clinical experts from three major urban centres in Quebec formed a panel representing two medical specialties (family medicine, geriatrics) and seven health or social services specialties (nursing, occupational therapy, psychology, neuropsychology, pharmacy, nutrition, social work), from primary or secondary levels of care, including long-term care.

PRISMA: a new model of integrated service delivery for the frail older people in Canada.

Purpose: PRISMA is an innovative co-ordination-type Integrated Service Delivery System developed to improve continuity and increase the efficacy and efficiency of services, especially for older and disabled populations.

Description: The mechanisms and tools developed and implemented by PRISMA include: (1) co-ordination between decision-makers and managers, (2) a single entry point, (3) a case management process, (4) individualised service plans, (5) a single assessment instrument based on the clients' functional autonomy, and (6) a computerised clinical chart for communicating between institutions for client monitoring purposes.

Preliminary Results: The efficacy of this model has been tested in a pilot project that showed a decreased incidence of functional decline, a decreased burden for caregivers and a smaller proportion of older people wishing to be institutionalised.

Seniors' views on the use of electronic health records.

In the Mauricie and Centre-du-Québec region of the province of Quebec, Canada, an integrated services network has been implemented for frail seniors. It combines three of the best practices in the field of integrated services, namely: single-entry point, case management and personalized care plan. A shared interdisciplinary electronic health record (EHR) system was set up in 1998.

Quasi-experimental study of the effectiveness of an integrated service delivery network for the frail elderly.

The aim of this study was to examine the effectiveness of a new, integrated service delivery (ISD) network of health and social services for frail elderly living in a semi-urban community. A quasi-experimental study was conducted from 1997 to 2000, with measures taken before implementation (T0) and every 12 months after implementation for a 3-year period (T1, T2, T3); 482 people aged 75 years or older from 2 communities, 272 in the experimental and 210 in the control group, were followed. Analyses were conducted using parametric and non-parametric statistics, a generalized linear model, and Cox regression for survival analysis.

Frail elderly patients. New model for integrated service delivery.

Problem Being Addressed: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity.

Objective Of Program: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services.

Program Description: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination.