New opioid prescription claims and their clinical indications: results from health administrative data in Quebec, Canada, over 14 years.

Objectives: Describe new opioid prescription claims, their clinical indications and annual trends among opioid naïve adults covered by the Quebec's public drug insurance plan (QPDIP) for the fiscal years 2006/2007-2019/2020.

Design And Setting: A retrospective observational study was conducted using data collected between 2006/2007 and 2019/2020 within the Quebec Integrated Chronic Disease Surveillance System, a linkage administrative data.

Participants: A cohort of opioid naïve adults and new opioid users was created for each study year (median number=2 263 380 and 168 183, respectively, over study period).

Perceptions and Preoccupations of Patients and Physicians Regarding Use of Medical Cannabis as an Intervention Against Chronic Musculoskeletal Pain: Results from a Qualitative Study.

Objective: Explore perceptions and preoccupations regarding use of medical cannabis against chronic musculoskeletal pain, among patients and physicians.

Design: Qualitative study using interviews with patients and physicians, based on the Theory of Planned Behavior (TPB).

Setting: The study was conducted in Quebec, Canada, in spring 2020.

Job Satisfaction for Caregivers and Other Employees in Innovative Long-Term Care Homes for Residents With Cognitive Problems.

New housing models have emerged in Europe, Australia, the United States, and Canada. Intended for individuals with neurocognitive disorders, these models are characterized by a philosophy centered on the person, self-determination, liberty of choice, flexibility of care, acceptance of risk, and autonomy. Work and care are organized according to the pace and preferences of residents.

Using co-creation focus groups to customise a remote multidomain programme designed to increase dementia literacy.

Objectives: To adapt the content and functionalities of a web-based multidomain program designed to increase dementia literacy, to the context and needs of users, providers and community organisations across Québec, Canada.

Design: Five consecutive qualitative co-creation focus group sessions 30-90 min in duration each, exploring potential barriers and facilitators to usability, accessibility, comprehensibility, participant recruitment and retention.

Setting: Virtual meetings.

The OptimaMed intervention to reduce medication burden in nursing home residents with severe dementia: results from a pragmatic, controlled study.

Background: Nursing home (NH) residents with severe dementia use many medications, sometimes inappropriately within a comfort care approach. Medications should be regularly reviewed and eventually deprescribed. This pragmatic, controlled trial assessed the effect of an interprofessional knowledge exchange (KE) intervention to decrease medication load and the use of medications of questionable benefit among these residents.

An automated analysis method enabling the screening of covalent thrombin and factor XIIa inhibitors via liquid chromatography-mass spectrometry.

An automated sample preparation and separation method for the analysis of various enzyme-inhibitor combinations using liquid chromatography (LC) coupled to mass spectrometry (MS) is presented. As conventional anticoagulants have several drawbacks, the most severe being the elevated risk of internal bleedings, it is necessary to develop new-generation anticoagulants with reduced side effects. Therefore, the screening of potential inhibitors against anticoagulation targets like thrombin and FXIIa is important to design a potent and selective inhibitor.

Potential Factors Influencing Adoption of a Primary Care Pathway to Prevent Functional Decline in Older Adults.

Introduction: To help recognize and care for community-dwelling older adults living with frailty, we plan to implement a primary care pathway consisting of frailty screening, shared decision-making to select a preventive intervention, and facilitated referral to community-based services. In this study, we examined the potential factors influencing adoption of this pathway.

Methods: In this qualitative, descriptive study, we conducted semi-structured interviews and focus groups with patients aged 70 years and older, health professionals (HPs), and managers from four primary care practices in the province of Quebec, representatives of community-based services and geriatric clinics located near the practices.

Reorganizing Pharmaceutical Care in Family Medicine Groups for Older Adults With or at Risk of Major Neurocognitive Disorders: Protocol for a Mixed Methods Study.

Background: The latest global figures show that 55 million persons lived with major neurocognitive disorders (MNCDs) worldwide in 2021. In Quebec, Canada, most of these older adults are cared for by family physicians in interdisciplinary primary care clinics such as family medicine groups (FMG). When a person has a MNCD, taking potentially inappropriate medications or polypharmacy (5 different medications or more) increases their vulnerability to serious adverse events.

Hospital characteristics associated with COVID-19 mortality: data from the multicenter cohort Brazilian Registry.

The COVID-19 pandemic caused unprecedented pressure over health care systems worldwide. Hospital-level data that may influence the prognosis in COVID-19 patients still needs to be better investigated. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with in-hospital mortality in COVID-19 patients admitted to Brazilian institutions.

Predictors of venous thromboembolism in COVID-19 patients: results of the COVID-19 Brazilian Registry.

Previous studies that assessed risk factors for venous thromboembolism (VTE) in COVID-19 patients have shown inconsistent results. Our aim was to investigate VTE predictors by both logistic regression (LR) and machine learning (ML) approaches, due to their potential complementarity. This cohort study of a large Brazilian COVID-19 Registry included 4120 COVID-19 adult patients from 16 hospitals.

Experience and Appreciation of Health Care Teams Regarding a New Model of Pharmaceutical Care in Long-Term Care Settings.

In long-term care (LTC) homes, the management of frail older residents' pharmacotherapy may be challenging for health care teams. A new pharmaceutical care model highlighting the recently expanded scope of pharmacists' practice in Quebec, Canada, was implemented in two LTC homes. This study aimed to evaluate health care providers' experience and satisfaction with this new practice model.

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.

A nursing mentoring programme on non-pharmacological interventions against BPSD: Effectiveness and use of antipsychotics-A retrospective, before-after study.

Behavioural and psychological symptoms of dementia (BPSD) are common and have significant implications for patients and caregivers. Non-pharmacological interventions (NPI) have shown to be effective in the management of BPSD. However, the use of antipsychotics to treat BPSD remains ubiquitous.

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.

Cannabis against chronic musculoskeletal pain: a scoping review on users and their perceptions.

Background: Chronic musculoskeletal pain (CMP) may lead to reduced physical function and is the most common cause of chronic non-cancer pain. Currently, the pharmacotherapeutic options against CMP are limited and frequently consist of pain management with non-steroidal anti-inflammatories, gabapentinoids, or opioids, which carry major adverse effects. Although the effectiveness of medical cannabis (MC) for CMP still lacks solid evidence, several patients suffering from it are exploring this therapeutic option with their physicians.

Cognitive Impairment and Length of Stay in Acute Care Hospitals: A Scoping Review of the Literature.

Older persons experiencing a longer length of stay (LOS) or delayed discharge (DD) may see a decline in their health and well-being, generating significant costs. This review aimed to identify evidence on the impact of cognitive impairment (CI) on acute care hospital LOS/DD. A scoping review of studies examining the association between CI and LOS/DD was performed.

User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study.

Background: We know little about the best approaches to design training for healthcare professionals. We thus studied how user-centered and theory-based design contribute to the development of a distance learning program for professionals, to increase their shared decision-making (SDM) with older adults living with neurocognitive disorders and their caregivers.

Methods: In this mixed-methods study, healthcare professionals who worked in family medicine clinics and homecare services evaluated a training program in a user-centered approach with several iterative phases of quantitative and qualitative evaluation, each followed by modifications.

A New Care Model Reduces Polypharmacy and Potentially Inappropriate Medications in Long-Term Care.

Objectives: Assess the impact of a new pharmaceutical care model on (1) polypharmacy and (2) potentially inappropriate medication (PIM) use in long-term care facilities (LTCFs).

Design: Pragmatic quasi-experimental study with a control group. This multifaceted model enables pharmacists and nurses to increase their professional autonomy by enforcing laws designed to expand their scope of practice.

Is there a clinical benefit from prostate cancer center certification? An evaluation of functional and oncologic outcomes from 22,649 radical prostatectomy patients.

Purpose: To explore whether patients undergoing radical prostatectomy at a German Cancer Society (DKG: Deutsche Krebsgesellschaft) certified center (CC) have superior functional and surgical outcomes compared to patients undergoing radical prostatectomy at a non-certified hospital (nCC).

Methods: A retrospective cohort of 22,649 patients treated between 2008 and 2017 and subsequently recovered at two rehabilitation clinics within 35 days of surgery were analyzed. Urine loss (24 h-pad-test), margin status, and nerve-sparing status at rehab admission were compared between CC and nCC patients, adjusting for age, histopathology (pT, pN, Gleason score), metastases (cM), Karnofsky performance status, time from surgery to rehabilitation, and insurance provider (statutory vs.

Professional training on shared decision making with older adults living with neurocognitive disorders: a mixed-methods implementation study.

Background: Shared decision making with older adults living with neurocognitive disorders is challenging for primary healthcare professionals. We studied the implementation of a professional training program featuring an e-learning activity on shared decision making and five Decision Boxes on the care of people with neurocognitive disorders, and measured the program's effects.

Methods: In this mixed-methods study, we recruited healthcare professionals in family medicine clinics and homecare settings in the Quebec City area (Canada).