Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care.

Background: Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations.

Tolerability of bedtime diuretics: a prospective cohort analysis.

Objectives: We sought to validate, or refute, the common belief that bedtime diuretics are poorly tolerated due to nocturia.

Design: Prespecified prospective cohort analysis embedded within the randomised BedMed trial, in which hypertensive participants are randomised to morning versus bedtime antihypertensive administration.

Setting: 352 community family practices across 4 Canadian provinces between March 2017 and September 2020.

Healthy food prescription incentive programme for adults with type 2 diabetes who are experiencing food insecurity: protocol for a randomised controlled trial, modelling and implementation studies.

Introduction: The high cost of many healthy foods poses a challenge to maintaining optimal blood glucose levels for adults with type 2 diabetes mellitus who are experiencing food insecurity, leading to diabetes complications and excess acute care usage and costs. Healthy food prescription programmes may reduce food insecurity and support patients to improve their diet quality, prevent diabetes complications and avoid acute care use. We will use a type 2 hybrid-effectiveness design to examine the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of a healthy food prescription incentive programme for adults experiencing food insecurity and persistent hyperglycaemia.

Association between continuity and access in primary care: a retrospective cohort study.

Background: Continuity of care is a tenet of primary care. Our objective was to explore the relation between a change in access to a primary care physician and continuity of care.

Methods: We conducted a retrospective cohort study among physicians in a primary care network in southwest Alberta who measured access consistently between 2009 and 2016.

Hypertension Canada's 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children.

Hypertension Canada's 2020 guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children provide comprehensive, evidence-based guidance for health care professionals and patients. Hypertension Canada develops the guidelines using rigourous methodology, carefully mitigating the risk of bias in our process. All draft recommendations undergo critical review by expert methodologists without conflict to ensure quality.

Value in Healthcare: Designing an Integrated Value-Based Healthcare System.

Value-based healthcare (VBHC) can be interpreted in many ways depending on one's jurisdiction. Often it is used synonymously with cost-effectiveness. In Alberta, VBHC might more appropriately be termed "values-based healthcare.

Variable Genomic and Metabolomic Responses to Varying Doses of Vitamin D Supplementation.

Background/aim: To assess the impact of vitamin D supplementation on genomic and metabolomic profiles and relate them to the individual's responsiveness to varying doses of vitamin D Patients and Methods: Healthy adults were given either 600, 4000 or 10,000 IUs vitamin D/day for 6 months. Circulating parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], calcium, peripheral white blood cells broad gene expression and urine and serum metabolomic profiles were evaluated.

Results: There was a dose-dependent effect of vitamin D supplementation on serum 25(OH)D, PTH and broad gene expression.

Informing Primary Care Changes in Alberta: Continuity and Potential Impacts on Acute Care.

Health systems across Canada are embarking on initiatives to enhance access to primary care services, with the intent of improving patient outcomes and mitigating escalating healthcare costs. However, it is important that such initiatives be carefully weighed with the evidence that the changes will indeed have the desired impact. In Alberta, part of the informative process involved an analysis to examine links between continuity with primary care and utilization of acute care services.

Correction to: Methods for identifying 30 chronic conditions: application to administrative data.

Following publication of the original manuscript [1], the authors noted several errors in Table 1. Details of the requested corrections are shown below.

Using Concept Maps to compare obesity knowledge between policy makers and primary care researchers in Canada.

Objective: Knowledge transfer is the process of information sharing between researchers, knowledge users and policy makers. Globally, public policies about obesity do not reflect the complexity of what is known about the cause and effects of obesity. We used Concept Maps, a qualitative method that represents mental models, to compare the understanding of obesity between policy makers in a Canadian province and local primary care researchers.

Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children.

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension in adults and children. This year, the adult and pediatric guidelines are combined in one document. The new 2018 pregnancy-specific hypertension guidelines are published separately.

The effect of provider affiliation with a primary care network on emergency department visits and hospital admissions.

Background: Primary care networks are designed to facilitate access to inter-professional, team-based care. We compared health outcomes associated with primary care networks versus conventional primary care.

Methods: We obtained data on all adult residents of Alberta who visited a primary care physician during fiscal years 2008 and 2009 and classified them as affiliated with a primary care network or not, based on the physician most involved in their care.

Patient navigators for people with chronic disease: A systematic review.

Background: People with chronic diseases experience barriers to managing their diseases and accessing available health services. Patient navigator programs are increasingly being used to help people with chronic diseases navigate and access health services.

Objective: The objective of this review was to summarize the evidence for patient navigator programs in people with a broad range of chronic diseases, compared to usual care.

Effect of a vitamin and mineral supplementation on glycemic status: Results from a community-based program.

Aims: Diet is a major risk factor for type 2 diabetes mellitus. As cofactors necessary for enzyme function of all metabolic pathways, vitamins and minerals have the potential to improve glucose metabolism. We investigated the effects of a nutrient intervention program on glycemic status.

Multimorbidity, dementia and health care in older people:a population-based cohort study.

Background: Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes.

Methods: We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013.

Comparison of Methods to Define High Use of Inpatient Services Using Population-Based Data.

Background: A variety of methods have been proposed to define "high users" of inpatient services, which may have implications for targeting subgroups for intervention.

Objective: To compare 3 common definitions of high inpatient service use and their influence on patient capture, outcomes, and inpatient burden.

Design, Setting, Patients: We defined "high use" based on the upper 5th percentile of the population by 3 definitions: (1) number of inpatient episodes (≥3 hospitalizations/year), (2) cumulative length of stay (≥56 days in hospital/year), and (3) cumulative cost based on hospitalization resource intensity weights (≥ $63,597 Canadian dollars/year).

Hypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults.

Hypertension Canada provides annually updated, evidence-based guidelines for the diagnosis, assessment, prevention, and treatment of hypertension. This year, we introduce 10 new guidelines. Three previous guidelines have been revised and 5 have been removed.

Emergency Department Use among Patients with CKD: A Population-Based Analysis.

Background And Objectives: Although prior studies have observed high resource use among patients with CKD, there is limited exploration of emergency department use in this population and the proportion of encounters related to CKD care specifically.

Design, Setting, Participants, & Measurements: We identified all adults (≥18 years old) with eGFR<60 ml/min per 1.73 m (including dialysis-dependent patients) in Alberta, Canada between April 1, 2010 and March 31, 2011.

Pay-for-performance remuneration for pharmacist prescribers' management of hypertension: A substudy of the RxACTION trial.

Background: To be sustainable, pharmacists providing direct patient care must receive appropriate payment for these services. This prespecified substudy of the RxACTION trial (a randomized trial of pharmacist prescribing vs usual care in patients with above-target blood pressure [BP]) aimed to determine if BP reduction achieved differed between patients whose pharmacist was paid by pay-for-performance (P4P) vs fee-for-service (FFS).

Methods: Within RxACTION, patients with elevated BP assigned to the pharmacist prescribing group were further randomized to P4P or FFS payment for the pharmacist.

Potentially Preventable Hospitalization among Patients with CKD and High Inpatient Use.

Background And Objectives: Although patients with CKD are commonly hospitalized, little is known about those with frequent hospitalization and/or longer lengths of stay (high inpatient use). The objective of this study was to explore clinical characteristics, patterns of hospital use, and potentially preventable acute care encounters among patients with CKD with at least one hospitalization.

Design, Setting, Participants, & Measurements: We identified all adults with nondialysis CKD (eGFR<60 ml/min per 1.

The association between sociodemographic and clinical characteristics and poor glycaemic control: a longitudinal cohort study.

Aims: People with diabetes and poor glycaemic control are at higher risk of diabetes-related complications and incur higher healthcare costs. An understanding of the sociodemographic and clinical characteristics associated with poor glycaemic control is needed to overcome the barriers to achieving care goals in this population.

Methods: We used linked administrative and laboratory data to create a provincial cohort of adults with prevalent diabetes, and a measure of HbA that occurred at least 1 year following the date of diagnosis.

Development and implementation of an online clinical pathway for adult chronic kidney disease in primary care: a mixed methods study.

Background: Primary care physicians and other primary health care professionals from Alberta, Canada identified a clinical pathway as a potential tool to facilitate uptake of clinical practice guidelines for the diagnosis, management and referral of adults with chronic kidney disease. We describe the development and implementation of a chronic kidney disease clinical pathway (CKD-CP; www.ckdpathway.

Hypertension in Canada: Past, Present, and Future.

Canada has an extremely successful hypertension detection and treatment program. The aim of this review was to highlight the historic and current infrastructure and initiatives that have led to this success, and the outlook moving forward into the future. We discuss the evolution of hypertension awareness and control in Canada; contributions made by organizations such as the Canadian Hypertension Society, Blood Pressure Canada, and the Canadian Hypertension Education Program; the amalgamation of these organizations into Hypertension Canada; and the impact that Hypertension Canada has had on hypertension care in Canada.