Publications by authors named "Tadrous M"

Concerns have been raised that glucagon-like peptide 1 receptor agonists (GLP1-RAs) may increase the risk of thyroid cancer, but evidence remains conflicting. We therefore investigated if GLP1-RA use, compared with use of dipeptidyl peptidase-4 inhibitors (DPP-4is), was associated with thyroid cancer risk in patients with type 2 diabetes. This multisite cohort study with subsequent meta-analysis included six population-based databases from Canada (Ontario), Denmark, Norway, South Korea, Sweden, and Taiwan.

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Background: Understanding how the efficacy of COVID-19 vaccines translates from clinical trials to real-world settings is critical to inform evolving vaccination policies. The objective of this study was to assess COVID-19 vaccine effectiveness (VE) against severe COVID-19-related outcomes in children aged 5-11 years, including COVID-19-related hospital admissions and multisystem inflammatory syndrome in children (MIS-C).

Methods: We conducted a retrospective, population-based cohort study using linked health administrative data in the first year following the emergence of the Omicron variant (January 2 to December 31, 2022) in Ontario, Canada.

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Background: Per capita spending on drugs in the United States is double that of Canada. One commonly debated point when comparing the 2 countries is whether this additional spending allows residents of the United States access to valuable therapies not available in Canada.

Objective: To characterize the therapeutic value of prescription drugs used in the United States that are not marketed in Canada.

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Purpose: Primary care access is a key health system metric, but little research has compared models to provide primary care access when one's regular physician is not available. We compared health system use after a visit with a patient's own family physician group (ie, within-group physician who was not the patient's primary physician) vs a visit with a walk-in clinic physician who was not part of the patient's family physician group.

Methods: We conducted a population-based, retrospective cohort study using administrative data from Ontario, Canada, including all individuals formally enrolled with a family physician, from April 1, 2019 to March 31, 2020.

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Article Synopsis
  • A study was conducted to investigate whether maternal vaccination with mRNA COVID-19 vaccines during the first trimester of pregnancy is linked to a higher rate of major congenital anomalies in newborns.
  • The research utilized data from over 174,000 live births in Ontario, Canada, comparing infants born to vaccinated mothers with those born to unvaccinated mothers and their older siblings for better analysis.
  • Results indicated that the incidence of major congenital anomalies was slightly lower in vaccinated mothers’ infants (24.3 per 1000 live births) compared to unvaccinated mothers’ infants (26.5 per 1000 live births), suggesting no significant increased risk associated with vaccination during early pregnancy.
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Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues.

Methods: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program.

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Objective: This proposed scoping review aims to examine studies assessing the impact of drug shortages on population-level drug utilization trends. The objectives of this review are to a) assess which drugs have been studied and describe associated drug characteristics, b) determine jurisdictions and healthcare settings that have conducted these studies, and c) describe how changes in drug use and the extent of shortage impacts are reported in literature.

Introduction: Drug shortages continue to impair drug access and delivery of quality care across the world.

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Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are effective medications for type 2 diabetes mellitus (T2DM) and obesity, yet their uptake among patients most likely to benefit has been slow.

Methods: We conducted a cross-sectional analysis of medication exposure in adults hospitalized at 16 hospitals in Ontario, Canada, between 2015 and 2022. We estimated the proportions of those with T2DM, obesity, and cardiovascular disease.

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Importance: Drug shortages are a persistent public health issue that increased during the COVID-19 pandemic. Both the US and Canada follow similar regulatory standards and require reporting of drug-related supply chain issues that may result in shortages. However, it is unknown what proportion are associated with meaningful shortages (defined by a significant decrease in drug supply) and whether differences exist between Canada and the US.

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Article Synopsis
  • The study explored the characteristics and healthcare service usage of individuals with Substance Use Disorder (SUD) across different levels of marginalization before and during the COVID-19 pandemic in Ontario, Canada.
  • A total of 259,497 individuals were analyzed pre-pandemic and 276,459 during the pandemic, revealing that over 40% belonged to the highest marginalization groups, and marginalized individuals had increased healthcare visits.
  • Despite no major changes in overall SUD prevalence or service usage, more marginalized individuals sought drug-related outpatient care, highlighting the need for further research on the link between marginalization and substance use.
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  • Opioids, while commonly prescribed for pain management, pose safety risks; the study explores whether strategies like audit and feedback can improve prescription practices among primary care physicians in Ontario.
  • The research used a matched-cohort design to compare the effects of audit and feedback, with or without academic detailing, on opioid prescribing rates over a 30-month period, focusing on family physicians.
  • Results indicated a general decline in opioid prescriptions pre-intervention across all groups, with significant reductions in high-prescribing physicians in the audit and feedback group, but no notable difference post-intervention between the groups, suggesting future efforts should target high-volume prescribers.
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Background/objective: The purpose of this study was to investigate the impact of the COVID-19 pandemic on mortality rates in a community-dwelling spinal cord injury (SCI) population in Ontario.

Methods: Using health administrative databases, monthly mortality rates were evaluated pre-pandemic, during the pandemic, and post-pandemic from March 2014 to May 2024. Data were stratified by sex, injury etiology, and mental health status.

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  • The study aimed to compare family physicians working in walk-in clinics with those providing long-term care in Ontario, focusing on their characteristics and patient demographics.
  • The research linked a 2019 physician survey with health care data, revealing differences such as a higher percentage of male physicians and a diverse language background among walk-in clinic practitioners.
  • Results showed that walk-in clinic physicians typically served younger, less frequently seeking patients, many of whom were from diverse backgrounds and often attached to other family physicians.
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  • The study aimed to analyze the trends of hyperpolypharmacy (taking 10 or more medications) in older adults before and after their admission to nursing homes in Ontario, Canada.
  • It involved a cohort of over 61,000 adults aged 75 and older and found that the prevalence of hyperpolypharmacy rose from 4.4% to 12.0% over ten years, continuing to 13.8% after admission.
  • The increase in specific drug classes like antidepressants and antipsychotics indicates a growing need for better medication management in both community and nursing home environments.
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Background And Objective: Real-world evidence (RWE) can complement and fill knowledge gaps from randomized controlled trials to assist in health-technology assessment (HTA) for regulatory decision-making. However, the generation of RWE is an intricate process with many sequential decision points, and different methods and approaches may impact the quality and reliability of evidence. Standardization and transparency in reporting these decisions is imperative to appraise RWE and incorporate it into HTA decision-making.

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Persons with disabilities experience numerous barriers to healthcare access including vaccine accessibility. The purpose of this study was to determine COVID-19 vaccine uptake in the spinal cord injury and disease (SCI/D) population of Ontario and identify potential factors influencing C OVID-19 vaccine uptake. This was a retrospective closed-cohort study using administrative health data on individuals with SCI/D of traumatic and non-traumatic causes to examine the monthly number of COVID-19 vaccine doses received between December 2020 and December 2023.

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  • Janus Kinase (JAK) inhibitors are a new type of medication used to treat immune-related conditions, yet there's limited understanding of how safety concerns affect their use and prescription in Canada.
  • From 2016 to 2022, over 26 million JAK-inhibitor units were dispensed in Canada, with an average of 9,431 units per 100,000 people, showing an increase in usage across all provinces.
  • Tofacitinib was the most commonly dispensed JAK-inhibitor, accounting for 76% of total units, while differences in prescribing rates among provinces suggest a need for further investigation into usage practices.
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Objectives: Adherence to medications is important for the management of chronic diseases. Although the proportion of days covered (PDC) is a common metric for measuring adherence, it may be insufficient to distinguish relevant differences in medication-taking behavior. Group-based trajectory models (GBTMs) have been used to better represent adherence over time.

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Several new classes of medications for diabetes have recently become available newer medication classes have been increasing in use. It is unclear how their utilization varied across provinces and how the COVID-19 pandemic may have affected these trends. Our objective was to investigate Canada-wide and province-specific trends in diabetes medication dispensed by drug class over time, while also examining the impact of the COVID-19 pandemic and related restrictions on diabetes medication dispensing.

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The COVID-19 pandemic was associated with increases in the prevalence of depression and anxiety among children and young adults. We studied whether the pandemic was associated with changes in prescription benzodiazepine use. We conducted a population-based study of benzodiazepine dispensing to children and young adults ≤ 24 years old between January 1, 2013, and June 30, 2022.

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Objective: Digital substance use treatment programs present an opportunity to provide nonresidential care for people with problematic substance use. In June 2021, the provincial government in Ontario provided free access to Breaking Free Online (BFO), a digital behavioral change program for people with substance use disorders.

Methods: An observational study was conducted with retrospective data to characterize clients' use and engagement patterns in BFO and examine changes in self-reported outcomes.

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