Medication therapy problems detected at community pharmacy INR checks.

Background: Despite the shift towards direct-acting anticoagulants, warfarin remains widely used in Canada and is traditionally managed by family physicians through laboratory-based international normalized ratio (INR) testing. The Community Pharmacy Anticoagulation Management Service (CPAMS) in Nova Scotia represents an innovative approach, enabling community pharmacists to conduct point-of-care (POC) INR testing and manage warfarin therapy. A potential benefit of this approach is the opportunity to identify non-warfarin medication therapy problems (nwMTPs) during routine visits.

Frailty Screening in Primary Care-Based Memory Clinics: Feasibility, Acceptability, and Preliminary Findings.

We evaluated the feasibility and acceptability of frailty screening using handgrip strength with gait speed measures within four primary care-based memory clinics in Ontario. This mixed methods quality improvement initiative examined the reach, effectiveness, adoption, implementation, and maintenance of frailty screening from the perspective of patients ( = 216), care partners ( = 142), and healthcare providers ( = 9). Frailty screening was well-received by patients and care partners and perceived as quick and easy to administer and integrate into assessment processes by healthcare providers at all four memory clinics.

Usability of an automated medication dispensation device and adherence dashboard: A study protocol.

Non-adherence to prescribed medication regimens can lead to suboptimal control of chronic health conditions and increased hospitalizations. Older adults may find it particularly challenging to self-manage medications due to physical and cognitive limitations, resulting in medication non-adherence. While automated medication dispensing technologies may offer a solution for medication self-management among older adults, these technologies must demonstrate usability before effectiveness can be investigated and products made available for widespread use.

Identifying pseudo-resistant hypertension and optimizing diuretic therapy for confirmed resistant cases in primary care.

Background: Approximately 10% of individuals with hypertension are expected to have resistant hypertension (RH). Many have pseudo-resistant hypertension (p-RH) due to a variety of factors. To date, the prevalence of p-RH and optimal diuretic therapy in primary care have not been studied.

An innovative approach to recruiting participants for dementia research: primary care and researcher perspectives.

To describe clinician and researcher perceptions of a new, patient preference focused approach to recruiting patients for research from primary care-based memory clinics. Memory clinic clinicians completed a survey and key informants completed an individual interview to gather their perceptions of this new program. The majority of clinicians were 'satisfied' or 'very satisfied' with this recruitment approach and indicated that this approach would have minimal negative impact on patient care or create conflict of interest.

Quality of Reporting Using Good Reporting of A Mixed Methods Study Criteria in Chiropractic Mixed Methods Research: A Methodological Review.

Objective: The purpose of this review was to examine the reporting in chiropractic mixed methods research using Good Reporting of A Mixed Methods Study (GRAMMS) criteria.

Methods: In this methodological review, we searched MEDLINE, Embase, CINAHL, and the Index to Chiropractic Literature from the inception of each database to December 31, 2020, for chiropractic studies reporting the use of both qualitative and quantitative methods or mixed qualitative methods. Pairs of reviewers independently screened titles, abstracts, and full-text studies, extracted data, and appraised reporting using the GRAMMS criteria and risk of bias with the Mixed Methods Appraisal Tool (MMAT).

Key Features of Smart Medication Adherence Products: Updated Scoping Review.

Background: Older adults often face challenges in self-managing their medication owing to physical and cognitive limitations, complex medication regimens, and packaging of medications. Emerging smart medication dispensing and adherence products (SMAPs) offer the options of automated dispensing, tracking medication intake in real time, and reminders and notifications. A 2021 review identified 51 SMAPs owing to the rapid influx of digital technology; an update to this review is required.

A "Patient Preference" Model of Recruitment for Research from Primary-Care-Based Memory Clinics: A Promising New Approach.

Recruiting persons with dementia for clinical trials can be challenging. Building on a guide initially developed to assist primary-care-based memory clinics in their efforts to support research, a key stakeholder working group meeting was held to develop a standardized research recruitment process, with input from patients, care partners, researchers, and clinicians. Discussions in this half-day facilitated meeting focused on the wishes and needs of patients and care partners, policy and procedures for researchers, information provided to patients, and considerations for memory clinics.

Cost-utility analysis of a multispecialty interprofessional team dementia care model in Ontario, Canada.

Objectives: To examine the cost-effectiveness of Multi-specialty INterprofessional Team (MINT) Memory Clinic care in comparison to the provision of usual care.

Design: Using a Markov-based state transition model, we performed a cost-utility (costs and quality-adjusted life years, QALY) analysis of MINT Memory Clinic care and usual care not involving MINT Memory Clinics.

Setting: A primary care-based Memory Clinic in Ontario, Canada.

Frailty prevalence and efficient screening in primary care-based memory clinics.

Background: Little is known about the prevalence of frailty among patients with memory concerns attending a primary care-based memory clinic.

Objective: This study aims to describe the prevalence of frailty among patients attending a primary care-based memory clinic and to determine if prevalence rates differ based on the screening tool that is used.

Methods: We conducted a retrospective medical record review for all consecutive patients assessed in a primary care-based memory clinic over 8 months.

Exploring the Value of Real-Time Medication Adherence Monitoring: A Qualitative Study.

Smart adherence products enable the monitoring of medication intake in real-time. However, the value of real-time medication intake monitoring to different stakeholders such as patients, their caregivers, clinicians, and insurers is not elucidated. The aim of this study was to explore the value different stakeholders place on the availability of smart adherence products and access to real-time medication intake data.

Clinical Pharmacy Services in Ambulatory Oncology: An Environmental Scan of the Canadian Practice Landscape.

Background: Canadian clinical pharmacy key performance indicators (cpKPIs) have been developed for inpatient hospital practice but are not established for ambulatory oncology. This study represents the first step in developing cpKPIs for ambulatory oncology.

Objectives: To describe the current landscape of pharmacy services in ambulatory oncology in Canada and to identify perspectives related to the development and implementation of cpKPIs in this practice setting.

Risk of bias in chiropractic mixed methods research: a secondary analysis of a meta-epidemiological review.

Objective: To examine the risk of bias in chiropractic mixed methods research.

Methods: We performed a secondary analysis of a meta-epidemiological review of chiropractic mixed methods studies. We assessed risk of bias with the Mixed Methods Appraisal Tool (MMAT) and used generalized estimating equations to explore factors associated with risk of bias.

An In-Home Medication Dispensing System to Support Medication Adherence for Patients With Chronic Conditions in the Community Setting: Prospective Observational Pilot Study.

Background: Innovative digital technology systems that support and monitor real-time medication intake are now available commercially; however, there is limited knowledge of the use of such technology in patients' homes. One such smart medication dispenser, spencer, provides alerts to patients to take their medications and allows for tracking and reporting real-time medication adherence data.

Objective: The objectives of this study were to examine the use of a smart medication dispenser as a medication adherence and self-management support tool for community dwelling adults over a 6-month period, in addition to usability, usefulness, satisfaction, and impact on caregiver support.

Recruitment of participants for dementia research: interprofessional perspectives from primary care-based memory clinics.

To understand clinician attitudes and the barriers that impede research recruitment from specialized primary care-based memory clinics. Clinicians completed a survey on attitudes and barriers to research recruitment from memory clinics. Comfort and willingness to recruit for research were low to moderate and were lower for drug trials than for observational and non-drug trials.

Development of a clinician guide for electronic medication adherence products in older adults.

Background/objectives: The ability to manage medications independently may be affected in older adults due to physical and cognitive limitations. Numerous electronic medication adherence products (eMAPs) are available to aid medication management. Unfortunately, there are no available guidelines to support clinicians in recommending eMAPs.

Integration of a smart multidose blister package for medication intake: A mixed method ethnographic informed study of older adults with chronic diseases.

Smart adherence products are marketed to assist with medication management. However, little is known about their in-home integration by older adults. It is necessary to investigate the facilitators and barriers older adults face when integrating these products into their medication taking routines before effectiveness can be examined.

Comparing Virtual to In-Person Delivery of Continuing Medical Education in Dementia Care: Which Is Preferred?

Objectives: There is limited understanding of learners' perceptions of virtual learning during the COVID-19 pandemic, as well as the use of virtual modalities for interprofessional education (IPE) in primary care. Four of 7 in-person annual "Booster Day" IPE sessions for health professionals working in primary care-based memory clinics in Ontario, Canada, were canceled when the pandemic was declared; these sessions were replaced with 2 sessions delivered via live-streamed videoconferencing. This study compares Booster Day session participants' perceptions of the in-person and virtual sessions and assesses their preferences for in-person or virtual sessions in the future.

In-home medication management by older adults: a modified ethnography study using digital photography walkabouts.

Background: Medication mismanagement can lead to non-optimal management of chronic diseases and poor health outcomes.

Objective: The purpose of this study was to better understand meanings associated with in-home medication management and storage practices of older adults with chronic diseases.

Methods: A modified ethnographic approach using digital photography walkabouts, observation protocols and field notes were used to document in-home medication organisation and storage locations.

Quality of reporting in chiropractic mixed methods research: a methodological review protocol.

Background: Mixed methods designs are increasingly used in health care research to enrich findings. However, little is known about the frequency of use of this methodology in chiropractic research, or the quality of reporting among chiropractic studies using mixed methods.

Objective: To quantify the use and quality of mixed methods in chiropractic research, and explore the association of study characteristics (e.

Frailty screening in older adults: is annual screening necessary in primary care?

Background: The Case-finding for Complex Chronic Conditions in Adults 75+ (C5-75) involves annual frailty screening in primary care using dual-trait screening measures of handgrip strength and gait speed, with additional screening for co-existing conditions in those deemed frail.

Objective: To identify low-risk individuals who could be screened for frailty every 2 years, rather than annually.

Methods: This study examined a prospective cohort of patients who completed at least two annual C5-75 screenings between April 2014 and December 2018.

Multispecialty Interprofessional Team Memory Clinics: Enhancing Collaborative Practice and Health Care Providers' Experience of Dementia Care.

This study explored whether working within Multispecialty INterprofessional Team (MINT) memory clinics has an impact on health care professionals' perceptions of the challenges, attitudes, and level of collaboration associated with providing dementia care. Surveys were completed by MINT memory clinic members pre- and 6-months post-clinic launch. A total of 228 pre-and-post-training surveys were matched for analysis.

Development and Content Validation of an Instrument to Measure Medication Self-Management in Older Adults.

Background: For older adults, the capacity to self-manage medications may be limited by several factors. However, currently available tools do not permit a comprehensive assessment of such limitations. The Domain Specific Limitation in Medication Management Capacity (DSL-MMC) was developed to address this need.

Use of an electronic medical record dashboard to identify gaps in osteoporosis care.

Unlabelled: Using an electronic medical record (EMR)-based dashboard, this study explored osteoporosis care gaps in primary care. Eighty-four physicians shared their practice activities related to bone mineral density testing, 10-year fracture risk calculation and treatment for those at high risk. Significant gaps in fracture risk calculation and osteoporosis management were identified.

Stakeholder Feedback of Electronic Medication Adherence Products: Qualitative Analysis.

Background: Medication management among older adults continues to be a challenge, and innovative electronic medication adherence products have been developed to address this need.

Objective: The aim of this study is to examine user experience with electronic medication adherence products, with particular emphasis on features, usefulness, and preferences.

Methods: Older adults, caregivers, and health care providers tested the usability of 22 electronic medication adherence products.