Bipolar Disorder, Schizophrenia
Conditions
Keywords
primary health care, primary care, schizophrenia, bipolar disorder, cluster randomized controlled trial, community health worker, randomized controlled trial
Brief summary
The COVID-19 pandemic significantly impacted primary care across Canada. Inequities in prevention activities and chronic disease management likely increased but the extent is unknown. Pragmatic interventions are required to prioritize patients and improve the quality of primary care post-COVID. In AFTERMATH, the investigators will conduct a pragmatic cluster randomized controlled trial (cRCT) at the largest primary care Practice-Based Research Network (PBRN) in Ontario, focused on a highly marginalized population: adults living with mental illness and one or more additional chronic diseases. The investigators will test an intervention that builds on the investigators' past work and combines data and supports to primary care providers to improve quality of life, reduce gaps in prevention activities and improve chronic disease management. The investigators' project will result in new evidence on ways to improve access to care and reduce inequities, and inform future efforts to use data beyond COVID-19.
Interventions
OTHERCommunity Health Worker
Physicians will work with a Community Health Worker (CHW) to review the data presented in their Quality Improvement reports, and triage patients for proactive outreach (e.g. No action necessary, Call patient to check-in, Arrange BP, weight and labs, Book for phone appointment, Book for in-person appointment).
Sponsors
Unity Health Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
A. Family physicians: Any family physician in a University of Toronto DFCM academic site with 10+ community-dwelling patients living with schizophrenia or bipolar disorder plus one or more additional chronic disease (COPD, diabetes, hypertension, osteoarthritis, dementia, epilepsy and Parkinson's). B. Patients: Patients from the included family physician practices living with schizophrenia or bipolar disorder plus one or more additional chronic disease (COPD, diabetes, hypertension, osteoarthritis, dementia, epilepsy and Parkinson's).
Exclusion criteria
A. Family Physicians: None B. Patients: Patients under 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| health-related quality of life | 9 months | We will assess health-related quality of life using the World Health Organization WHO QOL-BREF scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Preventive care activities and chronic disease management outcomes | 9 months | Preventive care activities up-to-date and chronic disease management outcomes, which reflect the goals of primary care teams, and health services outcomes (primary care visits, emergency department visits, hospitalizations, and total health services costs). |
Contacts
Primary ContactDanial Behzad, BSc
Backup ContactAndrew Pinto, MD MSc
Outcome results
None listed