Primary Care Reform and Medication Appropriateness for Older Adults
This research aims to understand whether and how different approaches to team-based primary care in Ontario and Québec have improved prescribing and related health outcomes among older adults. Both provinces have implemented major reforms to the organization and delivery of primary care, with goals of improving quality, patient experience, and outcomes. This research project will answer the following questions using a mixed-methods design:
1) What are the primary care practice and patient characteristics that are associated with polypharmacy, potentially inappropriate prescribing, and adverse drug events for older adults in Ontario and Québec?
2) To what extent have the different approaches taken to implement team-based primary care in Ontario and Québec affected appropriateness, multiple drug use, and drug-related hospitalizations for older adults?
3) How is medication management in primary care shaped by provincial policies, and what are the regulatory, policy and other mechanisms by which medication management is established and implemented in multi-professional team practice?
4) How can primary care policies optimize the organization of team-based primary care to improve medication management and related health outcomes among older adults?
The results of this research will generate evidence for policy-makers across Canada who are interested in optimizing the composition and design of team-based primary care delivery models.
Nominated Principal Investigator: David Rudoler
Co-Principal Investigators: Agnes Grudniewicz, Elisabeth Martin, Erin Strumpf, Sara Allin
Co-Investigators and Collaborators: Audrey Laporte, Caroline Sirois, Greg Marchildon, Lisa Dolovich, Lise Bjerre, Monika Roerig, Nichole Austin, Rick Glazier
Papers & Preprints
Allin, S., Martin, E., Rudoler, D., Church Carson, M., Grudniewicz, A., Jopling, S., & Strumpf, E. (2021). Comparing public policies impacting prescribing and medication management in primary care in two Canadian provinces. Health Policy, 125(9), 1121–1130.
Austin, N., Rudoler, D., Allin, S., Dolovich, L., Glazier, R. H., Grudniewicz, A., Martin, E., Sirois, C., & Strumpf, E. (2023). Team-based primary care reforms and older adults: A descriptive assessment of sociodemographic trends and prescribing endpoints in two Canadian provinces. BMC Primary Care, 24(1), 7.
Rudoler, D., Austin, N., Allin, S., Bjerre, L. M., Dolovich, L., Glazier, R. H., Grudniewicz, A., Laporte, A., Martin, E., Schultz, S., Sirois, C., & Strumpf, E. (2023). The impact of team-based primary care on medication-related outcomes in older adults: A comparative analysis of two Canadian provinces. Preventive Medicine Reports, 36, 102512.