Transforming primary care for older Canadians living with frailty: mixed
methods study protocol for a complex primary care intervention
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abstract
IntroductionOlder Canadians living with frailty are high users of healthcare
services; however, the healthcare system is not well designed to meet
the complex needs of many older adults. Older persons look to their
primary care practitioners to assess their needs and coordinate their
care. They may need care from a variety of providers and services, but
often this care is not well coordinated. Older adults and their family
caregivers are the experts in their own needs and preferences, but often
do not have a chance to participate fully in treatment decisions or care
planning. As a result, older adults may have health problems that are
not properly assessed, managed or treated, resulting in poorer health
outcomes and higher economic and social costs. We will be implementing
enhanced primary healthcare approaches for older patients, including
risk screening, patient engagement and shared decision making and care
coordination. These interventions will be tailored to the needs and
circumstances of the primary care study sites. In this article, we
describe our study protocol for implementing and testing these
approaches.Methods and analysisNine primary care sites in three Canadian provinces will participate
in a multi-phase mixed methods study. In phase 1, baseline information
will be collected through questionnaires and interviews with patients
and healthcare providers (HCPs). In phase 2, HCPs and patients will be
consulted to tailor the evidence-based interventions to site-specific
needs and circumstances. In phase 3, sites will implement the tailored
care model. Evaluation of the care model will include measures of
patient and provider experience, a quality of life measure, qualitative
interviews and economic evaluation.Ethics and disseminationThis study has received ethics clearance from the host academic
institutions: University of Calgary (REB17-0617), University of Waterloo
(ORE#22446) and Université Laval (#MP-13-2019-1500 and 2017-2018-12-MP).
Results will be disseminated through traditional means, including
peer-reviewed publications and conferences and through an extensive
network of knowledge user partners.Trial registration numberNCT03442426; Pre-results.
