PriCARE

Date

2018-2023

Partners

Canadian Institutes of Health Research
Population- Health Axis
Université de Sherbrooke Hospital Research Center
Dalhousie Medical Research Foundation
Department of Family and Emergency Medicine, Université de Sherbrooke
Faculty of Medicine, Dalhousie University
Université de Sherbrooke Foundation
Fondation de ma Vie
Fonds de recherche du Québec en santé
Institut universitaire de première ligne en santé et services sociaux
Ministère de la santé et des services sociaux du Québec
New Brunswick Health Research Foundation
Nova Scotia Health Authority
Réseau-1 Québec
Network in Primary and Integrated Health Care Innovations
Saskatchewan Health Research Foundation
Université de Sherbrooke
Université du Québec à Chicoutimi
Memorial University

Aim

Implementing and evaluating a case management intervention in ten primary care clinics from five Canadian provinces (Newfoundland and Labrador, New Brunswick, Nova Scotia, Saskatchewan and Québec) in partnership with patients.

Articles, presentations and posters

Protocols

• Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: an implementation and realist evaluation protocol
• Protocol for a mixed-method analysis of implementation of case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs

Results

• Reconciling validity and challenges of patient comfort and understanding: Guidelines to patient-oriented questionnaires
• Patient and researcher experiences of patient engagement in primary care health care research: a participatory qualitative study
• Planning the Evaluation of Patient Engagement in the PriCare Research Program
• Implementation analysis of a case management intervention for people with complex care needs in primary care: a multiple case study across Canada
• Patient Engagement in Primary Care Implementation Research: A Logic Model.
• Stakeholders’ perceptions of a nurse-led telehealth case management intervention in primary care for patients with complex care needs: a qualitative descriptive study
• Fostering collective leadership to improve integrated primary care: lessons learned from the PriCARE program
• Interviewing in realist evaluation in healthcare research: theoretical and practical guidelines. International Journal of Health Planning and Management (Submitted)

Scientific presentations

• Mener un projet de recherche multi-provinces en partenariat avec des patients : l’expérience de l’équipe PriCARE. Wébinaire Réseau-1 2020.
• The implementation of case management in primary care for frequent users of health care services. Horizon Health Network Experience Conference 2020.
• Introduction to realist approaches to inform innovations in primary care. North American Primary Care Research Group (NAPCRG) annual conference 2020.
• Reconciling Validity and challenges of patient comfort and understanding : Guidelines to Patient Questionnaires. Canadian Association for Health Services and Policy Research (CAHSPR) annual conference (2021). [Video]
• Patient engagement works: Patient and researcher experiences of patient partnership in primary healthcare research. North American Primary Care Research Group (NAPCRG) annual conference 2021. [Video]
• Implementation Analysis of Case Management Interventions for Frequent Users of Healthcare Services: A Multiple-Case Study. North American Primary Research Group (NAPCRG) annual conference 2021. [Video]
• Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs. New Brunswick Health Research Foundation (NBHRF) Health Research Week 2021.
• Case management in primary care for frequent users of the health care system with complex care needs. University of New Brunswick Health Research Conference 2021.
• Integrating research in primary care settings: challenges and lessons from the PriCARE case management study in Nova Scotia PHC.
• Implementing Case Management in Primary Care: Findings and reflections from a multi-province SPOR Study. PIHCI Network Learning Series 2020-2022 (Special Session) 2022. [Slides]
• Realist interviewing in primary healthcare research. Workshop presented at North American Primary Research Group (NAPCRG) annual conference 2022.
• Meaningful patient-oriented research: Working together on a collaborative multi-provincial study. QUEST: Focus of the month. [Slides et Video]
• La flexibilité dans le partenariat en recherche axée avec et pour les patients. Journée scientifique des boursières et boursiers de l’Unité de Soutien SSA 2022. (french only)
• From Start to Finish: Added Value of Patient Partners in the PriCARE Program. Canadian Association for Health Services and Policy Research (CAHSPR) annual conference 2023.
• Case management for individuals with chronic conditions and complex care needs. New-Brunswick Health Research Week 2023.
• Case management for individuals with complex care needs: Factors assisting and hindering implementation. North American Primary Care Research Group (NAPCRG) annual conference 2023.
• Case management in primary care for people with complex care needs: a realist evaluation. North American Primary Care Research Group (NAPCRG) annual conference 2023.
• Positive outcomes and limitations of a case management intervention in primary care for patients with complex care needs. North American Primary Care Research Group (NAPCRG) annual conference 2023.

Scientific posters

• La gestion de cas en soins de première ligne pour les grands utilisateurs de soins atteints de conditions chroniques et ayant des besoins de santé complexes : protocole d’une évaluation d’implantation et d’une évaluation réaliste. Journée scientifique du Réseau-1 2018. (french only)
• Case management in primary care for frequent users of healthcare services with chronic diseases and complex care needs: protocol of an implementation and realist evaluation. North American Primary Care Research Group (NAPCRG) annual conference 2018.
• Patient engagement in research on a case management intervention for patients with chronic diseases and complex care needs. North American Primary Care Research Group (NAPCRG) annual conference 2019.
• Initial implementation strategies of a case management intervention in primary care clinics across Canada. North American Primary Care Research Group (NAPCRG) annual conference 2019.
• Case management implementation in primary care clinics in Nova Scotia. Primary Healthcare Research Day 2019.
• A logic analysis of patient engagement in implementation research: Lessons learned from a multi-site case management intervention in primary care. North American Primary Care Research Group (NAPCRG) annual conference 2020.
• Case Study with a Participatory Approach in Implementation Science of Healthcare Innovations: Good Practice Recommendations for Primary Care Research. WONCA conference 2021.
• Using a realist approach to deepen evidence about how case management works for frequent users of healthcare services. REALIST conference 2021.
• Planning, Operationalizing, and Evaluating Patient Partners’ Engagement in Primary Care Research: A Logic Model. North American Primary Care Research Group (NAPCRG) annual conference 2021.
• Telehealth case management in primary care: An innovative approach for service disruption. Canadian Association for Health Services and Policy Research (CAHSPR) annual conference 2022.
• A primary care case management program for people with complex care needs who frequently use healthcare services : a realist evaluation protocol. North American Primary Care Research Group (NAPCRG) annual conference 2022.
• Sturgeon Lake First Nation: Co-Created Case Management in Primary Care with Individuals who have Chronic Diseases and require Complex Care. North American Primary Care Research Group (NAPCRG) annual conference 2022.
• Realist Evaluation in health services research: An introduction and guidance for interviewing. Canadian Association for Health Services and Policy Research (CAHSPR) annual conference 2023. 
• Strategies used by nurse case managers in primary care for patients with complex needs who frequently use health services: a qualitative study. Canadian Association for Health Services and Policy Research (CAHSPR) annual conference 2023. 
• Recruiting Patients with Complex Care Needs to a Case Management Program in Primary Care: Engaging Patient Partners. North American Primary Care Research Group (NAPCRG) annual conference 2023.

Online publications

• Case management program: A case study in patient engagement. NL Support Newsletter 2021.
• Blog: Patient Partners and researchers work together to navigate and spread knowledge about nurse-led primary care in Nova Scotia. BRIC-NS 2022.
• Patient Partners and Researchers co-develop Knowledge Translation Initiatives for Greater Impact in Nova Scotia. Spring 2022 Edition of the SPOR Update Newsletter.

Knowledge transfer material

• Enhancing research through meaningful engagement with patient partners (infographic).
• This is Max (video of patient Max’s case management experience).
• What is Case Management (infographic).
• Patient Journey Map during case management follow up (infographic).
• From outlier to insight: the power of different perspectives

Results

Implementation analysis: The leadership of healthcare professionals and managers, the experience and skills of nurse case managers and the development of team capabilities facilitated the early stages of the case management intervention’s implementation. Participants perceived the intervention as a comprehensive, adaptable, and organized approach to care, offering more resources and support to patients and better coordination of primary care.

Telehealth: Case management via telehealth has been greatly appreciated by patients, primary care providers and case managers. This approach is appropriate for most consultations, and offers several advantages, including easier and faster access to care.

Patient engagement in research: Both patient partners and academic researchers highlighted the importance of finding a balance between providing structure or guidelines for patient engagement, while allowing for flexibility along the way. As an empirical and standardized illustration that facilitates a shared understanding, the logic model provides guidance for maximizing the impact of patient partnership in various contexts for research, patients, providers and health care.

Realistic evaluation: results are not yet available.

Team

Principal investigators

Catherine Hudon, Professor, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

Maud-Christine Chouinard, Professor, Faculty of Nursing, Université de Montréal

Kris Aubrey-Bassler, Associate Professor, Department of Family Medicine, Memorial University

Fred Burge, Professor, Department of Family Medicine, Community Health and Epidemiology, Dalhousie University

Joanna Zed, Assistant Professor, Department of Family Medicine, Dalhousie University

Shelley Doucet, Associate Professor, Department of Nursing and Health Science, University of New Brunswick

Vivian R. Ramsden, Professor, Department of Family Medicine, University of Saskatchewan

Co-investigators

Yves Couturier, Professor, School of Social Work, Université de Sherbrooke

Alison Luke, Senior Research Associate, Department of Nursing and Health Sciences, University of New Brunswick

Marie-Eve Poitras, Professor, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

Marilyn Macdonald, Professor, School of Nursing, Faculty of Health, Dalhousie University

Magaly Brodeur, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

Research assistants

Québec

Mathieu Bisson, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

Olivier Dumont-Samson, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

Mireille Lambert, Department of Family Medicine and Emergency Medicine, Université de Sherbrooke

New Brunswick

Charlotte Schwarz, Department of Nursing, University of New Brunswick

Decision makers and managers

Cassie Chisholm, Director of Primary Care, Department of Health and Community Services – Newfoundland and Labrador

Daniel Doherty, Director of Primary Care, Horizon Health Network, New Brunswick

Philippe Lachance, Director of Access and Organization of Primary Care Services, Ministère de la Santé et des Services sociaux, Québec

Tara Sampalli, Senior Scientific Director, Research, Innovation and Discovery, Nova Scotia Health Authority

Patient partners

Nova Scotia

Judy Porter

Donna Rubenstein

New Brunswick

Linda Wilhelm

Jennifer Taylor

Newfoundland and Labrador

Mike Warren