scholarly journals Long term outcomes of cluster randomized trial to improve cardiovascular health at population level: The Cardiovascular Health Awareness Program (CHAP)

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0201802 ◽  
Author(s):  
Simone Dahrouge ◽  
Janusz Kaczorowski ◽  
Lisa Dolovich ◽  
Michael Paterson ◽  
Lehana Thabane ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cardiovascular Health ◽  
Population Level ◽  
Cluster Randomized Trial ◽  
Health Awareness ◽  
Long Term Outcomes ◽  
Awareness Program ◽  
Cluster Randomized

scholarly journals Long-Term Outcomes of a Cluster-Randomized Trial Testing the Effects of Blood Pressure Telemonitoring and Pharmacist Management

2017 ◽  
Vol 4 (3) ◽  
pp. 166
Author(s):  
Stephen Asche ◽  
Anna Bergdall ◽  
Steven Dehmer ◽  
Beverly Green ◽  
JoAnn Sperl-Hillen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Long Term Outcomes ◽  
Trial Testing ◽  
Cluster Randomized

scholarly journals A randomized trial of mail vs. telephone invitation to a community-based cardiovascular health awareness program for older family practice patients [ISRCTN61739603]

2005 ◽  
Vol 6 (1) ◽  
Author(s):  
Tina Karwalajtys ◽  
Janusz Kaczorowski ◽  
Larry W Chambers ◽  
Cheryl Levitt ◽  
Lisa Dolovich ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Family Practice ◽  
Cardiovascular Health ◽  
Health Awareness ◽  
Community Based ◽  
Awareness Program

scholarly journals Spread and scale of an electronic deprescribing software to improve health outcomes of older adults living in nursing homes: study protocol for a stepped wedge cluster randomized trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marc-Eric Nadeau ◽  
Justine L. Henry ◽  
Todd C. Lee ◽  
Émilie Bortolussi-Courval ◽  
Carole Goodine ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Trial ◽  
Study Design ◽  
Long Term Care ◽  
Cluster Randomized Trial ◽  
Stepped Wedge ◽  
Term Care ◽  
Medication Reviews ◽  
Cluster Randomized

Abstract Background Medication overload or problematic polypharmacy is a major problem causing widespread harm, particularly to older adults. Taking multiple medications increases the risk of potentially inappropriate medications (PIMs), and residents in long-term care (LTC) are frequently prescribed 10 or more medications at once. One strategy to address this problem is for the physician and/or pharmacist to perform regular medication reviews; however, this process can be complicated and time-consuming. With a prescription review, medications may be decreased, changed, or stopped altogether. MedReviewRx is a software that runs an analysis using deprescribing rules to produce a report to guide medication reviews addressing medication overload for residents in LTC. Methods This study will employ a mixed methods effectiveness-implementation hybrid type 2 study design. To measure effectiveness, a stepped wedge cluster randomized trial design is planned, which allows us to approximate a randomized clinical trial. Approximately 1000 residents living in LTC will be recruited from five facilities in New Brunswick. The study will begin with 3 months of baseline data on rates of deprescribing. Thereafter, every 3 months a new cluster will enter the intervention mode. The intervention consists of medication reviews augmented with the MedReviewRx software, which will be used by staff and clinicians in the facilities. The estimated study duration is 18 months and the main outcome will be the proportion of patients with one or more PIMs deprescribed (reduced/stopped or changed to a safer alternative) in the 90 days following a prescription review. The goal is to study the impact of MedReviewRx on medication overload among older adults living in LTC. In typical fashion of a stepped wedge cluster randomized trial, each cluster acts as an internal control (before and after) as well as a control for the other clusters (external control). Qualitative data collected will include resident/caregiver attitudes towards deprescribing and semi-structured interviews with staff working in the long-term care homes. Discussion This study design addresses issues with seasonality and allows all clusters to participate in the intervention, which is an advantage when the intervention is related to quality improvement. This study will provide valuable information on PIM use, cost savings, and facilitators and challenges associated with medication reviews and deprescribing. This study represents an important step towards understanding and promoting tools to guide safe and rational reduction of PIM use among older adults. Trial registration NCT04762303, Registered February 21, 2021.

scholarly journals Design and rationale for a pragmatic cluster randomized trial of the Cardiovascular Health Awareness Program (CHAP) for social housing residents in Ontario and Quebec, Canada

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Gina Agarwal ◽  
Magali Girard ◽  
Ricardo Angeles ◽  
Melissa Pirrie ◽  
Marie-Thérèse Lussier ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Social Housing ◽  
Cardiovascular Health ◽  
Primary Care Providers ◽  
Care Providers ◽  
Health Awareness ◽  
Awareness Program ◽  
Ed Visits ◽  
Cluster Randomized

Abstract Background The Cardiovascular Health Awareness Program (CHAP) uses volunteers to provide cardiovascular disease (CVD) and diabetes screening in a community setting, referrals to primary care providers, and locally available programs targeting lifestyle modification. CHAP has been adapted to target older adults residing in social housing, a vulnerable segment of the population. Older adults living in social housing report poorer health status and have a higher burden of a multitude of chronic illnesses, such as CVD and diabetes. The study objective is to evaluate whether there is a reduction in unplanned CVD-related Emergency Department (ED) visits and hospital admissions among residents of social seniors’ housing buildings receiving the CHAP program for 1 year compared to residents in matched buildings not receiving the program. Methods/design This is a pragmatic, cluster randomized controlled trial in community-based social (subsidized) housing buildings in Ontario and Quebec. All residents of 14 matched pairs (intervention/control) of apartment buildings will be included. Buildings with 50–200 apartment units with the majority of residents aged 55+ and a unique postal code are included. All individuals residing within the buildings at the start of the intervention period are included (intention to treat, open cohort). The intervention instrument consists of CHAP screens for high blood pressure using automated blood pressure monitors and for diabetes using the Canadian Diabetes Risk (CANRISK) assessment tool. Monthly drop-in sessions for screening/monitoring are held within a common area of the building. Group health education sessions are also held monthly. Reports are sent to family doctors, and attendees are encouraged to visit their family doctor. The primary outcome measure is monthly CVD-related ED visits and hospitalizations over a 1-year period post randomization. Secondary outcomes are all ED visits, hospitalizations, quality of life, cost-effectiveness, and participant experience. Discussion It is anticipated that CVD-related ED visits and hospitalizations will decrease in the intervention buildings. Using the volunteer-led CHAP program, there is significant opportunity to improve the health of older adults in social housing. Trial registration ClinicalTrials.gov,NCT03549845. Registered on 15 May 2018. Updated on 21 May 2019.

scholarly journals Improving cardiovascular health at population level: 39 community cluster randomised trial of Cardiovascular Health Awareness Program (CHAP)

BMJ ◽  
2011 ◽  
Vol 342 (feb07 1) ◽  
pp. d442-d442 ◽  
Author(s):  
J. Kaczorowski ◽  
L. W. Chambers ◽  
L. Dolovich ◽  
J. M. Paterson ◽  
T. Karwalajtys ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Randomised Trial ◽  
Population Level ◽  
Cluster Randomised Trial ◽  
Health Awareness ◽  
Cluster Randomised ◽  
Awareness Program

Hearing conservation program for agricultural students: Short-term outcomes from a cluster-randomized trial with planned long-term follow-up

2009 ◽  
Vol 49 (6) ◽  
pp. 546-552 ◽  
Author(s):  
Richard L. Berg ◽  
William Pickett ◽  
Marcy Fitz-Randolph ◽  
Steven K. Broste ◽  
Mary Jo Knobloch ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Short Term ◽  
Hearing Conservation ◽  
Conservation Program ◽  
Long Term Follow Up ◽  
Agricultural Students ◽  
Cluster Randomized
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