Table 1 Characteristics of the of the Pfizer-FRQS-MSSS funded programs
Program | Sites | Target population | Health professionals in interdisciplinary team | Basis for self-management program | Study design | Evaluation method |
|---|---|---|---|---|---|---|
P1. Implementation and evaluation of an integrated primary care network for prevention and management of chronic pain | 4 CSSS | Inclusion: low back pain <1 year, exclusion: severe dependence, mental of cognitive problems; Covered by CSST or SAAQ | Doctor, nurse, psychologist, physiotherapist | Stanford model 5A program | Quasi-experimental multiple pretest/posttest interrupted time series | Mixed methods (triangulation): qualitative (multiple case study) and quantitative |
P2. Evaluation of an integrated primary care network for prevention and management for cardiometabolic risk in Montreal | 6 CSSS | Inclusion: marginal fasting glycemia, or glucose intolerance, or diabetes treated with diet only, or diabetes treated with monotherapie, or diabetes treated with more than one medication if HbA1c ≤8.0 %; as well as adults with hypertension with BP in the doctor’s office ≥140/90 (if diabetic, with BP ≥130/80) | Nurse, psychologist (or social worker), kinesiologist, nutritionist, pharmacist | Quasi-experimental multiple pretest/posttest interrupted time series | Mixed methods (triangulation): qualitative (multiple case study) and quantitative | |
P3. TRANSforming InTerprofessional clinical practices to improve cardiovascular disease prevention in primary care [10, 11] | 8 FMG | Inclusion: multimorbid patients with moderate to high cardiovascular risk | Doctor, nurse, pharmacist, and either a nutritionist, kinesiologist, or psychologist | Randomized trial NCT01418716 | Development: Participatory research | |
Impact: qualitative and quantitative, with triangulation | ||||||
P4. SIID2: intersectoral and interdisciplinary management of type 2 diabetes (http://www.siid2.ca) | 1 RLS | Inclusion: 45 years+, all patients at-risk of diabetes (screened with CANRISK) or with diabetes | Doctor, nurse, kinesiologist, social worker, nutritionist, pharmacist, | CCM | Randomized trial | Quantitative (impact and implementation) |
Survey | ||||||
Exclusion: Pregnancy, institutionalized patients, cognitive deficit | ||||||
P5. PR1MaC: evaluating the integration of chronic disease prevention and management services into primary health care [12] | 2 CSSS | Inclusion: patients aged 18 and 75 years with at least one of the following conditions: diabetes, cardiovascular disease, COPD, asthma or risk factors (smoking, obesity, dyslipidemia, glucose intolerance, and metabolic syndrome, sedentarity) | Nurse, kinesiologist, nutritionist, smoking cessation therapist, respiratory therapist | CCM, Stanford | Randomized trial with delayed intervention arm, before-and-after design with repeated measures, and quasi-experimental design using a comparative cohort NCT01319656 | Realist evaluation and practical participatory approach (implementation) |
Quantitative (impact) | ||||||
Exclusion: patients with serious cognitive problems | ||||||
P6. VISAGES: implementation and evaluation of a pragmatic intervention of case management and self-management support for frequent users [13] | 2 CSSS | Inclusion: high users of hospital services, aged 18–80 years with diabetes, cardiovascular disease, respiratory diseases, musculoskeletal diseases and/or chronic pain | Doctor, nurse, psychologist, social worker, kinesiologist, nutritionist, pharmacist | Stanford model | Implementation analysis, Randomized trial with delayed intervention arm NCT01719991 | Realist evaluation and practical participatory approach (implementation) |
Exclusion: severe mental health or cognitive problems | ||||||
4 FMG | ||||||
Qualitative and quantitative (impact) | ||||||
Cost-effectiveness and cost-benefit analysis | ||||||
Economic analysis | ||||||
P7. Self management of health within the territory of Rocher-percé | 2 CSSS | Inclusion: patients aged 18 and over with ≥1 chronic conditions (diabetes, COPD, cardiovascular disease, kidney failure) and related risk factors (obesity, hypercholesterolemia, HT etc.) | Nurse, kinesiologist, nutritionist | Home made | Quasi-experimental multiple pretest/posttest interrupted time series | Collaborative research with developmental approach |
Mixed methods for efficacy (triangulation): qualitative and quantitative | ||||||
Qualitative (implementation) | ||||||
Exclusion: severe dependence, cognitive problems, decompensated cardiac insufficiency, stage 3–4 COPD, Severe uncontrolled HT |