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Volume 18, Issue 3, Winter 2018

Jeff Award 2018

University of Alberta 2018 Excellence in Leadership Awardee - Jeff Johnson

Please join us in congratulating Jeff Johnson, one of the two recipients of the University of Alberta Human Resource Services 2018 Excellence in Leadership Award. ACHORD staff and students nominated Jeff for this honour; we were very pleased that the selection committee chose him for this well deserved award.

The University of Alberta gives this award annually to "outstanding leaders or leadership teams for their awareness and attention to issues and concerns that impact the quality of work and learning environments".

Congratulations Jeff!

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Report from the Chair

Hello All! Here is a quick update on what has been happening in the ACHORD Group since our last newsletter.

We have two student successes to celebrate in this edition of the ACHORD Newsletter; congratulations are in order for Nathan McClure and Hayford Avedzi. Nathan was awarded a Graduate Internship with the Network of Alberta Health Economists (NOAHE), which will support his PhD thesis research, and help to build up his network in the Alberta health economics community. On December 5, Hayford successfully defended his PhD thesis, which focused on the glycemic index as part of a healthy diet for people with type 2 diabetes. This means that Hayford will convocate with his PhD in Spring 2019. Congratulations to both Nathan and Hayford!

ACHORD will be teaming up with the Diabetes, Obesity and Nutrition Strategic Clinical Network (DON SCN) and holding a joint meeting/retreat on March 4 and 5, 2019 at the Peter Lougheed Centre, University of Alberta Campus in Edmonton. ACHORD colleagues Rose Yeung and Padma Kaul, as part of the DON SCN, obtained a meeting grant from Campus Alberta Public Health and Health Outcomes to support the Diabetes and Pregnancy meeting, and are working with ACHORD to organize the 2-day meeting. Day One of the joint meeting will focus on Diabetes in Pregnancy with Day Two focusing more on ACHORD Projects and Trainee presentations. Please mark these dates in your calendar, noting that the retreat will be held on a Monday and Tuesday this year.

ACHORD Members attended many conferences this fall: International Population Data Linkage Network (IPDLN) meeting in Calgary; the CASCH Conference in Calgary; EuroQol Annual Plenary in Lisbon, Portugal; EASD conference in Berlin, Germany; Diabetes Canada in Halifax, Nova Scotia; ISOQOL in Dublin, Ireland; ISPOR Europe in Barcelona, Spain.

The Alberta’s PROMs and EQ-5D Research and Support Unit (APERSU), based in the ACHORD offices, continues to grow as more people are aware of the EQ-5D tool and asking for our support. The 4th Annual APERSU End-User Meeting was held at the Varscona Hotel in Edmonton on October 11 and 12, where we welcomed guests from across North America as well as the UK, the Netherlands and Sweden. In addition to the informative presentations, we also held face-to-face meetings for the APERSU Board of Directors and Scientific Advisory Committee at the event. As usual, the guidance these two bodies provide is invaluable; thank you to committee members and to all that attended this years meeting.

The Northern Alberta Renal Program (NARP) implemented the Evaluation of routinely Measured PATient reported outcomes in HemodialYsis care (EMPATHY) Trial in mid-September. While sites continue to implement the PROMs protocols over the next 12 months, we will provide support and ongoing education as needed. One nurse at each site will serve as EMPATHY site lead, acting as a champion for the trial and a liaison between the site and the research team to ensure sites are well equipped to carry out the trial. We will also been implementing a qualitative sub-study to evaluate the EMPATHY interventions in the New Year. We were successful in applying for funds from the EuroQol Foundation for the qualitative study, where clinicians and patients will be interviewed to explore the effects and value of PROMs in the clinical management of hemodialysis patients.

The Southern Alberta Renal Program (SARP) initially piloted one arm of the EMPATHY intervention in October in order to test their electronic data collection tool. Some technical and implementation issues were experienced as the project began to role out, so SARP is working to troubleshoot these issues and then re-initiate the pilot again in December. The remaining units will be rolled out in the New Year in a phased approach. The Ontario Renal Network (ORN) is continuing its planning for EMPATHY implementation in Spring 2019. 16 sites have been recruited and randomized. Due to various charting differences from site to site, clinical workflows will be developed at each site. The ORN is planning for patient and provider education and training early in the New Year.

We are happy to continue our collaboration with the DON-SCN on the Diabetes Infrastructure for Surveillance, Evaluation and Research (DISER) project. Under the DISER project, we are continuing the follow-up of participants in the ABCD cohort study, where we are pleased to report some descriptive data for Wave 4 of the cohort survey. The ABCD cohort includes adults living with type 2 diabetes; the average age is 69.5, 46% are female, 76% live in urban Alberta, 64% are retired and over 47% have at least a university/college education. The demographics are similar to the previous waves, with no major differences. Work is underway to administer Wave 5 starting in January 2019. One of the plans for the DISER project is to expand the population that would be included in the surveillance activities, such as people living with type 1 diabetes who are registered insulin pump users, and examining the feasibility of linking survey data, like ABCD, with administrative health care utilization data within the data repositories in AHS. More details will unfold in the coming months.

I hope the information in our newsletter is informative, and if you have any questions about our activities, please do not hesitate to contact us. I wish you all the very best in the holiday season; I look forward to updating you in spring on ACHORD’s activities.

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Patient-reported outcome measures in Primary Care Networks

A patient-reported outcome (PRO) is a direct report by patients about their health status, quality of life, functional status associated with health care or treatment, or their experience with healthcare. Instruments that assess PROs systematically assess how patients feel about their own health. This quantitative information can be used to enhance patient management and monitor their outcomes.

The Alberta PROMs and EQ-5D Research Unit (APERSU), housed within ACHORD, provides licensing, registration, education, implementation and evaluation support for the EQ-5D, a commonly used patient-reported outcome measurement (PROM). Alberta Health Services and Alberta Health have both endorsed the use of the EQ-5D as a generic PROM, which has been increasingly used in primary care networks (PCNs).

We recently explored how PCNs have been using the EQ-5D in their programs. Our objective was to conduct a thorough assessment of the current use, implementation and value of EQ-5D in PCNs. We visited and conducted interviews with staff members and executives involved in EQ-5D implementation in 19 PCNs to document why and how they use it, what they do with the data and results, and whether its use has influenced patient management or decision-making within the PCN. The interviews were supplemented by a short checklist, capturing how useful the tool is, which level of training the interviewee(s) had, preferred methods of training and potential toolkit topics.

Overall, most PCNs find the EQ-5D easy to use and to administer to patients:
• 79% use the EQ-5D for program evaluation purposes
• 87% administer the EQ-5D by paper or laminated paper

Challenges with the use of PROMS that were identified include:
• Integrating into existing workflow
• Clinician engagement
• EMR/infrastructure

The foundation for successful implementation is influenced by:
• Effective communication and training with clinicians
• Pilot testing before rolling it out across all PCN clinics and patients

Our next steps include:
• Conduct in-person consultation visits to meet individual PCN needs
• Establish a PCN working group to help shape APERSU activities
• Facilitate learning and communication among PCNs
• Increase support for data analysis and visualization
• Create a tool kit with resources to implement, analyze and report EQ-5D use

For more information on this project – please email Allison Soprovich, allison.soprovich@ualberta.ca

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Cerina Lee

Meet the Staff - Cerina Lee

Cerina Lee is an MPH graduate (Health Promotion) from the University of Alberta in 2016. Since then, she has been working as the Project Coordinator for Action on Smoking & Health in Edmonton, and works with the World Federation of United Nations Associations (WFUNA) on their diplomacy programs. Cerina is currently working with Dr. Dean Eurich as a Research Assistant, working on the publication of medical cannabis-use patients and health outcomes in Canada. In her free time, Cerina loves to figure-skate and teach fitness classes!

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ACHORD Seen and Heard

Recent Publications

Boyne DJ, Mickle AT, Brenner DR, Friedenreich CM, Cheung WY, Tang KL, Wilson TA, Lorenzetti DL, James MT, Ronksley PE, Rabi DM. Long-term risk of cardiovascular mortality in lymphoma survivors: A systematic review and meta-analysis. Cancer Med. 2018 Sep;7(9):4801-4813. PMID: 30112841.

Finley CR, Chan DS, Garrison S, Korownyk C, Kolber MR, Campbell S, Eurich DT, Lindblad AJ, Vandermeer B, Allan GM. What are the most common conditions in primary care? Systematic review. Can Fam Physician. 2018 Nov;64(11):832-840.
PMID: 30429181.

Gamble JM, Donnan JR, Chibrikov E, Twells LK, Midodzi WK, Majumdar SR. Comparative Safety of Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas and Other Glucose-lowering Therapies for Three Acute Outcomes. Sci Rep. 2018 Oct 11;8(1):15142. PMID: 30310100.

Gamble JM, Chibrikov E, Midodzi WK, Twells LK, Majumdar SR. Examining the risk of depression or self-harm associated with incretin-based therapies used to manage hyperglycaemia in patients with type 2 diabetes: a cohort study using the UK Clinical Practice Research Datalink. BMJ Open. 2018 Oct 8;8(10):e023830. PMID: 30297350.

Law V, Featherstone T, Eurich DT, Simpson SH. Knowledge of a Diabetes Risk Score Does Not Alter Diabetes Screening Practice in a Seniors Population: A Randomized Controlled Trial. J Am Med Dir Assoc. 2018 Nov;19(11):1021-1023. PMID: 30049541.

Levin A, Adams E, Barrett BJ, Beanlands H, Burns KD, Chiu HHL, Chong K, Dart A, Ferera J, Fernandez N, Fowler E, Garg AX, Gilbert R, Harris H, Harvey R, Hemmelgarn B, James M, Johnson J, Kappel J, Komenda P, McCormick M, McIntyre C, Mahmud F, Pei Y, Pollock G, Reich H, Rosenblum ND, Scholey J, Sochett E, Tang M, Tangri N, Tonelli M, Turner C, Walsh M, Woods C, Manns B. Canadians seeking solutions and innovations to overcome chronic kidney disease (Can-SOLVE CKD): Form and function. Can J Kidney Health and Disease 2018;5: 2054358117749530. PMID: 29372064.

Lipscombe L, Booth G, Butalia S, Dasgupta K, Eurich DT, Goldenberg R, Khan N, MacCallum L, Shah BR, Simpson S. Erratum to "Pharmacologic Glycemic Management of Type 2 Diabetes in Adults": Canadian Journal of Diabetes 2018;42(S1):S88-S103. Can J Diabetes 2018;42(5):575. PMID: 30268231.

Short H, Al Sayah F, Ohinmaa A, Lahtinen M, Johnson JA. The relationship of neighbourhood-level material and social deprivation with health-related quality of life. Qual Life Res 2018;27:3265-3274. PMID: 30069793.

Sharp P, Bottorff JL, Hunt K, Oliffe JL, Johnson ST, Dudley L, Caperchione CM. Men's Perspectives of a Gender-Sensitized Health Promotion Program Targeting Healthy Eating, Active Living, and Social Connectedness. Am J Mens Health. 2018 Nov;12(6):2157-2166. PMID: 30234419.

Tobe SW, Stone JA, Anderson T, Bacon S, Cheng AYY, Daskalopoulou SS, Ezekowitz JA, Gregoire JC, Gubitz G, Jain R, Keshavjee K, Lindsay P, L'Abbe M, Lau DCW, Leiter LA, O'Meara E, Pearson GJ, Rabi DM, Sherifali D, Selby P, Tu JV, Wharton S, Walker KM, Hua-Stewart D, Liu PP. Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2018 update. CMAJ. 2018 Oct 9;190(40):E1192-E1206. PMID: 30301743.

Tricco AC, Moore JE, Beben N, Brownson RC, Chambers DA, Dolovich LR, Edwards A, Fairclough L, Glasziou PP, Graham ID, Hemmelgarn BR, Holmes B, Isaranuwatchai W, Lachance CC, Legare F, McGowan J, Majumdar SR, Presseau J, Squires JE, Stelfox HT, Strifler L, Thompson K, Van der Weijden T, Veroniki AA, Straus SE. Sustaining knowledge translation interventions for chronic disease management in older adults: protocol for a systematic review and network meta-analysis. Syst Rev. 2018 Sep 15;7(1):140. PMID: 30219107.

Vallance JK, Gardiner PA, Lynch BM, D'Silva A, Boyle T, Taylor LM, Johnson ST, Buman MP, Owen N. Evaluating the Evidence on Sitting, Smoking, and Health: Is Sitting Really the New Smoking? Am J Public Health. 2018 Nov;108(11):1478-1482. PMID: 30252516.

Weir DL, Abrahamowicz M, Beauchamp ME, Eurich DT. Acute vs cumulative benefits of metformin use in patients with type 2 diabetes and heart failure. Diabetes Obes Metab 2018;20(11):2653-2660. PMID: 29934961.

Recent Presentations
McClure NS. Thokala P et al. Cost-Effectiveness Thresholds: the Past, the Present and the Future. Paper Discussion at the Network of Alberta Health Economists-Health Economics and Outcomes Research Student-led Seminar Series, Edmonton, AB, September 25, 2018.

Avedzi H, Soprovich A, Alghamdi A, Storey K, Johnson JA, Johnson ST. Computer proficiency and web-based lifestyle intervention use among older adults with Type 2 Diabetes. [Poster Presentation] 2018 ADI Research Day, Edmonton, Alberta, October 2, 2018.

Avedzi H, Soprovich A, Storey K, Johnson JA, Johnson ST. Healthy Eating & Active Living for Diabetes-Glycemic Index (HEALD-GI): A Pragmatic Randomized Controlled Trial. [Oral Presentation] 2018 ADI Research Day, Edmonton, Alberta, October 2, 2018.

Jin X, Al Sayah F, Ohinmaa A, Marshall D, Johnson JA. EQ-5D-5L vs. EQ-5D-3L: A cross-sectional comparison of measurement properties among total hip and knee replacement patients. ISOQOL 25th Annual Conference, 24-27 October, 2018, Dublin. Quality of Life Research 2018; 27 (Suppl.): 1027:s61.

Jin X, Al Sayah F, Ohinmaa A, Marshall D, Johnson JA. Responsiveness of the EQ-5D-5L and EQ-5D-3L in patients following total hip or knee replacement. ISOQOL 25th Annual Conference, 24-27 October, 2018, Dublin. Quality of Life Research 2018; 27 (Suppl.): 3028:s177.

McClure NS. Applying the minimally important difference of health-related quality of life index scores in the calculation of quality-adjusted life years. PhD Candidacy Presentation at the School of Public Health, University of Alberta, Edmonton, AB, October 30, 2018.

Avedzi H, Soprovich A, Alghamdi A, Storey K, Johnson JA, Johnson ST. Healthy Eating And Active Living for Diabetes-Glycemic Index (HEALD-GI): A Pragmatic Randomized Controlled Trial. [Poster Presentation]. This is Public Health 2018, School of Public Health, Edmonton, AB, November 8, 2018.

McClure NS, Jin X, Al Sayah F, Le C, Baghbaninaghadehi F, Ohinmaa A, Johnson JA. Minimally Important Difference Estimates for the EQ-5D: A Systematic Review. Poster Presentation at This is Public Health Week, School of Public Health, University of Alberta, Edmonton, AB, November 8, 2018.

Jin X, Al Sayah F, Ohinmaa A, Marshall DA, Johnson JA. EQ-5D-3L VS EQ-5D-5L: A cross-sectional comparison of measurement properties among total hip and knee replacement patients. [Poster Presentation]. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, Barcelona, Spain, November 10-14, 2018.

Jin X, Al Sayah F, Ohinmaa A, Marshall DA, Johnson JA. Responsiveness of the EQ-5D-5L and EQ-5D-3L in patients following total hip or knee replacement. [Poster Presentation]. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, Barcelona, Spain, November 10-14, 2018.

Al Sayah F, Ohinmaa A, Johnson JA. Can the EQ-5D-3L predict post-hospitalization healthcare use and outcomes? [Poster Presentation]. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, Barcelona, Spain, November 10-14, 2018.

Kashem T, Al Sayah F, Ohinmaa A, Johnson JA. The relationship between individual-level deprivation with health-related quality of life in the general population. [Poster Presentation]. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, Barcelona, Spain, November 10-14, 2018.

Tawiah A, Al Sayah F, Ohinmaa A, Johnson JA. Discriminative validity of the EQ-5D-5L and SF-12 in older adults with arthritis. [Poster Presentation]. International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Europe 2018, Barcelona, Spain, November 10-14, 2018.

Ye M, Eurich DT, Vena JE, Johnson JA. Discrepancies between Survey and Administrative Data on Chronic Conditions: Findings from Data Linkage of Administrative Healthcare Data to Alberta’s Tomorrow Project Cohort. CPTP Data Linkage Working Group Meeting, Calgary, AB, November 19, 2018.

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ACHORD Accolades

Congratulations to:

▪ Dean Eurich on his Small Class Teaching award from the School of Public Health
▪ Dax Rumsey and Ben Dubois on their MSc convocations
▪ Nathan McClure on successfully completing his PhD Candidacy Exam
▪ Nathan McClure on receiving a Network of Alberta Health Economists (NOAHE) Health Economics Graduate Internship
▪ Jeff Johnson on receiving a University of Alberta Excellence in Leadership Award
▪ Hayford Avedzi on receiving the Douglas R Wilson Award for his PhD Poster Presenation at "This is Public Health" lecture
▪ Hayford Avedzi on successfully completing his PhD Oral Exam
Dean Eurich on his Small Class Teaching award from the School of Public Health
Dax Rumsey and Ben Dubois on their MSc convocations
Nathan McClure on successfully completing his PhD Candidacy Exam
Nathan McClure on receiving a Network of Alberta Health Economists (NOAHE) Health Economics Graduate Internship
Jeff Johnson on receiving a University of Alberta Excellence in Leadership Award
Hayford Avedzi on receiving the Douglas R Wilson Award for his PhD Poster Presenation at "This is Public Health" lecture
Hayford Avedzi on successfully completing his PhD Oral Exam
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Upcoming Events

16th Annual ACHORD Retreat

March 4 & 5, 2019

Peter Lougheed Hall, University of Alberta Campus

Edmonton, Alberta, Canada

5th Annual APERSU End-User Meeting

October 17 & 18, 2019

Coast Canmore Hotel and Conference Centre

Canmore, Alberta, Canada

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ACHORD
University of Alberta
2-040 Li Ka Shing CHRI
Edmonton, AB T6G 2E1
email: achord@ualberta.ca
Phone: 780-248-1010

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