Browsing by Author "Sharpe, Heather"
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- ItemOpen AccessDevelopments in asthma incidence and prevalence in Alberta between 1995 and 2015(2020-10-09) Bosonea, Ana-Maria; Sharpe, Heather; Wang, Ting; Bakal, Jeffrey A; Befus, A. D; Svenson, Lawrence W; Vliagoftis, HarissiosAbstract Background Asthma is a chronic respiratory disease characterized by reversible bronchoconstriction and airway inflammation. According to Statistics Canada in 2014, 8.1% of Canadians aged 12 and older reported having asthma diagnosed by a health care professional. Therefore, in 2014 there were an estimated 274,661 persons with asthma in Alberta. Most epidemiological studies estimate prevalence and incidence using survey-based data, which has limitations. The Ontario Asthma Surveillance Information System (OASIS) group has developed and validated an algorithm for epidemiologic asthma studies using provincial health databases. In Alberta, there are some studies using provincial databases, but most are restricted to emergency department visits and do not represent the entire asthma population. Using the validated asthma definition for epidemiologic studies, we performed an analysis of the Alberta Health administrative databases to investigate and report province-wide asthma prevalence, incidence and mortality in Alberta from 1995 to 2015. Methods Data from administrative databases, provided by Alberta Health, was analyzed to determine age and sex specific prevalence, incidence and mortality of the asthma population. The population cohort was all individuals residing in the province of Alberta, ages 0 to 99 from 1995–2015. Kendall’s Tau coefficient test was used to ascertain whether the observed trends were statistically significant. Results Between 1995 and 2015, the age-standardized incidence of asthma decreased by more than 50% in both males and females. Prevalence, however, increased threefold over the 20 years (for both genders) from 3.9 to 12.3% (Tau = 1.00, p < 0.0001) in females and from 3.5 to 11.6% (Tau = 1.00, p < 0.0001) in males. Thus, in 2015 there were 496,927 people with asthma in Alberta. All-cause mortality in the asthma population decreased over time, in both females (Tau = − 0.71, p < 0.0001) and males (Tau = − 0.69, p = 0.0001). For the last several years, all-cause mortality was higher in those with asthma. There were ~ 7 deaths/1000 in the population with asthma versus ~ 5 deaths/1000 in those without asthma. Conclusions The incidence of asthma decreased in both females and males while prevalence continued to increase, although at a slower rate than previously. All-cause mortality in asthma patients was higher than in those without asthma, but both decreased over time.
- ItemOpen AccessDocumenting cannabis use in primary care: a descriptive cross-sectional study using electronic medical record data in Alberta, Canada(2023-02-01) Soos, Boglarka; Garies, Stephanie; Cornect-Benoit, Ashley; Montgomery, Lori; Sharpe, Heather; Rittenbach, Katherine; Manca, Donna; Duerksen, Kimberley; Forst, Brian; Drummond, NeilAbstract Objective Documenting cannabis use is important for patient care, but no formal requirements for consistent reporting exist in primary care. The objective of this study was to understand how cannabis use is documented in primary care electronic medical record (EMR) data. Results This was a cross-sectional study using de-identified EMR data from over 398,000 patients and 333 primary care providers in Alberta, Canada. An automated pattern-matching algorithm was developed to identify text and ICD-9 diagnostic codes indicating cannabis use in the EMR. There was a total of 11,724 records indicating cannabis use from 4652 patients, representing approximately 1.2% of the patient sample. Commonly used terms and ICD-9 codes included cannabis, marijuana/marihuana, THC, 304.3 and 305.2. Nabilone was the most frequently prescribed cannabinoid medication. Slightly more males and those with a chronic condition had cannabis use recorded more often. Overall, very few patients have cannabis use recorded in primary care EMR data and this is not captured in a systematic way. We propose several strategies to improve the documentation of cannabis use to facilitate more effective clinical care, research, and surveillance.
- ItemOpen AccessThe Uptake of Physician Approved Written Asthma Action Plans: A Mixed Methods Study(2013-01-25) Sharpe, Heather; Benzies, KarenThis mixed methods study aimed to evaluate implementing a simple intervention to increase Written Asthma Action Plan (WAAP) possession by patients with asthma. The intervention included health care professionals (HCPs) providing WAAPs and basic teaching to patients with asthma. For the qualitative component of the study, HCPs were interviewed to explore their experiences with implementing the WAAP in their practice; a thematic analysis was used to analyze the data. For the quantitative component, patients that were provided with the WAAP were assessed at baseline and again 6 months later. The primary quantitative outcome of interest was the possession of a physician approved WAAP by the individual with asthma, secondary outcome included asthma control. In Phase 1, six sessions of interviews were conducted over 3 months. Seventeen HCPs participated in the interviews, with 1 to 7 participants in each interview session. HCPs were overwhelmingly positive about the WAAP and stated it was a valuable tool for educating patients and demonstrating the criteria for asthma control. They felt qualified to complete the WAAP and expressed confidence in completing the yellow zone of the plan. HCPs that were successful at implementing the intervention had physician colleagues that were supportive. Several barriers to implementation were discovered. Most notably, asthma was a low priority for chronic disease management. HCPs did not receive referrals for asthma patients, and identifying patients with asthma was challenging. Additionally, time was a barrier to implementation, as HCPs identified it was challenging to find time to provide education to patients, particularly when addressing other health concerns. In Phase 2, the intervention resulted in an association between the provision of a WAAP template by a health care professional and rate of physician approved WAAP possession 6 months following the intervention. The mean score for the Asthma Control Questionnaire increased significantly 6 months post intervention; however, it did not reach the level of clinical significance. The findings of this study suggest that community based HCP can dispense WAAPs that receive physician approval. However, in order for HCPs to provide WAAPs, significant barriers, particularly the low priority of asthma in chronic disease management and time to provide education, need to be addressed.