Biomedical subjects

Jean Gray

Publications and source records attributed to Jean Gray.

At least 19 recordsLinked to original sources

PubMed2005

Responding to rising cancer caseloads: family physician learning needs and challenges in cancer care.

BACKGROUND: In this study, we addressed physicians' learning needs and practice challenges throughout the continuum of cancer care using an interprofessional approach. METHODS: Data sources and tools included (1) 150 family physician questionnaires, (2) 11 oncologist interviews, (3) 13 focus groups with 125 health care providers, and (4) secondary sources. RESULTS: Family physicians wish to play a larger role in their cancer patients' care. Their self-reported learning needs were confirmed by other data sources. Important practice and systemic challenges to improving care exist. CONCLUSION: Decreasing cancer rates and improving cancer care are complex issues requiring educational interventions as well as organizational and communications initiatives.

Adult↗

PubMed2005

SARS and the Academic Health Sector.

SARS illustrated the vulnerability of the entire country to the importation of new organisms and other unexpected health crises. As the federal government assumes a leadership role in developing programs and policies affecting the security of Canada, so, too, should it assume a leadership role in public health matters, especially in an era of possible bioterrorism. The essential needs of such a system include: * A real-time inventory of research and response capacity to include the academic, industry, and government communities that could respond to a major health crisis in the future. * Research platforms in place across the country such as appropriately secure animal care facilities, biobanks, and other technologies necessary to immediately address research issues arising from such a crisis. * Coordinated processes to move appropriate people and resources into place when a health crisis requires such action. * Financial contingency funds that can be mobilized on relatively short notice to respond to the needs of altered patient care patterns and research.

Academic Medical Centers↗

PubMed2003

Providing evidence-based information to patients in general practice and pharmacies: what is the acceptability, usefulness and impact on drug use?

BACKGROUND: A common and often integral method of delivering patient information is the use of patient guides. However, the acceptability, utility and impact of evidence-based therapeutic guides on physicians, pharmacists and patients have not been well evaluated. METHODS: This study was a prospective evaluation of 53 general practitioners' offices and 30 community pharmacies from three locations in Canada. Evidence-based guides were provided to 1176 patients who presented to either a general practitioner or a community pharmacist and were interested in receiving information about sore throat, heartburn, or osteoporosis (http://www.ti.ubc.ca/canadadrugguide). The acceptability, utility and impact of the guides were assessed via structured patient telephone interviews, structured health professional interviews, and patient chart audits. RESULTS: Eighty to 90% of patients reported that the guides were 'very easy' to understand. Fifty six per cent/47%/38% (sore throat/heartburn/osteoporosis) of patients rated the guides as 'very' or 'extremely' useful. Seventy-two per cent/67%/58% of respondents reported that the information helped them make decisions about their treatment. Ninety eight per cent of physicians and 92% of pharmacists reported that the guides helped their patients understand the issues involved in their treatment. None of the analyses showed any significant differences in prescribing of medications between the intervention and control groups. INTERPRETATIONS: Patients found these evidence-based guides to be useful, easy to understand, and that they helped them in their understanding of treatment options and the decision-making process. Physicians and pharmacists reported that the guides helped their patients understand the issues involved in their treatment. Further research is required to determine the degree to which providing evidence-based guides to patients can impact on prescribing and patient outcomes.

Adult↗

PubMed2003

Academic health leadership: looking to the future. Proceedings of a workshop held at the Canadian Institute of Academic Medicine meeting Québec, Que., Canada, Apr. 25 and 26, 2003.

The academic health sector will face major changes in governance, health care delivery, educational requirements and research programs over the next decade. Increased emphasis on disease prevention and health outcomes, the need for evidence to support both clinical and policy decisions, educational changes both in content and delivery, and the importance of working in teams will challenge the academic health care community. Large research teams may require new ways of training and nurturing young investigators, including improved grant writing and knowledge translation, human resource management skills and the ability to interact with disciplines that have different research methodologies. MD/PhD and Clinician Investigator Programs may help to fill these gaps in medicine, but nursing is faced with a serious shortage of doctoral-trained educators and researchers and may need targeted programs to achieve a critical mass of academics able to accept leadership roles. The success of the Quebec model of support for health research networks and researchers is encouraging. There is a leadership gap within health care institutions that spans jurisdictions and affects both institutional performance and individual careers. Young investigators need good mentors and adequate protected time to acquire the skills necessary for leadership roles. Policy changes within health care institutions and academic organizations will be necessary to adapt to the coming decade. The Canadian Institute of Academic Medicine is committed to developing better mentoring strategies for the next generation of academic leaders and to creating formal assessments of major Canadian health issues that can be used by health care advocacy groups when talking with policy-makers.

Biomedical Research↗

PubMed2002

Helping family physicians improve their cardiac auscultation skills with an interactive CD-ROM.

INTRODUCTION: There have been few studies of the cardiac auscultation skills of residents and family physicians. This study assessed a group of family physicians' cardiac auscultation skills and use of a computerized self-instructional program to improve these skills. METHODS: Forty-two volunteer family physicians participated in an initial assessment of cardiac auscultation skills using test recordings of 12 common heart sounds. They were provided with a CD-ROM instructional program and were asked to devote 15 hours of self-study to the program and to return in 9 months for reassessment. RESULTS: The 42 family physicians in the initial assessment identified 39% of the heart sounds. Twenty-one returned for reassessment and showed significant improvement. Their initial mean score was 4.3 of 12 (35%), and their final mean score was 8.0 of 12 (67%). They found the CD-ROM program to be a valuable resource. The feature most liked was the unlimited opportunity to review sounds, cases, and tutorials. Most frequent problems related to computer access or skills. Eleven respondents reported using the program to resolve patient problems in their clinical practices. DISCUSSION: The cardiac auscultation skills of a group of volunteer family physicians showed low initial scores that improved significantly after self-study with a CD-ROM instructional program. The program was a valuable self-instructional aid, and physicians used it as a resource in clinical practice. However, only 50% of the initial group completed the self-study and returned for final assessment. Providing more support and assistance in the initial phase, especially with computer use, may enable completion of similar computerized self-study programs.

CD-ROM↗

PubMed2002

Drug policy: an oxymoron?

The use of the words "drug" and "policy" together highlights some of the inconsistencies and ironies in healthcare delivery in Canada. Not that the legislators and the government mandarins don't try to create and implement policy, but events (and the pharmaceutical industry) are always one step ahead so the policy-makers find themselves in the role of "follower" rather than "leader." It is time to re-examine the current approach to decision-making about pharmaceuticals and to identify a process that allows all Canadians to receive the care that was promised with the passage of the Canada Health Act.

Canada↗

PubMed2002

What patients want to know about their medications. Focus group study of patient and clinician perspectives.

OBJECTIVE: To describe what patients want to know about their medications and how they currently access information. To describe how physicians and pharmacists respond to patients' information needs. To use patients', physicians', and pharmacists' feedback to develop evidence-based treatment information sheets. DESIGN: Qualitative study using focus groups and a grounded-theory approach. SETTING: Three regions of Canada (British Columbia, Nova Scotia, and Ontario). PARTICIPANTS: Eighty-eight patients, 27 physicians, and 35 pharmacists each took part in one of 19 focus groups. METHOD: Purposeful and convenience sampling was used. A trained facilitator used a semistructured interview guide to conduct the focus groups. Analysis was completed by at least two research-team members. MAIN FINDINGS: Patients wanted both general and specific information when considering medication treatments. They wanted basic information about the medical condition being treated and specific information about side effects, duration of treatment, and range of available treatment options. Physicians and pharmacists questioned the amount of side-effect and safety information patients wanted and thought that too much information might deter patients from taking their medications. Patients, physicians, and pharmacists supported the use of evidence-based treatment information sheets. CONCLUSION: Patients and clinicians each appear to have a different understanding of what and how much information patients should receive about medications. Feedback from patients can be used to develop patient-oriented treatment information.

Drug Therapy↗

PubMedDate not supplied

Experience with providing drugs for seniors in Canada.

The provincial and territorial governments in Canada are responsible for the provision of health care to all Canadians and, as part of this mandate, they provide drug coverage to all hospitalized patients regardless of age, and to seniors and patients with certain diagnoses, dependent on some forms of means testing. The federal government is responsible for regulation and setting standards for health care. It provides financial subsidies to the provincial programs as well as direct funding for specific groups of individuals. This article reviews the roles of each level of government in the provision of pharmaceuticals to seniors in Canada.

Aged↗

PubMedDate not supplied