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The impact of team-based primary care on medication-related outcomes in older adults: a comparative analysis of two Canadian provinces


Objective — To evaluate if access to team-based primary care is related to medication management outcomes for older adults.

Methods — We completed two retrospective cohort studies using administrative health data for older adults (66+) in Ontario (n = 428,852) and Québec (n = 310,198) who were rostered with a family physician (FP) between the 2001/02 and 2017/18 fiscal years. We generated matched comparison groups of older adults rostered to an FP practicing in a team-based model, and older adults rostered to an FP in a non-team model. We compared the following outcomes between these groups: any adverse drug reactions (ADRs), any potentially inappropriate prescription (PIP), and polypharmacy. Average treatment effects of access to team-based care were estimated using a difference-in-differences estimator.

Results — The risk of an ADR was 22% higher (RR = 1.22, 95% CI = 1.18, 1.26) for older adults rostered to a team-based FP in Québec and 6% lower (RR = .943, 95% CI = .907, .978) in Ontario. However, absolute risk differences were less than 0.5%. Differences in the risk of polypharmacy were small in Québec (RR = 1.005, 95% CI = 1.001, 1.009) and Ontario (RR = 1.004, 95% CI = 1.001, 1.007) and had absolute risk differences of less than 1% in both provinces. Effects on PIP were not statistically or clinically significant in adjusted models.

Interpretation — We did not find evidence that access to team-based primary care in Ontario or Québec meaningfully improved medication management outcomes for older adults.



Rudoler D, Austin N, Allin S, Bjerre LM, Dolovich L, Glazier RH, Grudniewicz A, Laporte A, Martin E, Schultz S, Sirois C, Strumpf E. Prev Med Rep. 2023; Nov 10 [Epub ahead of print].

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