NCT05813652

Relative Impacts on Preventative Primary Care--a Longitudinal Evaluation of COVID-19:Phase 1

Relative Impacts on Preventative Primary Care--a Longitudinal Evaluation of COVID-19 (Phase 1: A Retrospective Cohort Analysis)

• Status: Completed
• Phase: —
• Study type: Observational
• Enrollment: 919,928 (actual)
• Sponsor: McMaster University · Academic / Other
• Sex: All
• Age: 18 Years – 105 Years
• Healthy volunteers: Not accepted

Summary

The goal of this observational study is to describe the impacts of COVID-19 on primary care chronic condition management in Canada within various patient populations. This will be done by analyzing primary care electronic medial record (EMR) data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database, including data on primary care encounters, as well as various markers for chronic conditions. The research questions to be investigated are: 1a) What are the changes to the management of chronic conditions in primary care since the onset of the COVID-19 pandemic? 1b) How do these changes differ by age, health status, and socioeconomic status?

Detailed description

This is a retrospective closed cohort study, using a single-arm, pre-post design. The objectives of this study are to describe the impacts of COVID-19 on access, comprehensiveness and appropriateness among adult patients with chronic diseases, and to determine whether changes were associated with socio-demographic characteristics and multi-morbidity. This will be done using using electronic medial record (EMR) data made available by the CPCSSN network. CPCSSN is a research network supported by a primary care EMR database, comprising over 1500 physicians, and nearly 2 million patients from across Canada. We will be examining prevention and management activities for several exemplar chronic conditions that have a validated CPCSSN case definition and substantial prevalence in primary care (e.g. diabetes, heart failure, etc.). CPCSSN data between 2018-2021 will be analyzed for changes in management of various chronic conditions prior to, and through phases of the pandemic. Changes will also be examined among specific sub-groups of adults, including those with multi-morbidity and socio-economic vulnerabilities. The primary exposure is the onset of the pandemic: March 13, 2020 to December 3, 2021 versus the equal time frame prior. March 13, 2020 was selected as the date when Canadian provincial governments began enforcing various public health and safety measures in response to the World Health Organization formally declaring the circulating SARS-CoV-2 as a pandemic on March 11, 2020. We will be examining whether there have been changes in overall access, comprehensiveness, continuity and appropriateness of care (including potential decreases in burdensome or unnecessary care) by applying indicators that incorporate chronic condition monitoring (physical measures, lab tests and investigations), prescriptions, referrals and preventive care, to chronic condition patient populations.

Conditions

• Diabetes Mellitus
• Congestive Heart Failure
• Chronic Kidney Diseases
• Chronic Obstructive Pulmonary Disease
• Depression, Anxiety
• Osteoarthritis
• Dementia

Interventions

Type	Name	Description
OTHER	Pre-pandemic time period (Jun 22, 2018 to March 12, 2020)	The primary exposure is the time period of the pandemic (March 13, 2020 to Dec 3, 2021), compared to pre-pandemic (Jun 22, 2018 to pandemic onset March 12, 2020)
OTHER	Peri-pandemic time period (March 13, 2020 to December 3, 2021)	The primary exposure is the time period of the pandemic (March 13, 2020 to Dec 3, 2021), compared to pre-pandemic (Jun 22, 2018 to pandemic onset March 12, 2020)

Timeline

• Start date: 2022-10-05
• Primary completion: 2025-01-31
• Completion: 2025-03-31
• First posted: 2023-04-14
• Last updated: 2025-09-25

Locations

1 site across 1 country: Canada