Past Projects
Past Projects
For more information on any of these past projects, please email us at achord@ualberta.ca.
ABCD and Quality Improvement
The Alberta’s Caring for Diabetes (ABCD) project, was funded by Alberta Health. It was developed to improve the quality and efficiency of care for diabetes in Alberta, with a focus on supporting primary care outside of the metro Edmonton and Calgary areas.
The ABCD project involved a large cohort study, the Diabetes Complications Study, two main quality improvement interventions: 1) Depression screening and collaborative care management for diabetes patients (TeamCare-PCN) and 2) Lifestyle behavioral support intervention called Healthy Eating and Active Living in Diabetes (HEALD-PCN), as well as other projects [APEXD, PROACTIVE, Accelerometer sub-study]. Research and evaluation of these interventions will contribute to a number of other studies lead by ACHORD researchers to determine and influence factors that lead to better quality of care and improved health outcomes for people with diabetes.
ABCD Project Design and Recruitment
The ABCD project is proud to collaborate with local Primary Care Networks throughout Alberta. A Primary Care Network (PCN) is a group of family doctors and other health professionals working together with Alberta Health Services to coordinate primary health services for patients.
PCNs take a comprehensive approach to health management, emphasizing health promotion, disease and injury prevention, and the care of patients with medically complex problems and chronic diseases. As such, PCNs are an ideal environment for the implementation and evaluation of the ABCD project.
For more information about PCN’s, visit Alberta Heath Services.
The following are other quality of care studies which took place under the ABCD and Quality Improvement umbrella:
TeamCare: A Collaborative Team Care Model
Accelerometer Sub-Study
Health Eating and Active Living for Diabetes (HEALD)
Quality Indicator Set for Diabetes (QISD)
Diabetes Outreach Van Enhancement Study (DOVE)
For more information on the following past quality of care studies listed above, please email achord@ualberta.ca
Diabetes and Influenza
Congratulations to Darren Lau, Dean Eurich, Me2 Majumdar, Alan Katz, and Jeff Johnson on their publication and extensive media attention on “Working-age adults with diabetes experience greater susceptibility to seasonal influenza: a population-based cohort study“.
Study Abstract
Aim:
The aim of this work was to compare the incidence of illness attributable to influenza in working-age adults (age <65 years) with and without diabetes.
Methods:
We performed a cohort study using administrative data from Manitoba, Canada, between 2000 and 2008. All working-age adults with diabetes were identified and matched with up to two non-diabetic controls. We analyzed the rates of influenza-like illness physician visits and hospitalizations, pneumonia and influenza hospitalizations, and all-cause hospitalizations. Multivariable regressions were used to estimate the influenza-attributable rate of each outcome.
Results:
We included 745,777 person-years of follow-up among 166,715 subjects. The median age was 50-51 years and 48-49% were women; adults with diabetes had more comorbidities and were more likely to be vaccinated for influenza than those without diabetes. Compared with similar adults without diabetes, those with diabetes had a 6% greater (RR 1.06, 95% CI 1.02, 1.10; absolute risk difference 6 per 1,000 adults per year) increase in all-cause hospitalisations associated with influenza, representing a total of 54 additional hospitalisations. There were no differences in the influenza-attributable rates of influenza-like illness (p = 0.06) or pneumonia and influenza (p = 0.11).
Conclusions:
Guidelines calling for influenza vaccinations in diabetic, in addition to elderly, adults implicitly single out working-age adults with diabetes. The evidence supporting such guidelines has hitherto been scant. We found that working-age adults with diabetes appear more susceptible to serious influenza-attributable illness. These findings represent the strongest available evidence for targeting diabetes as an indication for influenza vaccination, irrespective of age.
ADSS and Diabetes Surveillance (click for more information)
The Alberta Diabetes Surveillance System (ADSS) provides an overall picture of the burden of diabetes in the province and a system to monitor trends of diabetes and its complications over time. The system tracks the number of people living with diabetes in Alberta, their related health conditions, and the health services they use. This information helps health care providers and policy makers understand the scope of the disease and how to deal with it. The ADSS is a partnership between the Institute of Health Economics, ACHORD and Alberta Health and Wellness. To support the ADSS, ACHORD also undertakes methodological studies to improve these surveillance systems using administrative data sources.
Other past studies and one ongoing study related to ADSS and Diabetes Surveillance are as follows:
Epidemiological and Economic Burden of Illness Studies of Diabetes 1991-2000
Alberta Diabetes Surveillance System (ADSS)
Validation of Diabetes Classification Algorithms from Cases Identified Through the National Diabetes Surveillance System in the Under 20 Population
RADAR (Recognizing the Approach to Diabetes through the Application of Registries)
Please email achord@ualberta.ca for more information on the above noted studies.
Cancer and Diabetes
The relationship between cancer and diabetes has becoming increasingly recognized in recent years. These two conditions have common risk factors, including obesity, unhealthy diet and physical inactivity. The ACHORD Group is exploring the relationship between diabetes and cancer and the role that glucose-lowering therapies might have in modulating this relationship.
Other past studies related to Cancer and Diabetes are as follows:
International Diabetes & Cancer Research Consortium
Cancer-related mortality for patients with type 2 diabetes exposed to oral hypoglycemics. Are there differences between agents?
Patterns of Healthcare Utilization and Risk of Cancer and Chronic Diseases: Linking Alberta's Tomorrow Project Data to Alberta Health Administrative Data
Please email achord@ualberta.ca for more information on the above noted studies.
Cardiovascular Disease and Diabetes
Cardiovascular disease is the leading cause of morbidity and mortality in people with diabetes. It has therefore been a major focus of our research in the ACHORD Group. In particular, we have been interested in the association between diabetes, various glucose lowering therapies and cardiovascular outcomes. We have also conducted intervention studies to improve the quality of care for type 2 diabetes in primary care settings, with a particular focus on improving the management of cardiovascular risk factors, such as blood pressure and lipid management.
Other past studies related to Cardiovascular Disease and Diabetes are as follows:
The Vascular Intervention Program (VIP): A strategy for medication management of cardiovascular risk in people with type 2 diabetes
Metformin and Clinical Outcomes
Patients with Heart Failure ANd Type 2 Diabetes Treated with Placebo Or Metformin (PHANTOM) Pilot Study
Please email achord@ualberta.ca for more information on the above noted studies.
Mental Health and Diabetes
The interaction between mental health and chronic diseases like diabetes has been an important area of focus for the ACHORD group. We have research projects evaluating the relationship between diabetes and schizophrenia, as well as diabetes and depression.
Other past studies related to Mental Health and Diabetes are as follows:
Schizophrenia and Diabetes
TeamCare: A Collaborative Team Care Model
Population-based Estimates of Incidence and Prevalence of Depression in People with Diabetes
Please email achord@ualberta.ca for more information on the above noted studies.
Whereas strong evidence supports the role of lifestyle modification in the prevention and management of T2D, we lack a clear understanding of best strategies for dietary and physical activity behaviour promotion among adults with T2D within primary care. Current clinical practice guidelines are based on resource laden, one-to-one individual and clinically-based approaches to lifestyle modification, with limited theoretical grounding for recommended health behaviour change. Furthermore, numerous barriers exist for the primary care physicians to direct counseling for lifestyle modification. Consequently, little guidance is available for practical, sustainable, economically viable solutions, with limited evidence of long-term efficacy and efficiency.
Other past studies related to Health Behaviors & Diabetes Prevention/Management are as follows:
Healthy Eating and Active Living for Diabetes (HEALD)
Economic Evaluation of Population-based Diabetes Prevention Programs
Alberta Retired Teachers Association (ARTA) Diabetes Strategy
Please email achord@ualberta.ca for more information on the above noted studies.
Economic and Pharmaceutical Policy
An important theme area for ACHORD is economic and policy oriented research. Using a variety of methods, including analysis of large provincial health care administrative databases, economic evaluations and controlled trials, we are addressing questions about the economic burden of diabetes, and how we can more efficiently allocate our limited resources within the health care system.
Other past studies related to Economic and Pharmaceutical Policy are as follows:
Evaluation of Provincial Pharmaceutical Coverage Policies
Economic Evaluation of Population-based Diabetes Prevention Programs
Expenditures on Diabetes and Related Conditions
Coverage of Diabetes Testing Supplies
Pharmacoepidemiological Assessment of Medication Adherence Rates and Clinical Outcomes in Type 2 Diabetes
Self Monitoring of Blood Glucose
Please email achord@ualberta.ca for more information on the above noted studies.
Health-Related Quality of Life
ACHORD Group has expertise in measurement of patient-reported outcomes, including health-related quality of life and patient satisfaction. Patient reported outcomes are becoming increasingly important in the assessments of population health and quality improvement interventions.
Other past studies related to Health-Related Quality of Life are as follows:
Health-Related Quality of Life and Cost-Utility Analysis in Islet Transplantation for Type 1 Diabetes
Health-Related Quality of Life Deficits in Patients after Coronary Revascularization
HUI3 (Health Utilities Index Mark 3)
Please email achord@ualberta.ca for more information on the above noted studies.
Community-acquired pneumonia
Click here for HEALTHe-news article on Dean Eurich’s research on the long-term health concerns for adults with community-acquired pneumonia.
The study is available at http://www.atsjournals.org/doi/abs/10.1164/rccm.201501-0140OC#.VXmxsPlVhHw
Food availability, accessibility, and dietary practices during the Coronavirus disease pandemic (COVID-19)
The World Health Organization (WHO) declared the coronavirus and COVID-19 outbreak a global pandemic. To date over four million people have been affected with over two hundred thousand deaths reported. Globally, countries have instituted varying levels of social and physical distancing, isolation, and quarantine protocols – which is limiting face-to-face contact between individuals – as a preventative measure to curb the spread of COVID-19. Governments have responded with nationwide lockdowns restricting the movement of people and goods.
The COVID-19 pandemic lockdowns have disrupted food systems and compromised accessibility and availability of food. The disruption to food systems may adversely affect the health and nutritional status of people across the world through increased food insecurity. To assess the effects of COVID-19 pandemic lockdown measures on availability and accessibility of food, researchers at ACHORD joined a global team of researchers to conduct an international online survey. Respondents from Canada, France and several African nations were invited to complete an online survey to gain insight into food availability and accessibility during the COVID-19 pandemic.
The survey was to:
1) Identify changes in food availability, accessibility and dietary practises during the COVID-19 outbreak
2) Investigate perceptions of the impact of COVID-19 on food security
3) Understand the coping mechanisms employed to curb hunger during COVID-19.
The University of Alberta Health Research Ethics Board approved the study which is now closed. For more information on this study, please email Nonsikelelo Mathe, mathe@ualberta.ca.