RT Journal Article
SR Electronic
T1 Health TAPESTRY Ontario: A Multi-Site Randomized Controlled Trial Testing Implementation and Reproducibility
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 132
OP 142
DO 10.1370/afm.2944
VO 21
IS 2
A1 Mangin, Dee
A1 Lamarche, Larkin
A1 Oliver, Doug
A1 Blackhouse, Gord
A1 Bomze, Sivan
A1 Borhan, Sayem
A1 Carr, Tracey
A1 Clark, Rebecca
A1 Datta, Julie
A1 Dolovich, Lisa
A1 Gaber, Jessica
A1 Forsyth, Pamela
A1 Howard, Michelle
A1 Marentette-Brown, Sarah
A1 Risdon, Cathy
A1 Talat, Samina
A1 Tarride, Jean-Éric
A1 Thabane, Lehana
A1 Valaitis, Ruta
A1 Price, David
YR 2023
UL http://www.annfammed.org/content/21/2/132.abstract
AB PURPOSE Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY) is a complex primary care program aimed at assisting older adults to stay healthier for longer. This study evaluated the feasibility of implementation across multiple sites, and the reproducibility of the effects found in the previous randomized controlled trial.METHODS This was a pragmatic, unblinded, 6-month parallel group randomized controlled trial. Participants were randomized (intervention or control) using a computer-generated system. Eligible patients, aged 70 years and older, were rostered to 1 of 6 participating interprofessional primary care practices (urban and rural). In total, 599 (301 intervention, 298 control) patients were recruited from March 2018 through August 2019. Intervention participants received a home visit from volunteers to collect information on physical and mental health, and social context. An interprofessional care team created and implemented a plan of care. The primary outcomes were physical activity and number of hospitalizations.RESULTS Based on the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, Health TAPESTRY had widespread reach and adoption. In the intention-to-treat analysis (257 intervention, 255 control), there were no statistically significant between-group differences for hospitalizations (incidence rate ratio = 0.79; 95% CI, 0.48-1.30; P = .35) or total physical activity (mean difference = −0.26; 95% CI, −1.18 to 0.67; P = .58). There were 37 non-study related serious adverse events (19 intervention, 18 control).CONCLUSIONS We found Health TAPESTRY was successfully implemented for patients in diverse primary care practices; however, implementation did not reproduce the effect on hospitalizations and physical activity found in the initial randomized controlled trial.