Maida Sewitch | McGill University (original) (raw)
Papers by Maida Sewitch
PLOS ONE, 2021
Background Mobile health (mHealth) technologies are innovative solutions for delivering instructi... more Background Mobile health (mHealth) technologies are innovative solutions for delivering instructions to patients preparing for colonoscopy. Objective To systematically review the literature evaluating the effectiveness of mHealth technologies supporting colonoscopy preparation on patient and clinical outcomes. Methods MEDLINE, EMBASE, CINAHL and CENTRAL were searched for randomized controlled trials (RCTs) that evaluated the effectiveness of mHealth technologies for colonoscopy preparation on patient and clinical outcomes. Two reviewers independently assessed study eligibility, extracted data, and appraised methodological quality using the Cochrane Risk-of-Bias tool. Data were pooled using random effects models and when heterogeneity, assessed using I2, was statistically significant, a qualitative synthesis of the data was performed. Publication bias was assessed using a funnel plot. Results Ten RCTs (3,383 participants) met inclusion criteria. MHealth interventions included smartph...
JMIR mHealth and uHealth, 2019
Background: The preparation for colonoscopy is elaborate and complex. In the context of colorecta... more Background: The preparation for colonoscopy is elaborate and complex. In the context of colorectal cancer screening, up to 11% of patients do not keep their colonoscopy appointments and up to 33% of those attending their appointments have inadequately cleansed bowels that can delay cancer diagnosis and treatment. A smartphone app may be an acceptable and wide-reaching tool to improve patient adherence to colonoscopy. Objective: The aim of this qualitative study was to employ a user-centered approach to design the content and features of a smartphone app called colonAPPscopy to support individuals preparing for their colonoscopy appointments. Methods: We conducted 2 focus group discussions (FGDs) with gastroenterology patients treated at the McGill University Health Centre in Montreal, Canada. Patients were aged 50 to 75 years, were English-or French-speaking, and had undergone outpatient colonoscopy in the previous 3 months; they did not have inflammatory bowel disease or colorectal cancer. FGDs were 75 to 90 min, conducted by a trained facilitator, and audiotaped. Participants discussed the electronic health support tools they might use to help them prepare for the colonoscopy, the content needed for colonoscopy preparation, and the features that would make the smartphone app useful. Recordings of FGDs were transcribed and analyzed using thematic analysis to identify key user-defined content and features to inform the design of colonAPPscopy. Results: A total of 9 patients (7 male and 2 female) participated in one of 2 FGDs. Main content areas focused on bowel preparation instructions, medication restrictions, appointment logistics, communication, and postcolonoscopy expectations. Design features to make the app useful and engaging included minimization of data input, reminders and alerts for up to 7 days precolonoscopy, and visual aids. Participants wanted a smartphone app that comes from a trusted source, sends timely and tailored messages, provides reassurance, provides clear instructions, and is simple to use. Conclusions: Participants identified the need for postcolonoscopy information as well as reminders and alerts in the week before colonoscopy, novel content, and features that had not been included in previous smartphone-based strategies for colonoscopy preparation. The ability to tailor instructions made the smartphone app preferable to other modes of delivery. Study findings recognize the importance of including potential users in the development phase of building a smartphone app.
Canadian Journal of Gastroenterology, 2012
The present report summarizes the proceedings of the pan-Canadian Expert Forum on Using Informati... more The present report summarizes the proceedings of the pan-Canadian Expert Forum on Using Information Technology to Facilitate Uptake and Impact of Colorectal Cancer Screening Guidelines, which was held in Montreal, Quebec, November 18 to 19, 2011. The meeting assembled a multidisciplinary group of family physicians, gastroenterologists, nurses, patients, foundation representatives, screening program administrators and researchers to discuss the development of a mechanism or strategy that would permit the collection of comparable data by all colorectal cancer (CRC) screening programs, which would not only support the needs of each program but also provide a national perspective. The overarching theme of the meeting was ‘designing a national approach to computerized electronic data collection and dissemination for CRC screening that would improve knowledge transfer across the continuum of preventive health care’. The forum encouraged presentations on clinical, research and technical to...
Journal of the Canadian Association of Gastroenterology, 2021
Background As beneficiaries of health service improvement initiatives, patients should have their... more Background As beneficiaries of health service improvement initiatives, patients should have their perspectives of and gaps in care elicited to inform and guide the development of quality indicators to assess health care services. The purpose of this study was to identify patient perspectives amenable for conversion into measurable inflammatory bowel disease (IBD) care quality indicators. Methods Crohn’s and Colitis Canada’s Promoting Access and Care through Centres of Excellence (PACE) program organized four patient focus groups in three Canadian provinces in 2016 to capture the perspective of patients on IBD care services. The RQDA package in R was used for transcript analysis, theme identification and for building a theme hierarchy based on the number of citations. The main themes were converted into patient-derived quality indicators. Results Several perceived unmet needs were elicited from participants that could be converted into measurable quality indicators. These unmet needs...
Maladies chroniques au Canada, 2008
Les lignes directrices canadiennes recommandent le dépistage du cancer colorectal (CCR) pour les ... more Les lignes directrices canadiennes recommandent le dépistage du cancer colorectal (CCR) pour les personnes âgées de 50 à 74 ans. L'étude vise à estimer les taux du dépistage du CCR selon des caractéristiques individuelles et géographiques et de l'observation des lignes directrices en vigueur à l'égard du dépistage du CCR. Des enquêtés du cycle 2.1 de l'Enquête sur la santé dans les collectivités canadiennes 2003 (âgés de ≥ 50 ans, sans CCR passé ou présent) ont participé à l'étude. Les taux d'utilisation et de dépistage par recherche de sang occulte dans les selles (RSOS) et endoscopie ont été calculés. L'échantillon comprend 16 747 résidents de Terre-Neuve, de l'Ontario, de la Saskatchewan et de la Colombie- Britannique. Dans l'ensemble, le taux de dépistage par RSOS était de 7,7 % au cours de la dernière année et le taux de dépistage par endoscopie était de 8,8 % dans les cinq dernières années. Les taux de dépistage par RSOS sont plus élevés che...
American Journal of Gastroenterology, 2013
Journal of Affective Disorders, 2019
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Almost 14% of fathers experienced depressive symptoms within 6 months postpartum. Antenatal paternal depression increases the risk of postpartum depression. Poor sleep quality is associated to paternal postpartum depressive symptoms. Father inclusive screening and interventions to promote mental health are needed.
![Research paper thumbnail of [The Management of Depression in Older Adults and Their Family Caregivers: Findings from a Research Program in Quebec]](https://attachments.academia-assets.com/94900349/thumbnails/1.jpg)
](Sante mentale au Quebec
Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Mon... more Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports.Results The results pertain to 4 research areas: detection of depression in primary care and general medical settings; collaborative care of depression; depression self-care interventions; and the role of family and friends in supporting depression self-care interventions.Conclusions We propose six recommendations for improving the man...
Santé mentale au Québec, 2017
La dépression est un problème répandu, sérieux, et souvent chronique chez les aînés, qui sont sou... more La dépression est un problème répandu, sérieux, et souvent chronique chez les aînés, qui sont souvent atteints de maladies physiques chroniques, et affecte de façon négative leurs traitements et leurs soins. Malheureusement, le taux de détection et de suivi adéquat de la dépression est faible dans cette population. Au cours des deux dernières décennies, notre équipe a mené une série d’études pour mieux comprendre et améliorer la gestion de la dépression chez les aînés. Nous présentons une revue narrative et synthèse de 25 articles qui incluent : 4 revues systématiques, 10 études observationnelles, 9 essais d’interventions, et 2 conférences de consensus. Nous proposons en conclusion nos recommandations pour 1) la détection de la dépression dans les soins de santé primaires ; 2) les soins collaboratifs de la dépression ; 3) des interventions d’autogestion de la dépression ; 4) le rôle des aidants naturels dans les interventions d’autogestion de la dépression.
Health Education Journal, 2016
Objective: Among primary care patients with chronic physical conditions and comorbid depressive s... more Objective: Among primary care patients with chronic physical conditions and comorbid depressive symptoms, to assess (1) the effect of lay telephone coaching on adherence to a psycho-educational intervention for depression, (2) demographic characteristics that predict adherence and (3) the association between adherence and 6-month outcomes. Design: Single blind randomised pragmatic trial of a lay telephone-supported depression self-care intervention compared to an unsupported intervention. Methods: All patients received a multimedia toolkit of paper and audiovisual materials on depression that provided education on depression and on self-care for depression. Core tools included a cognitive-behavioural therapy (CBT)-based workbook and a mood monitoring notebook, with opportunities for written exercises and notes, and a video. Intervention group patients were additionally offered telephone coaching. Self-reported use of the materials was assessed at 3 and 6 months post-randomisation; 6...
Clinical & experimental ophthalmology, Jan 7, 2016
Depression is very common in people with age-related eye disease. Our goal was to determine if se... more Depression is very common in people with age-related eye disease. Our goal was to determine if self-care tools plus limited telephone support could reduce depressive symptoms in patients with age-related macular degeneration or diabetic retinopathy. A single-blind randomized controlled clinical trial was conducted at Maisonneuve-Rosemont Hospital in Montreal, Canada. Eighty participants were recruited. To be eligible, participants must have had either late stage age-related macular degeneration or diabetic retinopathy, at least mild depressive symptoms, and visual acuity better than 20/200. Half were randomized to the intervention arm and half to delayed intervention/usual care. The intervention consisted of large print written and audio tools incorporating cognitive-behavioral principles plus three 10-minute telephone calls from a lay coach. Eight-week follow-up data were collected by telephone. The primary outcome was the 8-week change in depressive symptoms as measured by the Pat...
Chronic illness, Sep 2, 2016
To describe the support that patients reported receiving from family or friends (F/F) while parti... more To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F. One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided. 30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient u...
![Research paper thumbnail of Corrigendum to “A randomized trial of a depression self-care toolkit with or without lay telephone coaching for primary care patients with chronic physical conditions” [Gen Hosp Psychiatry 37 (2015) 257–265]](https://attachments.academia-assets.com/94900348/thumbnails/1.jpg)
](General Hospital Psychiatry, 2016
The authors regret that the published version of this article contained a number of errors. All t... more The authors regret that the published version of this article contained a number of errors. All the errors are due to a mistake in the data entry procedures for antidepressant medications at baseline for some patients (n=13). This mistake affects some numbers presented in Tables 2 to 4 and the Appendix. This mistake, however, did not affect the conclusions of the study. Overall (n=223), the proportion using antidepressant medications at baseline increased from 29.6% to 35.1%. The corrections are listed below for the manuscript and highlighted in gray for the tables (appended).
Inflammatory Bowel Diseases, 2016
Background: Mortality rates greater than in the general population have been reported in the popu... more Background: Mortality rates greater than in the general population have been reported in the population with Crohn's disease (CD), but reports for ulcerative colitis (UC) are conflicting. Trends with time were rarely described. We aimed to assess whether CD and UC mortality in Québec differs from that in the general population and to describe the trends over a 10-year observation period. Methods: This is a population-based cohort study using the Québec administrative health databases and death certificates registry. All-cause and cause-specific standardized mortality ratios (SMRs) were computed for 1999 to 2008. A time trend analysis was used to assess changes in the SMR with the calendar year. Results: All-cause mortality was significantly increased in CD and UC compared to the general population: SMR: CD 1.45 (95% confidence interval: 1.34-1.58), UC 1.21 (95% confidence interval: 1.12-1.32). In CD, mortality from digestive conditions, all neoplasms, digestive neoplasms, and colorectal, lymphatic, and lung cancer was significantly higher than in the general population. In UC, mortality from digestive, respiratory, and infectious conditions was also significantly increased. In both CD and UC, there was a decrease with time in all-cause SMRs and in digestive conditions, digestive neoplasms, colorectal cancer, and infectious diseases. SMRs for lung cancer and respiratory conditions increased over time in CD. Conclusions: All-cause mortality was significantly higher in CD and UC populations than in the general population. However, a decreasing trend with time was observed in all-cause and some cause-specific SMRs. In CD, SMRs for lung cancer and respiratory conditions increased during the observation period.
American Journal of Men's Health, 2015
This cross-sectional study aims to determine the prevalence and determinants of depressive sympto... more This cross-sectional study aims to determine the prevalence and determinants of depressive symptoms in first-time expectant fathers during their partner’s third trimester of pregnancy. As part of a prospective study examining depressive symptoms in men over the first postnatal year, 622 men (mean age = 34.3 years, ±5.0 years) completed standardized online self-report questionnaires measuring depressed mood, physical activity, sleep quality, social support, marital adjustment, life events, financial stress, and demographics during their partner’s third trimester of pregnancy. The Edinburgh Depression Scale was used to assess depressed mood. Partners also completed the Edinburgh Depression Scale in the third trimester. The results revealed that 13.3% of expectant fathers exhibited elevated levels of depressive symptoms during their partner’s third trimester of pregnancy. Significant independent factors associated with antenatal depressive symptoms in men were poorer sleep quality, fam...
INTRODUCTION: Administrative databases are used extensively to describe the epidemiology, burden ... more INTRODUCTION: Administrative databases are used extensively to describe the epidemiology, burden of disease and health outcomes of chronic diseases such as inflammatory bowel disease (IBD). Time-related biases may have been introduced in studies using administrative databases to estimate the incidence of IBD. AIMS&METHODS: To illustrate and quantify the impact of time-related bias on estimates of IBD incidence rates using multiple validated case definitions. A population-based cohort study was conducted using the administrative databases of the Régie de l’Assurance Maladie du Québec to identify all people with an IBD diagnosis code associated with physician billings or hospital admissions during the period 1996-2009. The IBD cases occurring during follow-up were identified using 5 different case definitions validated for use with IBD administrative databases. The definitions had as criteria varying combinations of physician claims and hospital discharge summaries with an IBD diagnos...
General Hospital Psychiatry
OBJECTIVE: This study aimed to examine the recognition of depression in older medical inpatients ... more OBJECTIVE: This study aimed to examine the recognition of depression in older medical inpatients by nonpsychiatric physicians over a 2-year period. METHODS: A cohort of medical inpatients aged 65 and above was recruited at two university-affiliated hospitals, with oversampling of depressed patients. Participants were assessed with research diagnoses of major or minor depression (DSM-IV) at admission and at 3, 6 and 12 months. Indicators of recognition during the 12 months before and the 12 months after admission, derived from administrative databases, included the following: depression diagnosis, antidepressant prescription and psychiatric referral. Multiple logistic regression analyses were used to identify factors associated with recognition. RESULTS: Among 185 patients with at least one research diagnosis of depression during the study, recognition rates ranged up to 56% during the 12 months before admission among patients with major depression lasting at least 6 months and up to...
PLOS ONE, 2021
Background Mobile health (mHealth) technologies are innovative solutions for delivering instructi... more Background Mobile health (mHealth) technologies are innovative solutions for delivering instructions to patients preparing for colonoscopy. Objective To systematically review the literature evaluating the effectiveness of mHealth technologies supporting colonoscopy preparation on patient and clinical outcomes. Methods MEDLINE, EMBASE, CINAHL and CENTRAL were searched for randomized controlled trials (RCTs) that evaluated the effectiveness of mHealth technologies for colonoscopy preparation on patient and clinical outcomes. Two reviewers independently assessed study eligibility, extracted data, and appraised methodological quality using the Cochrane Risk-of-Bias tool. Data were pooled using random effects models and when heterogeneity, assessed using I2, was statistically significant, a qualitative synthesis of the data was performed. Publication bias was assessed using a funnel plot. Results Ten RCTs (3,383 participants) met inclusion criteria. MHealth interventions included smartph...
JMIR mHealth and uHealth, 2019
Background: The preparation for colonoscopy is elaborate and complex. In the context of colorecta... more Background: The preparation for colonoscopy is elaborate and complex. In the context of colorectal cancer screening, up to 11% of patients do not keep their colonoscopy appointments and up to 33% of those attending their appointments have inadequately cleansed bowels that can delay cancer diagnosis and treatment. A smartphone app may be an acceptable and wide-reaching tool to improve patient adherence to colonoscopy. Objective: The aim of this qualitative study was to employ a user-centered approach to design the content and features of a smartphone app called colonAPPscopy to support individuals preparing for their colonoscopy appointments. Methods: We conducted 2 focus group discussions (FGDs) with gastroenterology patients treated at the McGill University Health Centre in Montreal, Canada. Patients were aged 50 to 75 years, were English-or French-speaking, and had undergone outpatient colonoscopy in the previous 3 months; they did not have inflammatory bowel disease or colorectal cancer. FGDs were 75 to 90 min, conducted by a trained facilitator, and audiotaped. Participants discussed the electronic health support tools they might use to help them prepare for the colonoscopy, the content needed for colonoscopy preparation, and the features that would make the smartphone app useful. Recordings of FGDs were transcribed and analyzed using thematic analysis to identify key user-defined content and features to inform the design of colonAPPscopy. Results: A total of 9 patients (7 male and 2 female) participated in one of 2 FGDs. Main content areas focused on bowel preparation instructions, medication restrictions, appointment logistics, communication, and postcolonoscopy expectations. Design features to make the app useful and engaging included minimization of data input, reminders and alerts for up to 7 days precolonoscopy, and visual aids. Participants wanted a smartphone app that comes from a trusted source, sends timely and tailored messages, provides reassurance, provides clear instructions, and is simple to use. Conclusions: Participants identified the need for postcolonoscopy information as well as reminders and alerts in the week before colonoscopy, novel content, and features that had not been included in previous smartphone-based strategies for colonoscopy preparation. The ability to tailor instructions made the smartphone app preferable to other modes of delivery. Study findings recognize the importance of including potential users in the development phase of building a smartphone app.
Canadian Journal of Gastroenterology, 2012
The present report summarizes the proceedings of the pan-Canadian Expert Forum on Using Informati... more The present report summarizes the proceedings of the pan-Canadian Expert Forum on Using Information Technology to Facilitate Uptake and Impact of Colorectal Cancer Screening Guidelines, which was held in Montreal, Quebec, November 18 to 19, 2011. The meeting assembled a multidisciplinary group of family physicians, gastroenterologists, nurses, patients, foundation representatives, screening program administrators and researchers to discuss the development of a mechanism or strategy that would permit the collection of comparable data by all colorectal cancer (CRC) screening programs, which would not only support the needs of each program but also provide a national perspective. The overarching theme of the meeting was ‘designing a national approach to computerized electronic data collection and dissemination for CRC screening that would improve knowledge transfer across the continuum of preventive health care’. The forum encouraged presentations on clinical, research and technical to...
Journal of the Canadian Association of Gastroenterology, 2021
Background As beneficiaries of health service improvement initiatives, patients should have their... more Background As beneficiaries of health service improvement initiatives, patients should have their perspectives of and gaps in care elicited to inform and guide the development of quality indicators to assess health care services. The purpose of this study was to identify patient perspectives amenable for conversion into measurable inflammatory bowel disease (IBD) care quality indicators. Methods Crohn’s and Colitis Canada’s Promoting Access and Care through Centres of Excellence (PACE) program organized four patient focus groups in three Canadian provinces in 2016 to capture the perspective of patients on IBD care services. The RQDA package in R was used for transcript analysis, theme identification and for building a theme hierarchy based on the number of citations. The main themes were converted into patient-derived quality indicators. Results Several perceived unmet needs were elicited from participants that could be converted into measurable quality indicators. These unmet needs...
Maladies chroniques au Canada, 2008
Les lignes directrices canadiennes recommandent le dépistage du cancer colorectal (CCR) pour les ... more Les lignes directrices canadiennes recommandent le dépistage du cancer colorectal (CCR) pour les personnes âgées de 50 à 74 ans. L'étude vise à estimer les taux du dépistage du CCR selon des caractéristiques individuelles et géographiques et de l'observation des lignes directrices en vigueur à l'égard du dépistage du CCR. Des enquêtés du cycle 2.1 de l'Enquête sur la santé dans les collectivités canadiennes 2003 (âgés de ≥ 50 ans, sans CCR passé ou présent) ont participé à l'étude. Les taux d'utilisation et de dépistage par recherche de sang occulte dans les selles (RSOS) et endoscopie ont été calculés. L'échantillon comprend 16 747 résidents de Terre-Neuve, de l'Ontario, de la Saskatchewan et de la Colombie- Britannique. Dans l'ensemble, le taux de dépistage par RSOS était de 7,7 % au cours de la dernière année et le taux de dépistage par endoscopie était de 8,8 % dans les cinq dernières années. Les taux de dépistage par RSOS sont plus élevés che...
American Journal of Gastroenterology, 2013
Journal of Affective Disorders, 2019
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights Almost 14% of fathers experienced depressive symptoms within 6 months postpartum. Antenatal paternal depression increases the risk of postpartum depression. Poor sleep quality is associated to paternal postpartum depressive symptoms. Father inclusive screening and interventions to promote mental health are needed.
Sante mentale au Quebec
Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Mon... more Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports.Results The results pertain to 4 research areas: detection of depression in primary care and general medical settings; collaborative care of depression; depression self-care interventions; and the role of family and friends in supporting depression self-care interventions.Conclusions We propose six recommendations for improving the man...
Santé mentale au Québec, 2017
La dépression est un problème répandu, sérieux, et souvent chronique chez les aînés, qui sont sou... more La dépression est un problème répandu, sérieux, et souvent chronique chez les aînés, qui sont souvent atteints de maladies physiques chroniques, et affecte de façon négative leurs traitements et leurs soins. Malheureusement, le taux de détection et de suivi adéquat de la dépression est faible dans cette population. Au cours des deux dernières décennies, notre équipe a mené une série d’études pour mieux comprendre et améliorer la gestion de la dépression chez les aînés. Nous présentons une revue narrative et synthèse de 25 articles qui incluent : 4 revues systématiques, 10 études observationnelles, 9 essais d’interventions, et 2 conférences de consensus. Nous proposons en conclusion nos recommandations pour 1) la détection de la dépression dans les soins de santé primaires ; 2) les soins collaboratifs de la dépression ; 3) des interventions d’autogestion de la dépression ; 4) le rôle des aidants naturels dans les interventions d’autogestion de la dépression.
Health Education Journal, 2016
Objective: Among primary care patients with chronic physical conditions and comorbid depressive s... more Objective: Among primary care patients with chronic physical conditions and comorbid depressive symptoms, to assess (1) the effect of lay telephone coaching on adherence to a psycho-educational intervention for depression, (2) demographic characteristics that predict adherence and (3) the association between adherence and 6-month outcomes. Design: Single blind randomised pragmatic trial of a lay telephone-supported depression self-care intervention compared to an unsupported intervention. Methods: All patients received a multimedia toolkit of paper and audiovisual materials on depression that provided education on depression and on self-care for depression. Core tools included a cognitive-behavioural therapy (CBT)-based workbook and a mood monitoring notebook, with opportunities for written exercises and notes, and a video. Intervention group patients were additionally offered telephone coaching. Self-reported use of the materials was assessed at 3 and 6 months post-randomisation; 6...
Clinical & experimental ophthalmology, Jan 7, 2016
Depression is very common in people with age-related eye disease. Our goal was to determine if se... more Depression is very common in people with age-related eye disease. Our goal was to determine if self-care tools plus limited telephone support could reduce depressive symptoms in patients with age-related macular degeneration or diabetic retinopathy. A single-blind randomized controlled clinical trial was conducted at Maisonneuve-Rosemont Hospital in Montreal, Canada. Eighty participants were recruited. To be eligible, participants must have had either late stage age-related macular degeneration or diabetic retinopathy, at least mild depressive symptoms, and visual acuity better than 20/200. Half were randomized to the intervention arm and half to delayed intervention/usual care. The intervention consisted of large print written and audio tools incorporating cognitive-behavioral principles plus three 10-minute telephone calls from a lay coach. Eight-week follow-up data were collected by telephone. The primary outcome was the 8-week change in depressive symptoms as measured by the Pat...
Chronic illness, Sep 2, 2016
To describe the support that patients reported receiving from family or friends (F/F) while parti... more To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F. One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided. 30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient u...
General Hospital Psychiatry, 2016
The authors regret that the published version of this article contained a number of errors. All t... more The authors regret that the published version of this article contained a number of errors. All the errors are due to a mistake in the data entry procedures for antidepressant medications at baseline for some patients (n=13). This mistake affects some numbers presented in Tables 2 to 4 and the Appendix. This mistake, however, did not affect the conclusions of the study. Overall (n=223), the proportion using antidepressant medications at baseline increased from 29.6% to 35.1%. The corrections are listed below for the manuscript and highlighted in gray for the tables (appended).
Inflammatory Bowel Diseases, 2016
Background: Mortality rates greater than in the general population have been reported in the popu... more Background: Mortality rates greater than in the general population have been reported in the population with Crohn's disease (CD), but reports for ulcerative colitis (UC) are conflicting. Trends with time were rarely described. We aimed to assess whether CD and UC mortality in Québec differs from that in the general population and to describe the trends over a 10-year observation period. Methods: This is a population-based cohort study using the Québec administrative health databases and death certificates registry. All-cause and cause-specific standardized mortality ratios (SMRs) were computed for 1999 to 2008. A time trend analysis was used to assess changes in the SMR with the calendar year. Results: All-cause mortality was significantly increased in CD and UC compared to the general population: SMR: CD 1.45 (95% confidence interval: 1.34-1.58), UC 1.21 (95% confidence interval: 1.12-1.32). In CD, mortality from digestive conditions, all neoplasms, digestive neoplasms, and colorectal, lymphatic, and lung cancer was significantly higher than in the general population. In UC, mortality from digestive, respiratory, and infectious conditions was also significantly increased. In both CD and UC, there was a decrease with time in all-cause SMRs and in digestive conditions, digestive neoplasms, colorectal cancer, and infectious diseases. SMRs for lung cancer and respiratory conditions increased over time in CD. Conclusions: All-cause mortality was significantly higher in CD and UC populations than in the general population. However, a decreasing trend with time was observed in all-cause and some cause-specific SMRs. In CD, SMRs for lung cancer and respiratory conditions increased during the observation period.
American Journal of Men's Health, 2015
This cross-sectional study aims to determine the prevalence and determinants of depressive sympto... more This cross-sectional study aims to determine the prevalence and determinants of depressive symptoms in first-time expectant fathers during their partner’s third trimester of pregnancy. As part of a prospective study examining depressive symptoms in men over the first postnatal year, 622 men (mean age = 34.3 years, ±5.0 years) completed standardized online self-report questionnaires measuring depressed mood, physical activity, sleep quality, social support, marital adjustment, life events, financial stress, and demographics during their partner’s third trimester of pregnancy. The Edinburgh Depression Scale was used to assess depressed mood. Partners also completed the Edinburgh Depression Scale in the third trimester. The results revealed that 13.3% of expectant fathers exhibited elevated levels of depressive symptoms during their partner’s third trimester of pregnancy. Significant independent factors associated with antenatal depressive symptoms in men were poorer sleep quality, fam...
INTRODUCTION: Administrative databases are used extensively to describe the epidemiology, burden ... more INTRODUCTION: Administrative databases are used extensively to describe the epidemiology, burden of disease and health outcomes of chronic diseases such as inflammatory bowel disease (IBD). Time-related biases may have been introduced in studies using administrative databases to estimate the incidence of IBD. AIMS&METHODS: To illustrate and quantify the impact of time-related bias on estimates of IBD incidence rates using multiple validated case definitions. A population-based cohort study was conducted using the administrative databases of the Régie de l’Assurance Maladie du Québec to identify all people with an IBD diagnosis code associated with physician billings or hospital admissions during the period 1996-2009. The IBD cases occurring during follow-up were identified using 5 different case definitions validated for use with IBD administrative databases. The definitions had as criteria varying combinations of physician claims and hospital discharge summaries with an IBD diagnos...
General Hospital Psychiatry
OBJECTIVE: This study aimed to examine the recognition of depression in older medical inpatients ... more OBJECTIVE: This study aimed to examine the recognition of depression in older medical inpatients by nonpsychiatric physicians over a 2-year period. METHODS: A cohort of medical inpatients aged 65 and above was recruited at two university-affiliated hospitals, with oversampling of depressed patients. Participants were assessed with research diagnoses of major or minor depression (DSM-IV) at admission and at 3, 6 and 12 months. Indicators of recognition during the 12 months before and the 12 months after admission, derived from administrative databases, included the following: depression diagnosis, antidepressant prescription and psychiatric referral. Multiple logistic regression analyses were used to identify factors associated with recognition. RESULTS: Among 185 patients with at least one research diagnosis of depression during the study, recognition rates ranged up to 56% during the 12 months before admission among patients with major depression lasting at least 6 months and up to...