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The acute care nurse practitioner role in Canada.

https://arctichealth.org/en/permalink/ahliterature135437
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Publication Type
Article
Date
Dec-2010
Author
Kelley Kilpatrick
Patricia Harbman
Nancy Carter
Ruth Martin-Misener
Denise Bryant-Lukosius
Faith Donald
Sharon Kaasalainen
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Department of Nursing, Université du Québec en Outaouais, CHSRF/CIHR Program in Advanced Practice Nursing, St-Jérôme, QC.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:114-39
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Acute Disease
Advanced Practice Nursing - education - organization & administration - standards
Canada
Clinical Competence
Curriculum
Delivery of Health Care - organization & administration
Educational Measurement
Educational Status
Focus Groups
Health Policy
Humans
Nurse Practitioners - education - organization & administration - standards
Nurse's Role
Quebec
Abstract
The acute care nurse practitioner (ACNP) role was developed in Canada in the late 1980s to offset rapidly increasing physician workloads in acute care settings and to address the lack of continuity of care for seriously ill patients and increased complexity of care delivery. These challenges provided an opportunity to develop an advanced practice nursing role to care for critically ill patients with the intent of improving continuity of care and patient outcomes. For this paper, we drew on the ACNP-related findings of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing. The synthesis revealed that ACNPs are working in a range of clinical settings. While ACNPs are trained at the master's level, there is a gap in specialty education for ACNPs. Important barriers to the full integration of ACNP roles into the Canadian healthcare system include lack of full utilization of role components, limitations to scope of practice, inconsistent team acceptance and funding issues. Facilitators to ACNP role implementation include clear communication about the role, with messages tailored to the specific information needs of various stakeholder groups; supportive leadership of healthcare managers; and stable and predictable funding. The status of ACNP roles continues to evolve across Canada. Ongoing leadership and continuing research are required to enhance the integration of these roles into our healthcare system.
PubMed ID
21478690 View in PubMed
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Adherence to beta-blocker therapy under drug cost-sharing in patients with and without acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature162000
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Publication Type
Article
Date
Aug-2007
Author
Sebastian Schneeweiss
Amanda R Patrick
Malcolm Maclure
Colin R Dormuth
Robert J Glynn
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont St (Ste 3030), Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
Am J Manag Care. 2007 Aug;13(8):445-52
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Adrenergic beta-Antagonists - economics - therapeutic use
Aged
Aged, 80 and over
British Columbia
Case-Control Studies
Cohort Studies
Comorbidity
Cost Sharing
Deductibles and Coinsurance
Diabetes Complications
Female
Health Policy - trends
Humans
Male
Medical Record Linkage
Myocardial Infarction - drug therapy - economics
Patient Compliance - statistics & numerical data
Prescription Fees
Vascular Diseases
Abstract
To evaluate the effects of patient copayment and coinsurance policies on adherence to therapy with beta-adrenergic blocking agents (beta-blockers) and on the rate of initiation of beta-blocker therapy after acute myocardial infarction (MI) in a population-based natural experiment.
Three sequential cohorts included British Columbia residents age 66 years and older who initiated beta-blocker therapy during time intervals with full drug coverage (2001), a $10 or $25 copayment (2002), and 25% coinsurance (2003-2004). We used linked data on all prescription drug dispensings, physician services, and hospitalizations. Follow-up of each cohort was 9 months after the policy changes.
We measured the proportion of subjects in each cohort who were adherent to beta-blocker therapy over time, with adherence defined as having >80% of days covered. We also measured the proportion of patients initiating beta-blocker therapy after acute MI. Policy effects were evaluated using multivariable regression.
Adherence to beta-blocker therapy was marginally reduced as a consequence of the copayment policy (-1.3 percentage points, 95% confidence interval [CI] = -2.5 , -0.04) or the coinsurance policy (-0.8 percentage points, 95% CI = -2.0, 0.3). The proportion of patients initiating beta-blockers after hospitalization for acute MI remained steady at about 61% during the study period, similar to that observed in a control population of elderly Pennsylvania residents with full drug coverage.
Fixed patient copayment and coinsurance policies had little negative effect on adherence to relatively inexpensive beta-blocker therapy, or initiation of beta-blockers after acute MI.
Notes
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PubMed ID
17685825 View in PubMed
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Advanced practice nursing in Canada: overview of a decision support synthesis.

https://arctichealth.org/en/permalink/ahliterature135441
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Ruth Martin-Misener
Denise Bryant-Lukosius
Ivy Bourgeault
Kelley Kilpatrick
Faith Donald
Sharon Kaasalainen
Patricia Harbman
Nancy Carter
Sandra Kioke
Julia Abelson
R James McKinlay
Dianna Pasic
Brandi Wasyluk
Julie Vohra
Renee Charbonneau-Smith
Author Affiliation
Ontario Training Centre in Health Services & Policy Research, Nursing and Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:15-34
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - classification - methods - organization & administration
Canada
Decision Support Systems, Clinical - classification - organization & administration
Focus Groups
Health Care Surveys
Health Policy
Humans
Leadership
Nurse Clinicians - classification - organization & administration
Nurse Practitioners - classification - organization & administration
Periodicals as Topic - statistics & numerical data
Publishing - statistics & numerical data
Abstract
The objective of this decision support synthesis was to identify and review published and grey literature and to conduct stakeholder interviews to (1) describe the distinguishing characteristics of clinical nurse specialist (CNS) and nurse practitioner (NP) role definitions and competencies relevant to Canadian contexts, (2) identify the key barriers and facilitators for the effective development and utilization of CNS and NP roles and (3) inform the development of evidence-based recommendations for the individual, organizational and system supports required to better integrate CNS and NP roles into the Canadian healthcare system and advance the delivery of nursing and patient care services in Canada. Four types of advanced practice nurses (APNs) were the focus: CNSs, primary healthcare nurse practitioners (PHCNPs), acute care nurse practitioners (ACNPs) and a blended CNS/NP role. We worked with a multidisciplinary, multijurisdictional advisory board that helped identify documents and key informant interviewees, develop interview questions and formulate implications from our findings. We included 468 published and unpublished English- and French-language papers in a scoping review of the literature. We conducted interviews in English and French with 62 Canadian and international key informants (APNs, healthcare administrators, policy makers, nursing regulators, educators, physicians and other team members). We conducted four focus groups with a total of 19 APNs, educators, administrators and policy makers. A multidisciplinary roundtable convened by the Canadian Health Services Research Foundation formulated evidence-informed policy and practice recommendations based on the synthesis findings. This paper forms the foundation for this special issue, which contains 10 papers summarizing different dimensions of our synthesis. Here, we summarize the synthesis methods and the recommendations formulated at the roundtable.
PubMed ID
21478685 View in PubMed
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Clinical and economic consequences of a reimbursement restriction of nebulised respiratory therapy in adults: direct comparison of randomised and observational evaluations.

https://arctichealth.org/en/permalink/ahliterature181384
Source
BMJ. 2004 Mar 6;328(7439):560
Publication Type
Article
Date
Mar-6-2004
Author
Sebastian Schneeweiss
Malcolm Maclure
Bruce Carleton
Robert J Glynn
Jerry Avorn
Author Affiliation
Brigham and Women's Hospital and Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, 1620 Tremont St (Suite 3030), Boston, MA 02120, USA. schneeweiss@post.harvard.edu
Source
BMJ. 2004 Mar 6;328(7439):560
Date
Mar-6-2004
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Adult
Aged
British Columbia
Bronchodilator Agents - administration & dosage - economics
Cluster analysis
Cohort Studies
Cost Savings
Drug Costs - statistics & numerical data
Health Expenditures
Health Policy - economics
Humans
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services - utilization
Medical Assistance - utilization
Middle Aged
Abstract
To compare the results of a randomised and an observational evaluation of the same policy that restricted reimbursement for nebulised respiratory medications in adult patients in a community setting.
Cluster randomised controlled trial and observational time series with historical controls.
Pharmacare, the government funded drug benefits plan for elderly people and patients receiving social assistance in British Columbia, Canada.
In the randomised controlled trial 104 clusters of medical practices, pair matched by geography and approximately by practice size, were randomised to the intervention group (449 patients affected by the policy on 1 March 1999), and the control group (offered a six month exemption, affecting 386 patients). The observational analysis included all Pharmacare beneficiaries (excluding the 386 exempt patients) who had used any nebulised drugs six months before the policy (4624 patients).
Pharmacare restricted reimbursement for nebulised bronchodilators, steroids, and cromoglycate to patients whose doctors applied for an individual patient's exemption, giving an appropriate clinical reason.
Number of contacts with doctors and services, emergency admissions to hospital, and utilisation of and expenditure for respiratory drugs in databases of British Columbia's Ministry of Health.
Contacts with doctors or emergency admissions to hospital did not increase in association with the restriction, regardless of the analytical approach. In the observational analysis, we found a reduction of C24 dollars per patient month in all nebulised drug use (95% confidence interval 19 to 29) and an increase of C3 dollars per patient month in all expenditure for inhalers (1.4 to 4.5). The randomised evaluation found savings of C8 dollars per patient month for nebulisers (P = 0.24) and no increase in spending on inhalers (P = 0.79). Correcting for 60% non-compliance by exempt doctors in a sensitivity analysis yielded similar results as the observational evaluation.
Observational as well as randomised analyses found moderate net savings and no increase in unintended healthcare outcomes after restricting reimbursement for nebulised respiratory drugs. Randomised policy trials are feasible and, if carefully implemented, likely to be concordant with observational evaluations.
Notes
Cites: Inquiry. 1999-00 Winter;36(4):481-9110711322
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PubMed ID
14982865 View in PubMed
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Clinical nurse specialists and nurse practitioners: title confusion and lack of role clarity.

https://arctichealth.org/en/permalink/ahliterature135434
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Publication Type
Article
Date
Dec-2010
Author
Faith Donald
Denise Bryant-Lukosius
Ruth Martin-Misener
Sharon Kaasalainen
Kelley Kilpatrick
Nancy Carter
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Affiliate Faculty, Daphne Cockwell School of Nursing, Ryerson University, CHSRF/CIHR Program in Advanced Practice Nursing, Toronto, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:189-201
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - organization & administration
Attitude of Health Personnel
Awareness
Canada
Curriculum
Focus Groups
Health Policy
Humans
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Nurse's Role
Social Perception
Abstract
Title confusion and lack of role clarity pose barriers to the integration of advanced practice nursing roles (i.e., clinical nurse specialist [CNS] and nurse practitioner [NP]). Lack of awareness and understanding about NP and CNS roles among the healthcare team and the public contributes to ambiguous role expectations, confusion about NP and CNS scopes of practice and turf protection. This paper draws on the results of a scoping review of the literature and qualitative key informant interviews conducted for a decision support synthesis commissioned by the Canadian Health Services Research Foundation and the Office of Nursing Policy in Health Canada. The goal of this synthesis was to develop a better understanding of advanced practice nursing roles and the factors that influence their effective development and integration in the Canadian healthcare system. Specific recommendations from interview participants and the literature to enhance title and role clarity included the use of consistent titles for NP and CNS roles; the creation of a vision statement to articulate the role of CNSs and NPs across settings; the use of a systematic planning process to guide role development and implementation; the development of a communication strategy to educate healthcare professionals, the public and employers about the roles; attention to inter-professional team dynamics when introducing these new roles; and addressing inter-professionalism in all health professional education program curricula.
PubMed ID
21478694 View in PubMed
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Emergency hospital admissions after income-based deductibles and prescription copayments in older users of inhaled medications.

https://arctichealth.org/en/permalink/ahliterature156082
Source
Clin Ther. 2008;30 Spec No:1038-50
Publication Type
Article
Date
2008
Author
Colin R Dormuth
Malcolm Maclure
Robert J Glynn
Peter Neumann
Alan M Brookhart
Sebastian Schneeweiss
Author Affiliation
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. colin.dormuth@ti.ubc.ca
Source
Clin Ther. 2008;30 Spec No:1038-50
Date
2008
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adrenergic beta-Agonists - economics - therapeutic use
Aged
Aged, 80 and over
Asthma - drug therapy
Canada
Cholinergic Antagonists - economics - therapeutic use
Cohort Studies
Deductibles and Coinsurance - economics
Drug Utilization
Emergency Service, Hospital - statistics & numerical data
Emphysema - drug therapy
Female
Glucocorticoids - economics - therapeutic use
Health Policy
Health Services - utilization
Humans
Insurance Claim Review
Lung Diseases - drug therapy
Male
Pulmonary Disease, Chronic Obstructive - drug therapy
State Health Plans - economics
Abstract
Rapid growth in prescription drug costs has compelled insurers to require increased patient cost-sharing.
The aim of this study was to compare the effects of 2 recent cost-sharing policies on emergency hospitalizations due to chronic obstructive pulmonary disease, asthma, or emphysema (CAE), and on physician visits.
We analyzed data from a large-scale natural experiment in British Columbia (BC), Canada. The cost-sharing policies were a fixed copayment policy (fixed copay policy) and an income-based deductible (IBD) policy with 25% coinsurance (IBD policy). Prescription, physician billing, and hospitalization records were obtained from the BC Ministry of Health. From the total population of BC residents > or = 65 years of age, we extracted data from all patients dispensed an inhaled corticosteroid, beta(2)-agonist, or anticholinergic from June 30, 1997, to April 30, 2004. Poisson regression was used to evaluate the impact of the policies in a cohort of patients receiving long-term inhaler treatment. An identically defined historical control group unaffected by the policy changes was used for comparison.
The study population included 37,320 users of long-term inhaled medications from the BC population of 576,000 persons > or = 65 years of age. During the IBD period but not the fixed copay period, emergency hospitalizations for CAE increased 41% (95% CI for adjusted rate ratio [RR], 1.24-1.60) in patients > or = 65 years of age. There was also a significant increase in physician visits of 3% (95% CI for adjusted RR, 1.01-1.05). No significant increases were observed during the fixed copay period. In a secondary analysis using a concurrent control group, we estimated a smaller but significant increase in emergency CAE hospitalizations of 29% (95% CI for adjusted RR, 1.09-1.52). This analysis also showed increases in physician visits (fixed copay period RR, 1.03 [95% CI for adjusted RR, 1.01-1.05]; IBD period RR, 1.07 [95% CI for adjusted RR, 1.05-1.08]).
The results suggest that the IBD policy was likely associated with an increased risk for emergency hospitalization and physician visits in these users of inhaled medications who were aged > or = 65 years.
Notes
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Cites: Clin Pharmacol Ther. 2003 Oct;74(4):388-40014534526
Cites: N Engl J Med. 2003 Dec 4;349(23):2224-3214657430
Cites: BMJ. 2004 Mar 6;328(7439):56014982865
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Cites: N Engl J Med. 2002 Mar 14;346(11):822-911893794
PubMed ID
18640478 View in PubMed
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Factors enabling advanced practice nursing role integration in Canada.

https://arctichealth.org/en/permalink/ahliterature135433
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Publication Type
Article
Date
Dec-2010
Author
Alba DiCenso
Denise Bryant-Lukosius
Ruth Martin-Misener
Faith Donald
Julia Abelson
Ivy Bourgeault
Kelley Kilpatrick
Nancy Carter
Sharon Kaasalainen
Patricia Harbman
Author Affiliation
CHSRF/CIHR in Advanced Practice Nursing, Ontario Training Centre in Health Services & Policy Research, McMaster University, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:211-38
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - manpower - organization & administration
Awareness
Canada
Curriculum
Decision Support Systems, Clinical
Delivery of Health Care - manpower - organization & administration
Education, Nursing, Continuing
Focus Groups
Great Britain
Health Care Surveys
Health Policy
Humans
Interprofessional Relations
Leadership
Nurse Clinicians - organization & administration - supply & distribution
Nurse Practitioners - organization & administration - supply & distribution
Personnel Turnover
Primary Health Care - organization & administration
United States
Abstract
Although advanced practice nurses (APNs) have existed in Canada for over 40 years and there is abundant evidence of their safety and effectiveness, their full integration into our healthcare system has not been fully realized. For this paper, we drew on pertinent sections of a scoping review of the Canadian literature from 1990 onward and interviews or focus groups with 81 key informants conducted for a decision support synthesis on advanced practice nursing to identify the factors that enable role development and implementation across the three types of APNs: clinical nurse specialists, primary healthcare nurse practitioners and acute care nurse practitioners. For development of advanced practice nursing roles, many of the enabling factors occur at the federal/provincial/territorial (F/P/T) level. They include utilization of a pan-Canadian approach, provision of high-quality education, and development of appropriate legislative and regulatory mechanisms. Systematic planning to guide role development is needed at both the F/P/T and organizational levels. For implementation of advanced practice nursing roles, some of the enabling factors require action at the F/P/T level. They include recruitment and retention, role funding, intra-professional relations between clinical nurse specialists and nurse practitioners, public awareness, national leadership support and role evaluation. Factors requiring action at the level of the organization include role clarity, healthcare setting support, implementation of all role components and continuing education. Finally, inter-professional relations require action at both the F/P/T and organizational levels. A multidisciplinary roundtable formulated policy and practice recommendations based on the synthesis findings, and these are summarized in this paper.
PubMed ID
21478695 View in PubMed
Less detail

A historical overview of the development of advanced practice nursing roles in Canada.

https://arctichealth.org/en/permalink/ahliterature135440
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Publication Type
Article
Date
Dec-2010
Author
Sharon Kaasalainen
Ruth Martin-Misener
Kelley Kilpatrick
Patricia Harbman
Denise Bryant-Lukosius
Faith Donald
Nancy Carter
Alba DiCenso
Author Affiliation
Affiliate Faculty, School of Nursing, McMaster University, Career Scientist, Ontario Ministry of Health and Long-Term Care, Hamilton, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:35-60
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Advanced Practice Nursing - history - manpower - methods
Canada
Delivery of Health Care - history - organization & administration
Health Policy - history - trends
Health services needs and demand
History of Nursing
History, 20th Century
Humans
Nurse Clinicians
Nurse's Role - history
Qualitative Research
Abstract
Advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide. To understand the development and current status of advanced practice nursing within a Canadian context, it is important to explore its historical roots and influences. The purpose of this paper is to provide a historical overview of the major influences on the development of advanced practice nursing roles that exist in Canada today, those roles being the nurse practitioner and the clinical nurse specialist. Using a scoping review and qualitative interviews, data were summarized according to three distinct time periods related to the development of advanced practice nursing. They are the early beginnings; the first formal wave, between the mid 1960s and mid 1980s; and the second wave, beginning in the late 1980s and continuing to the present. This paper highlights how advanced practice nursing roles have evolved over the years to meet emerging needs within the Canadian healthcare system. A number of influential factors have both facilitated and hindered the development of the roles, despite strong evidence to support their effectiveness. Given the progress over the past few decades, the future of advanced practice nursing within the Canadian healthcare system is promising.
PubMed ID
21478686 View in PubMed
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The impact of cost sharing on antidepressant use among older adults in British Columbia.

https://arctichealth.org/en/permalink/ahliterature157979
Source
Psychiatr Serv. 2008 Apr;59(4):377-83
Publication Type
Article
Date
Apr-2008
Author
Philip S Wang
Amanda R Patrick
Colin R Dormuth
Jerry Avorn
Malcolm Maclure
Claire F Canning
Sebastian Schneeweiss
Author Affiliation
National Institute of Mental Health, Bethesda, MD 20892-9629, USA. wangphi@mail.nih.gov
Source
Psychiatr Serv. 2008 Apr;59(4):377-83
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Adrenergic Uptake Inhibitors - therapeutic use
Aged
Antidepressive Agents - therapeutic use
British Columbia - epidemiology
Cost Sharing - statistics & numerical data
Depressive Disorder - drug therapy - epidemiology
Drug Therapy - trends - utilization
Female
Health Policy
Humans
Imipramine - therapeutic use
Male
Middle Aged
Prevalence
Abstract
Antidepressant therapies are underused among older adults and could be further curtailed by patient cost-sharing requirements. The authors studied the effects of two sequential cost-sharing policies in a large, stable population of all British Columbia seniors: change from full prescription coverage to 10-25 dollars copayments (copay) in January 2002 and replacement with income-based deductibles and 25% coinsurance in May 2003.
PharmaNet data were used to calculate monthly dispensing of antidepressants (in imipramine-equivalent milligrams) among all British Columbia residents age 65 and older beginning January 1997 through December 2005. Monthly rates of starting and stopping antidepressants were calculated. Population-level patterns over time were plotted, and the effects of implementing cost-sharing policies on antidepressant use, initiation, and stopping were examined in segmented linear regression models.
Implementation of the copay policy was not associated with significant changes in level of antidepressant dispensing or the rate of dispensing growth. Subsequent implementation of the income-based deductible policy also did not lead to a significant change in dispensing level but led to a significant (p=.02) decrease in the rate of growth of antidepressant dispensing. The copay policy was associated with a significant (p=.01) drop in the frequency of antidepressant initiation among persons with depression. Income-based deductibles reduced the rate of increase in antidepressant initiation over time. Implementation of the copay and income-based deductible policies did not have significant effects on stopping rates.
Introducing new forms of medication cost sharing appears to have the potential to reduce some use and initiation of antidepressant therapy by seniors. The clinical consequences of such reduced use need to be clarified.
Notes
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PubMed ID
18378836 View in PubMed
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The primary healthcare nurse practitioner role in Canada.

https://arctichealth.org/en/permalink/ahliterature135438
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:88-113
Publication Type
Article
Date
Dec-2010
Author
Faith Donald
Ruth Martin-Misener
Denise Bryant-Lukosius
Kelley Kilpatrick
Sharon Kaasalainen
Nancy Carter
Patricia Harbman
Ivy Bourgeault
Alba DiCenso
Author Affiliation
Affiliate Faculty, Daphne Cockwell School of Nursing, Ryerson University, CHSRF/CIHR Program in Advanced Practice Nursing, Toronto, ON.
Source
Nurs Leadersh (Tor Ont). 2010 Dec;23 Spec No 2010:88-113
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Canada
Clinical Competence
Educational Measurement
Educational Status
Focus Groups
Government Regulation
Health Care Surveys
Health Policy
Humans
Nurse Clinicians - legislation & jurisprudence - organization & administration
Nurse Practitioners - legislation & jurisprudence - organization & administration
Nurse's Role
Primary Health Care - legislation & jurisprudence - organization & administration
Abstract
Primary healthcare nurse practitioners (PHCNPs), also known as family or all-ages nurse practitioners, are the fastest growing advanced practice nursing role in Canada. All 10 provinces and three territories now have legislation that authorizes their role. Their introduction is linked to countrywide health reform efforts to improve the accessibility and quality of primary healthcare.
PubMed ID
21478689 View in PubMed
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