Evidence map›Paper›PMID 29807936›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2018

Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial.

Gina Agarwal, Ricardo Angeles, Melissa Pirrie, Brent McLeod, Francine Marzanek, Jenna Parascandalo, Lehana Thabane

Open access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 2 pooled it
8.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.

  1. Community emergency medical services approaches to fall prevention: a systematic review.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Gina AgarwalDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont. gina.agarwal@gmail.com.
Ricardo AngelesDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Melissa PirrieDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Brent McLeodDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Francine MarzanekDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Jenna ParascandaloDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Lehana ThabaneDepartment of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
Impact · CAMcMaster University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow-income older adults who live in subsidized housing have higher mortality and morbidity. We aimed to determine if a community paramedicine program - in which paramedics provide health care services outside of the traditional emergency response - reduced the number of ambulance calls to subsidized housing for older adults.

methodsWe conducted an open-label pragmatic cluster-randomized controlled trial (RCT) with parallel intervention and control groups in subsidized apartment buildings for older adults. We selected 6 buildings using predefined criteria, which we then randomly assigned to intervention (Community Paramedicine at Clinic [CP@clinic] for 1 yr) or control (usual health care) using computer-generated paired randomization. CP@clinic is a paramedic-led, community-based health promotion program to prevent diabetes, cardiovascular disease and falls for residents 55 years of age and older. The primary outcome was building-level mean monthly ambulance calls. Secondary outcomes were individual-level changes in blood pressure, health behaviours and risk of diabetes assessed using the Canadian Diabetes Risk Questionnaire. We analyzed the data using generalized estimating equations and hierarchical linear modelling.

resultsThe 3 intervention and 3 control buildings had 455 and 637 residents, respectively. Mean monthly ambulance calls in the intervention buildings (3.11 [standard deviation (SD) 1.30] calls per 100 units/mo) was significantly lower (-0.88, 95% confidence interval [CI] -0.45 to -1.30) than in control buildings (3.99 [SD 1.17] calls per 100 units/mo), when adjusted for baseline calls and building pairs. Survey participation was 28.4% (

interpretationA paramedic-led, community-based health promotion program (CP@clinic) significantly lowered the number of ambulance calls, improved QALYs and ability to perform usual activities, and lowered systolic blood pressure among older adults living in subsidized housing.

Indexed as

Emergency Medical TechniciansAgedAllied Health PersonnelCanadaCluster AnalysisCommunity Health ServicesDelivery of Health Care, IntegratedEmergency Medical ServicesFemaleHealth PromotionHumansMaleMiddle AgedProgram EvaluationRisk Assessment

Identifiers

PMID29807936
PMCPMC5973885
OpenAlexW2804589314

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.