Evidence map›Paper›PMID 30674347›Full record

ArticleTrials2019

Rationale and methods of an Evaluation of the Effectiveness of the Community Paramedicine at Home (CP@home) program for frequent users of emergency medical services in multiple Ontario regions: a study protocol for a randomized controlled trial.

Gina Agarwal, Melissa Pirrie, Brent McLeod, Ricardo Angeles, Walter Tavares, Francine Marzanek, Lehana Thabane

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02835989 (Community Paramedicine at Home), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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.

NCT02835989 nacompletednot on this map

Community Paramedicine at Home (CP @Home)

TypeinterventionalSponsorMcMaster UniversityRan2018 to 2021Enrolled2,826ConditionsCardiovascular Disease, Diabetes Mellitus, Accidental Falls, Social IsolationArmsCP@Home
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. The role of community paramedicine in fall prevention: A SWOT analysis.Journal of the American Geriatrics Society · 2024
    Article
  6. Review
  7. Article
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.

Gina AgarwalDepartment of Family Medicine, McMaster University, 100 Main Street W, Hamilton, ON, L8P 1H6, Canada. agarg@mcmaster.ca.ORCID http://orcid.org/0000-0002-5691-4675
Melissa PirrieDepartment of Family Medicine, McMaster University, 100 Main Street W, Hamilton, ON, L8P 1H6, Canada.
Brent McLeodHamilton Paramedic Services, Hamilton, ON, Canada.
Ricardo AngelesDepartment of Family Medicine, McMaster University, 100 Main Street W, Hamilton, ON, L8P 1H6, Canada.
Walter TavaresThe Wilson Centre, Department of Medicine, University of Toronto/University Health Network, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
Francine MarzanekDepartment of Family Medicine, McMaster University, 100 Main Street W, Hamilton, ON, L8P 1H6, Canada.
Lehana ThabaneDepartment of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.

Funding

Canadian Institutes of Health Research PJT -152951
6 · The paper itself

Abstract

backgroundFrequent users of emergency medical services for issues that could be more appropriately managed through non-urgent care deplete the limited resources of the health-care system. Community paramedicine is an emerging field that extends the role of paramedics beyond the traditional emergency response. The goal of the current study is to evaluate the impact of a community paramedicine home-visit intervention with frequent users on reducing ambulance calls, hospital visits, and admissions. The study will also provide a cross-sectional description of the characteristics of frequent users of emergency medical services. METHODS/

designAn open-label, pragmatic, randomized controlled trial with parallel intervention and control groups will be conducted in four paramedic services in Ontario. The sample size has been calculated as 261 per group for a 25% reduction in ambulance calls. Eligible participants will be frequent callers (three or more calls in 6 months), individuals who call for at least one lift assist, or individuals referred to the program by a paramedic. Individuals will be randomly allocated to receive either the Community Paramedicine at Home (CP@home) program intervention or their usual care (control). Intervention participants will receive up to three visits from a community paramedic, who will conduct health risk assessments, provide health promotion and education, provide referrals to local resources, and fax reports back to the family physician. Data will be collected from administrative databases (e.g., paramedic services), a custom CP@home program database, participant surveys, and key informant interviews. An intention-to-treat analysis will be conducted, including descriptive statistics and multi-level modeling to find factors predictive of primary and secondary outcomes. A thematic analysis will be used to analyze the qualitative outcomes. An economic analysis will consider the cost-effectiveness of the program. DISCUSSION: CP@home has the potential to reduce the health-care system burden significantly by targeting current frequent users of emergency medical services. By targeting this population, CP@home aims to decrease ambulance calls and emergency department visits, reducing health-care costs and improving the quality of life of a vulnerable population. If successful, CP@home will inform the development of community paramedicine policies and the expanding role of paramedics in regions across Canada.

trial registrationClinicalTrials.gov, NCT02835989 . Registered on July 14 2016.

Indexed as

Allied Health PersonnelCommunity Health ServicesEmergency Medical ServicesPragmatic Clinical Trials as TopicProgram EvaluationAdolescentAdultAgedAged, 80 and overCross-Sectional StudiesData Interpretation, StatisticalFemaleHumansMaleMiddle AgedOutcome Assessment, Health CareCommunity paramedicinecomplex needsemergency medical servicesHealth-care Utilizationprimary careseniors

Identifiers

PMID30674347
PMCPMC6343307

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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.