Evidence map›Paper›PMID 34403118›Full record

ArticleCJEM2021

Paramedics assessing patients with complex comorbidities in community settings: results from the CARPE study.

Matthew S Leyenaar, Brent McLeod, Aaron Jones, Audrey-Anne Brousseau, Eric Mercier, Ryan P Strum, Michael Nolan, Samir K Sinha, Gina Agarwal, Walter Tavares and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CJEM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.4field-weighted citation impact, top 7% 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

9 citing papers in PubMed, 18 citations in OpenAlex.

  1. Paramedics: A Missing Workforce in Australia's Mental Health System.The Australian journal of rural health · 2026
    Article
  2. Article
  3. Article
  4. Observational
  5. Article
  6. The development of community paramedicine; a restricted review.Health & social care in the community · 2022
    Review
  7. Review
  8. Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Matthew S LeyenaarPrince Edward Island Department of Health and Wellness, Charlottetown, PEI, Canada. leyenam@mcmaster.ca.ORCID 0000-0002-1151-9479
Brent McLeodHamilton Niagara Haldimand Brant Local Health Integration Network, Grimsby, ON, Canada.
Aaron JonesDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Audrey-Anne BrousseauDépartement de Médecine d'urgence, Université de Sherbrooke, Sherbrooke, QC, Canada.
Eric MercierDépartement de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine de l'Université Laval, Quebec, QC, Canada.
Ryan P StrumDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Michael NolanCounty of Renfrew Paramedic Service, Pembroke, ON, Canada.
Samir K SinhaSinai Health, Toronto, ON, Canada.
Gina AgarwalDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Walter TavaresFaculty of Medicine, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Heath, University of Toronto, Toronto, ON, Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Impact · CASinai Health System · CAUniversité de Sherbrooke · CAUniversité Laval · CAUniversity of Toronto · CA

Funding

CIHR Health System Impact Fellowship 403790Mitacs IT09932
6 · The paper itself

Abstract

objectivesThe aim for this study was to provide information about how community paramedicine home visit programs best "navigate" their role delivering preventative care to frequent 9-1-1 users by describing demographic and clinical characteristics of their patients and comparing them to existing community care populations.

methodsOur study used secondary data from standardized assessment instruments used in the delivery of home care, community support services, and community paramedicine home visit programs in Ontario. Identical assessment items from each instrument enabled comparisons of demographic, clinical, and social characteristics of community-dwelling older adults using descriptive statistics and z-tests.

resultsData were analyzed for 29,938 home care clients, 13,782 community support services clients, and 136 community paramedicine patients. Differences were observed in proportions of individuals living alone between community paramedicine patients versus home care clients and community support clients (47.8%, 33.8%, and 59.9% respectively). We found higher proportions of community paramedicine patients with multiple chronic disease (87%, compared to 63% and 42%) and mental health-related conditions (43.4%, compared to 26.2% and 18.8% for depression, as an example).

conclusionWhen using existing community care populations as a reference group, it appears that patients seen in community paramedicine home visit programs are a distinct sub-group of the community-dwelling older adult population with more complex comorbidities, possibly exacerbated by mental illness and social isolation from living alone. Community paramedicine programs may serve as a sentinel support opportunity for patients whose health conditions are not being addressed through timely access to other existing care providers. PROTOCOL REGISTRATION: ISRCTN 58273216.

Indexed as

Emergency Medical ServicesAgedAllied Health PersonnelHouse CallsHumansCase findingCommunity paramedicineEmergency medical servicesStandardized assessment

Identifiers

PMID34403118
PMCPMC8575756
OpenAlexW3194867875

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.