Trends in the Primary Care Management and Health Service Use of the Dementia Population in New Brunswick ​

1. Trends in the Primary Care
Management and Health Service
Use of the Dementia Population in
New Brunswick
Dr. Pam Jarrett
Samantha Fowler
Heather Bursey
Kyle Rogers
Dr. Sandra Magalhaes

2. Dementia in New Brunswick
• Incidence
– 2008: 2580 newly diagnosed cases/year
– 2038: 5550 newly diagnosed cases/year
• Prevalence
– 2008: 12 047 people with dementia (1.6% of the total population)
– 2038: 24 796 people with dementia (2.6% of the total population)
2
Smetanin, P., Kobak, P., Briante, C., Stiff, D., Sherman, G., and Ahmad, S. Rising Tide: The
Impact of Dementia in New Brunswick 2008 to 2038. RiskAnalytica, 2009.

3. Alzheimer’s Society Canada. The approaching tsunami of Alzheimer’s disease and
dementia: The Canadian Alzheimer’s disease and dementia partnership Ottawa, ON2013.
Sivananthan SN, Lavergne MR, McGrail KM. Caring for dementia: A population-based study
examining variations in guideline-consistent medical care. Alzheimer's & Dementia.
2015;11(8):906-16.
Challenges in Dementia Care
• Many Canadians with dementia experience
care that is variable in terms of quality
• The year following diagnosis is a vulnerable
period with increased transitions in care
• Fragmented care can result in increased
emergency department visits, hospital
admissions, and nursing home care
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4. The Role of Primary Care
• Primary care physicians are best positioned to
provide care to persons with dementia
• Access to specialists for persons with dementia
is also important
• Provincial governments are investing in
reforms to strength primary care
4
World Health Organization. Dementia: a public health priority Geneva, Switzerland: World
Health Organization; 2012.
Canadian Institutes of Health Research. Living Longer, Living Better. Canadian Institutes of
Health Research Institute of Aging 2013-18 Strategic Plan. Ottawa; 2013.

5. The Present Study
• This study is part of a larger program of
research being conducted by Research on
Organization of Health Services for Alzheimer’s
(ROSA)
• Involves Ontario, Quebec, and New Brunswick
5
Canadian Institute for Health Research (2019, February 15). Canadian Consortium on
Neurodegeneration in Aging (CCNA) Retrieved from http://www.cihr-
irsc.gc.ca/e/46475.html

6. Canadian Consortium for
Neurodegeneration in Aging
• Vision: Canadian researchers will work
collaboratively and synergistically to make a
difference for dementia care
• Goal: Perform bold and transformative
research that will make a difference in the
quality of life and services for those with
dementia and their care givers
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7. • Collaborative research group focusing on the
dementia care in the primary care setting
• Ontario, Quebec, and New Brunswick
• New Brunswick membership
– Dr. Pamela Jarrett
– Heather Bursey
– Samantha Fowler
– Dr. Sandra Magalhaes
– Dr. Shelley Doucet
– Dr. Alison Luke
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Research on Organization of
Healthcare Services for Alzheimer’s (ROSA)
McGill Department of Family Medicine (2019). Research on Organization
of Healthcare Services for Alzheimer's (ROSA). Retrieved from
https://www.mcgill.ca/familymed/research/projects/research-
organization-healthcare-services-alzheimers-rosa

8. OBSERVATIONAL
(Quantitative) Study
The Present Study
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Participatory research approach.
Collaboration with stakeholders: decision-makers, managers,
clinicians and patients and caregivers representatives.
Provincial, Canadian and International Councils
IMPLEMENTATION
(Qualitative) Study
To examine the implementation strategies of the
dementia initiatives in the three provinces
EVOLUTION
Administrative Data
To measure evolution of quality of care and use of
health services over 15 years
To identify key patient, clinical, and organizational
factors associated with high quality dementia care

9. The Present Study
• Examines population-level trends in the quality
of care and health service use of newly
diagnosed persons with dementia in New
Brunswick
– Hospital Admissions
– Emergency Department Visits
– Primary Care Physician Visits
– Specialist Visits
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10. Method
Participants
• Community-dwelling older adults (≥ 65 years)
with a new diagnosis of dementia between
2002 and 2014
• Identified through the New Brunswick Institute
for Research Data and Training (NB-IRDT)
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11. Method
Materials
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Database Example Variables
CCDSS Hypertension and Neurological Conditions Case Rule
Date of Diagnosis
Citizen Database Sex
Citizenship Status
Urban/Rural

12. Method
Materials
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Database Example Variables
Discharge Abstracts Database Diagnosis
Length of Stay
Physician Billing Service Supplied
Provider Registry Speciality
Vital Statistics Date of Death

13. Implications
• Better understanding of the care needs of
those with dementia
• Inform the New Brunswick Dementia Strategy
and Action Plan
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14. Take Home Messages
• Rigorous dementia research is needed to
inform policy
• Administrative data allows for population level
analyses that would not otherwise be feasible
• The NB-IRDT is flexible and will assist you to
participate in interprovincial studies
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