Integration of Chronic Disease Rehabilitation Services Into Primary Care

Summary

The aim of PR1MaC is to establish a clinical intervention that will adapt and permanently integrate rehabilitation services into primary care settings, which would be the reference point in the health care system for people with Chronic diseases (CD). More specifically, the intervention will aim to: (1) clinically operationalize the mechanisms and tools necessary for delivery of integrated CD services, promoting continuity of care in response to the needs expressed by stakeholders; (2) implement and deploy rehabilitation services adapted to the realities of various clinical primary care settings and develop tools to ensure the sustainability of interventions beyond the rehabilitation period; and (3) support clinical primary care teams in the acquisition and maintenance of evidence-based practices for the targeted CDs.

Conditions

• Cardiovascular Disease
• Heart Failure
• Chronic Obstructive Pulmonary Disease
• Asthma
• Diabetes

Interventions

BEHAVIORAL

Support, management, educational, counselling, follow-up

The project offers a range of activities (educational, counselling, follow-up) by several professionals. The varied range of services is spread out over six months and may include individual or group meetings with professionals. Informational documents and follow-up tools are provided to patients based on their condition, to facilitate the acquisition and maintenance of knowledge, self-management, and changes in risk behaviour.

Sponsors & Collaborators

• Pfizer

  collaborator INDUSTRY

• Fonds de la Recherche en Santé du Québec

  collaborator OTHER_GOV

• Ministere de la Sante et des Services Sociaux

  collaborator OTHER

• Centre de santé et de services sociaux de Chicoutimi

  collaborator OTHER

• Centre de santé et de services sociaux de Jonquière

  collaborator OTHER

• Martin Fortin

  lead OTHER

Principal Investigators

• Martin Fortin, MD, M.Sc. · Université de Sherbrooke

Study Design

Allocation

NON_RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

FACTORIAL

Eligibility

Min Age

18 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2011-02-28

Primary Completion

2012-07-31

Completion

2013-11-30

Countries

• Canada

Study Locations