Patient-Centred Innovations for Persons With Multimorbidity - Ontario

NACompletedINTERVENTIONAL
Enrollment

175

Participants

Timeline

Start Date

January 12, 2016

Primary Completion Date

April 7, 2019

Study Completion Date

October 19, 2022

Conditions
HypertensionDepressionAnxietyMusculoskeletal PainArthritisRheumatoid ArthritisOsteoporosisChronic Obstructive Pulmonary Disease (COPD)AsthmaChronic BronchitisCardiovascular DiseaseHeart FailureStrokeTransient Ischemic AttacksUlcerGastroesophageal RefluxIrritable BowelCrohn's DiseaseUlcerative ColitisDiverticulosisChronic HepatitisDiabetesThyroid DisorderCancerKidney DiseaseUrinary Tract ProblemDementiaAlzheimer's DiseaseHyperlipidemiaHIVMultimorbidity
Interventions
BEHAVIORAL

TIP / IMPACT Plus Care Coordination

The intervention will involve the patient attending an interdisciplinary team meeting, either through the Ontario Telemedicine Network's teleconferencing technology or in person, along with their caregiver(s), the referring practitioner, inter-professional (IP) teams and home care coordinators to discuss and uncover the patient's condition covering a diverse range of medical, functional and psycho-social issues and the development of a patient-centred treatment plan. The care plans are documented, shared, implemented and monitored by an assigned nurse from the program.

Trial Locations (9)

N6A 3K7

Western University, London

Unknown

Mount Sinai Hospital, Toronto

Providence Healthcare, Toronto

St. Michael's Hospital, Toronto

Sunnybrook Health Sciences Centre, Toronto

Toronto Central Community Care Access Centre, Toronto

Toronto East General Hospital, Toronto

University Hospital Network, Toronto

Women's College Hospital, Toronto

All Listed Sponsors
collaborator

Western University, Canada

OTHER

collaborator

Université de Sherbrooke

OTHER

collaborator

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

collaborator

Sunnybrook Health Sciences Centre

OTHER

collaborator

Unity Health Toronto

OTHER

collaborator

University Health Network, Toronto

OTHER

collaborator

Michael Garron Hospital

OTHER

collaborator

Providence Healthcare

OTHER

collaborator

Mount Sinai Hospital, Canada

OTHER

collaborator

Toronto Central Community Care Access Centre

OTHER

collaborator

Women's College Hospital

OTHER

lead

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

NCT02742597 - Patient-Centred Innovations for Persons With Multimorbidity - Ontario | Biotech Hunter | Biotech Hunter