Public Health Commons^™

Sleep And Multimorbidity In The Canadian Longitudinal Study On Aging, Shreni Patel

Electronic Thesis and Dissertation Repository

Sleep health is a latent construct comprising various sleep measures such as duration, quality, initiation, maintenance, and daytime sleepiness. This thesis compared the association of two measures of sleep health, a conventional summary score and a pooled index, with incident multimorbidity over a 3-year follow-up in 30,097 middle- to older-aged adults from the Canadian Longitudinal Study on Aging. At baseline, approximately 26% and 29% of participants with multimorbidity displayed poor sleep patterns according to additive and pooled indexing methods. Longitudinal analysis indicated that those with additive scores of 4 to 5 at baseline had a 1.54 (95% CI: 1.18, 2.03) …

Chronic Disease Risk Prediction Models And Their Impacts On Behavioural And Health Outcomes: A Systematic Review And Meta-Analysis, Patrick Kim

Electronic Thesis and Dissertation Repository

Risk prediction models are tools that predict an individual’s risk of developing a health outcome. They were developed to influence patient management by guiding preventive interventions, with the goal of reducing the incidence of new diseases. Studies examining their impacts are uncommon, and no consensus regarding their effects has been reached. This systematic review sought to determine the impact of risk prediction models for chronic diseases on physician behaviour, patient behaviour, and patient health outcomes. Twenty-two studies were found to be eligible for review. The results demonstrated that: 1) physician behaviour may be positively influenced, though a statistically significant result …

Multimorbidity Among Adult Primary Health Care Patients In Canada: Examining Multiple Chronic Diseases Using An Electronic Medical Record Database, Kathryn Nicholson

Electronic Thesis and Dissertation Repository

Introduction: The coexistence of multiple chronic diseases within an individual, also known as multimorbidity, is an ongoing challenge for patients, caregivers and primary health care (PHC) providers. An enhanced understanding of the burden of multimorbidity in Canada is needed.

Objectives: This research had two main objectives. Objective One aimed to understand the prevalence of multimorbidity among adult PHC patients, as well as the patterns of unordered and ordered clusters of multiple chronic diseases. Objective Two aimed to determine the natural progression of multimorbidity over time, as well as the patient-, provider- and practice-level predictors of progressing into more complex clinical …