CORE Faculty

Slanay skwalwin: Developing foraging walks with Squamish Nation to promote Indigenous women's heart health

A community-based participatory action research with Squamish Nation Elders and community members. The first of eight Sharing Circles will be held in March 2022 using Zoom, facilitated by Elders Latash Nahanee and Elder Roberta Price, PhD from the Squamish Nation.

Multiple social tie transitions and their impact on cardiometabolic risk factors in aging women and men (MORE)

A CIHR project grant for three years to quantify the longitudinal associations between different social ties and CVD risk factors such as obesity and hypertension. It will use secondary data analysis of the repeated measures from the Canadian Longitudinal Study on Aging (CLSA) and apply a gender-based analysis framework.

Social connectedness, life transitions, gender and eating habits: longitudinal study of a Canadian aging cohort

A SSHRC insight development grant for two years to map the trends and patterns of transitions in social ties among aging adults, and their linkages to healthy food habits, using a gender perspective. This research draws on robust data from the Canadian Longitudinal Study on Aging (CLSA).

Pediatric Spinal Cord Injury Epidemiology

This research portfolio is being led by CORE postdoctoral Dr. James Crispo, Michael Smith Health Research BC Trainee Award 2021: (https://www.msfhr.org/1/award/paediatric-spinal-cord-injury-in-canada-u…)

A spinal cord injury (SCI) is defined as damage to the spinal cord that results from traumatic (e.g. motor vehicle accidents or falls) or non-traumatic (e.g. spina bifida or tumour diagnosis) causes. Children with SCI often require extensive medical follow-up and rehabilitation, and are at increased risk of adverse health effects (such as bladder issues, respiratory and cardiovascular disorders, and death) compared to children without SCI. Despite presumed increases in the number of Canadian children living with SCI over time, little is actually known about paediatric SCI in Canada. Using electronic health data from British Columbia and Ontario and health analytics, our proposed research aims to address existing SCI knowledge gaps by 1) developing national case definitions for traumatic and non-traumatic paediatric SCI, 2) estimating the number of Canadian children living with SCI, and 3) increasing understanding of long-term health outcomes and healthcare utilization among children with SCI. Findings from this research will, for the first time, describe paediatric SCI in Canada, identify paediatric populations most at risk of SCI, and identify opportunities to improve paediatric SCI care in British Columbia and across Canada.

In the shadows of the opioid crisis: the epidemiology and impact of methamphetamine use in Canada

Methamphetamines are potent stimulants with significant health and societal consequences. In the United States, amphetamine-related hospitalizations have recently tripled following a brief period of decline. In Canada, anecdotal reports have noted similar trends, but surprisingly little research has been conducted to assess the purported increase in the use of the drug. Of special importance is the lack of nationwide epidemiological data. Given this growing concern and the paucity of research on the topic, our work will investigate trends in methamphetamine use in Canada. Specifically, we will examine geographic, sociodemographic, and temporal trends of methamphetamine use, as well as trends in polysubstance abuse. We will also quantify corresponding health care utilization and hospital costs to understand the national economic impact. Our study will use a nationally representative Canadian cohort, which will provide the most comprehensive and up to date figures of epidemiological trends on methamphetamine use in Canada. In order to lay the groundwork for successful interventions at all levels (including treatment, harm reduction, and at the levels of health service systems), epidemiological studies using large, current, and representative samples are urgently needed.

Fostering Science: a mentoring program to empower youth in care in British Columbia

Fostering Science is a new program that introduces youth in or from care (eg. foster care, group homes) in the Province of British Columbia (BC) to the wonders of science. It is designed and run by a group of scientists who are passionate about science and youth, in partnership with the Federation of BC Youth in Care Networks and the Science Fair Foundation BC. The program includes an orientation camp and mentorship program, with the opportunity to present at regional science fairs throughout BC. The overall goal of the program is to foster a passion for science, and the program will ideally encourage youth in or from care, who are currently an underrepresented group in universities and colleges in BC, to pursue undergraduate degrees and careers in science and engineering.

Mapping the epidemiology and the role of treatments in mental health complications in inflammatory arthritis (MATTERS)

Arthritis is a very painful condition that affects almost 1 million Canadians. The goal of this project is to study mental health in arthritis, an understudied issue despite the complex relationship between arthritis and psychiatric conditions. We will use “big data” in BC, which links all health data on doctor visits, hospitalizations, and prescriptions for the entire population.  We will evaluate whether the number of people newly diagnosed with arthritis who also have depression and/or anxiety has increased over time. We will also evaluate the onset of depression and anxiety after diagnosis of arthritis, including when it occurs and associated factors. We will study how depression and anxiety are treated among people with arthritis and whether medications (biologics) for arthritis may reduce the risk of depression and anxiety.  This will be the first study of its kind in Canada on mental health in arthritis.  A better understanding of mental health complications will help improve care for arthritis and bring awareness to the equal importance of mental health to physical health.

The Lifetime Exposures and Asthma outcomes Projection (LEAP) model

The objective of this project is to develop a reference policy model of asthma for Canada, which we will use to evaluate a wide range of strategies for early intervention and prevention, with a focus on the impact of reducing exposure to outdoor air pollution. LEAP will be a ‘whole disease’ microsimulation model of asthma, meaning it tracks the lifetime course in individuals, beginning with incidence in the general Canadian population. Our work involves generating evidence from a variety of data sources, including administrative health databases, clinical studies, and climate modelling, and is supported by an interdisciplinary team of clinicians, environmental epidemiologists, and modelers. We work closely with Legacy for Airway Health and the Peer Models Network for patient engagement and knowledge translation.

Population-Based Study to Determine the Appropriateness of Antibiotic Use for Primary Care in British Columbia and Ontario Using Administrative Data

In this study, we use large healthcare databases from two Canadian provinces, British Columbia and Ontario, to understand how often patients incorrectly receive prescriptions for antibiotics. This is done by looking at characteristics of the patients, the disease and the prescribing doctor. This information will help us determine how we can better educate patients and doctors about correct use of antibiotics. Finally, we will determine what the effect of these incorrect prescriptions is on patients, in terms of more side effects or hospital admissions. Overall, we aim to contribute to appropriate use of antibiotics in primary care across Canada, where the correct choice of drugs, dose, and duration of antibiotic therapy is imperative to safeguard the healing power of these important drugs.

New insights from patients’ anticoagulant use patterns to better prevent strokes in atrial fibrillation

Atrial fibrillation (Afib) is a common type of irregular heartbeat that affects more than half a million Canadians. Patients with Afib are at much higher risk of stroke than those without Afib. Stroke can lead to disability or death, so it is crucial to prevent it in those at risk. A group of medications called oral anticoagulants (OACs) are very effective for preventing stroke in Afib patients, but they can’t work if they are not taken reliably, a concept called “adherence”. Our goal is to gain a better understanding of the complexities of adherence to find effective ways to help patients be more adherent to OACs, and thereby prevent the serious consequences of Afib, including stroke, death, and hospitalization. Two extremely promising areas for making such discoveries are: finding the cut-off points (“thresholds”) below which nonadherence leads to serious outcomes, and 2) measuring the clinical consequences of various long-term patterns (“trajectories”) of adherence that patients exhibit.

To do this, we are using health data (e.g., prescriptions, physician billing records, hospital records) of all Afib patients in British Columbia since 2010 when newer OACs became available. We are studying their OAC adherence to see what thresholds are most important for predicting serious outcomes. We are also studying how different trajectories of adherence affect the rate of serious outcomes. Our research team includes clinicians and researchers with extensive experience working with patients with AF and doing this type of research with large population-level databases.

The results of this research will help care providers, researchers, and policymakers better identify which patients are at highest risk and could benefit the most from improving their OAC adherence, design more effective programs to help patients be more adherent to their OACs, implement policies that provide the greatest benefit for patients, and do better research about all these issues in the future.

Learn more about Dr. Loewen's work at https://peterloewen.com.

Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo)

https://mssociety.ca/about-ms-research/about-our-research-program/research-we-fund/11/canadian-prospective-cohort-study-to-understand-progression-in-ms-canproco

Project Description:

The over-arching objective of establishing the CANadian PROspective COhort Study for People Living with MS (CanProCo) is to better understand progression in MS using scientific methods from many different fields, with the ultimate hope of improving the lives of people living with MS. The research team aims to achieve this goal by assembling a carefully-selected group of people living with MS with different subtypes of the disease, and in different disease stages, and following them over time for at least five years. The information collected by the CanProCo project has the potential to provide an in-depth understanding of both how progression in MS starts, and why progression takes place more rapidly in some patients versus others. One of the most innovative aspects of CanProCo is that this study will be collecting data spanning the fields of epidemiology, health outcomes, health economics, health services utilization, advanced and conventional neuroimaging, and neuroimmunology. By collecting detailed data from such different fields of study, the team expects to gain insight into various factors that contribute to progression in MS, starting from the underlying biology of the disease extending all the way to evaluating how patient, treatment, disease subtype, environmental, and health systems factors interact to impact progression in MS. Bringing together these different fields of study will be a powerful way to assess many different aspects of progression in MS, and will result in a better understanding of biological mechanisms of progression, identification of risk factors (environmental, clinical, health systems) for progression, and developing markers that can assist in patient care, including markers that can better predict how people will do over time. All of these insights have the potential to improve how patients are cared for in the clinic and to improve health policies that impact people living with MS.

Potential Impact: The knowledge gained from this endeavor will lay the foundation for better treatment strategies and will inform future research, which will ultimately result in better health outcomes and quality of life of people living with MS.

The IMPACT STUDY

https://resp.core.ubc.ca/research/Specific_Projects/IMPACT

Pharmacist-led intervention for Optimal Heart Failure Medications: A pilot randomized controlled trial (PHARM Optimal-HF Pilot)

Medication information needs and decisional preferences of people living with heart failure.

Evaluation for the Pharmacists in Primary Care Network (PCN) Program

The evaluation for the Pharmacists in Primary Care Network (PCN) Program will explore the implementation outcomes as well as quality of care outcomes of integrating Primary Care Clinical Pharmacists into team-case primary cares in PCNs across the province over the period of 2020-23.