The Canadian Task Force on Preventive Health Care (CTFPHC) is composed of experts who develop recommendations for clinical preventive services delivered by Canadian primary care practitioners. The CTFPHC is responsible for prioritizing the topics that will be reviewed and works with the Global Health and Guidelines Division (GHGD) of the Public Health Agency of Canada to define the analytic framework and scope of each topic. In the preparation of evidence reviews and the development of recommendations for each topic, the CTFPHC collaborates with two evidence review and synthesis centres and the GHGD. The CTFPHC also leads knowledge translation (KT) activities to promote guideline reach and uptake.
Message From the Chair
Greetings! In this issue, I am pleased to share information about a number of activities that took place this fall, which were done to help clinicians better understand and implement CTFPHC guidelines. This fall the CTFPHC hosted a booth at three conferences: Congrès annuel de médecine, Family Medicine Forum, and Practising Wisely Day. Each conference event was a success, and the CTFPHC disseminated thousands of KT Tools.
The CTFPHC has launched an article series, Prevention in Practice, in the Canadian Family Physician. Thanks to Neil Bell, who has coordinated this project, and to other past and present CTFPHC members who have contributed.
Also in the Canadian Family Physician, CTFPHC members have published an article, “Periodic preventive health visits: Providing a more appropriate approach to delivering preventive services”, which encourages family doctors to focus on preventive health visits and to move away from providing non-specific annual checkups. See below to access and learn more about this article. Other exciting news involves the Continuing Medical Education modules offered by the CTFPHC on Obesity Prevention and Management and Screening for Cervical Cancer – see below for more information.
In additional exciting news, the CTFPHC is offering an Internship Program. The CTFPHC is committed to providing mentored training opportunities to Canadian healthcare trainees and early career professionals. Opportunities for CTFPHC Interns include short-term training opportunities and longer-term internships. For more information, see below and/or visit our website.
Since our last newsletter, the CTFPHC began the 2-year pilot initiative of the Clinical Prevention Leaders Network, which is a research study aimed at developing and evaluating a network of Canadian clinical prevention leaders (CPLs), with expertise in CTFPHC guideline development and implementation. The purpose of this network will be to promote the uptake of evidence-based guidelines and to address barriers to guideline implementation at a local level through educational outreach and other KT activities. For more information, see below and/or visit our website.
This is my first newsletter as chair of the CTFPHC. I look forward to working with the CTFPHC members to continue the outstanding work that was done under the leadership of Dr. Marcello Tonelli. I also look forward to working with our CTFPHC partners, including the Public Health Agency of Canada Global Health and Guidelines Division, Evidence Synthesis and Review Centres from the University of Ottawa and the University of Alberta, and the Knowledge Translation Program at St. Michael’s Hospital in Toronto. The CTFPHC is keen to expand and strengthen our relationships with our stakeholders, including Canada’s family physicians. Please do not hesitate to contact me with ideas that you may have for the CTFPHC or if you are interested in joining our team.
As always, we appreciate your interest in the CTFPHC and we encourage you to stay up to date on our work by visiting our website at www.canadiantaskforce.ca.
Sincerely,
Brett Thombs, PhD
Chair, CTFPHC
Conferences
Attending key conferences is an important component of the CTFPHC’s strategy to ensure that practitioners have the opportunity to learn about the CTPFHC, our clinical practice guidelines, and other activities while directly accessing our KT tools and other resources. This year the CTFPHC attended the Congrès annuel de médecine, Family Medicine Forum, and Practising Wisely Day.
Congrès annuel de médecine 2017
The CTFPHC exhibited at the 2017 Congrès annuel de médecine hosted by the Médecins francophones du Canada from October 25 to 26, 2017 in Montreal, Quebec. The Médecins francophones du Canada represents Canada’s French-speaking physicians and their annual conference attracts hundreds of physicians and other health care professionals, including those working in family medicine. The CTFPHC disseminated hundreds of our French KT tools and had great conversations with those who attended the conference.
Click here for more information about this conference.
Family Medicine Forum 2017
The CTFPHC also exhibited at the Family Medicine Forum from November 9 to 11, 2017. Hosted by the College of Family Physicians of Canada, the conference took place in Montreal, Quebec. Thousands of delegates attended the conference this year, including primary care practitioners, residents, medical students, physician assistants, and nurse practitioners. The CTFPHC distributed around 8000 KT tools, including our most recently published tools on prevention and treatment of tobacco smoking in children and adolescents, screening for hepatitis C, and screening for abdominal aortic aneurysm. The soon-to-be- released CTFPHC animated lung cancer screening video was also previewed at our booth. Members and alumni of the CTFPHC also presented a session on “Better Decision Making with Patients on the Harms and Benefits of Preventive Screening”.
Click here for more information about this conference.
Practising Wisely Day
For the first time, the CTFPHC was invited to exhibit at Practising Wisely Day hosted by the Ontario College of Family Physicians on November 22, 2017 in Toronto, Ontario. Over 100 primary care providers attended this pre-conference event and learned about how to “practise wisely” with a focus on strategies to reduce unnecessary testing and treatment. The CTFPHC’s KT tools were popular among attendees.
Click here for more information about this conference.
Canadian Family Physician
NEW – Periodic Preventive Health Visits: A more appropriate approach to delivering preventive services
In a new article published in the Canadian Family Physician, the CTFPHC reiterated its stance that the annual checkup should be replaced by focused age-appropriate health prevention activities.
The traditional annual physical examination of asymptomatic adults is not supported by evidence of effectiveness and may result in harm. There is better value in a periodic (i.e., according to age, risk, and specific test intervals) preventive visits to provide preventive counseling and screening tests proven to be of benefit.
An annual physical examination of asymptomatic adults typically includes a review of the patient’s health history, medications, allergies, and organ systems, and a complete physical examination that may be followed by laboratory testing and discussion of health risks, life style behaviour, and social situation. A systematic review of 14 randomized controlled trials (RCTs) indicated that these general checkups do not reduce total mortality, cardiovascular mortality, or cancer mortality.
In comparison, a periodic preventive health visit of asymptomatic adults involves scheduling visits based on the age, sex, and health conditions of the individual to provide preventive counseling, immunization, and known effective screening tests. A meta- analysis of 19 trials on periodic preventive health visits among people older than 65 years indicated a decrease in mortality and increase in their likelihood of living independently in the community. This approach allows for a more detailed discussion of the benefits and risks of screening and a shared decision making approach in the context of each patient’s particular circumstances.
The full article can be found in the November Issue of Canadian Family Physician.
Prevention in Practice Article Series
The CTFPHC is pleased to present the article series, Prevention in Practice, which appears in the Canadian Family Physician. This series is intended to equip primary care providers with strategies on how to implement preventive health evidence into their work and engage in shared, informed decision making.
The article series covers topics such as communicating the balance between benefits and harms; shared decision making; measures of outcome and effect size; assessing guidelines, eliciting patient values and preferences; and KT tools.
Access the first four parts of the series here:
- Introduction
- Better decision making in preventive health screening: Balancing benefits and harms
- Shared decision making in preventive health care: What it is; what it is not
- Knowledge Translation tools in preventive health care
Continuing Medical Education
The Obesity Prevention and Management e-learning module
The Obesity Prevention and Management e-learning module, developed by the Centre for Effective Practice (CEP), expands on the CTFPHC’s 2015 guidelines on the prevention and management of obesity in adults and in youth and children. The module is intended to help primary care providers better understand the impact of obesity on patients; explains
measures for assessing and monitoring obesity in adults, youth, and children; and provides an overview of behavioural and pharmacotherapeutic interventions available to patients.
This Self-Learning program has been certified by the College of Family Physicians of Canada for up to 1 Mainpro+ credits.
Screening for Cervical Cancer e-learning module
The CTFPHC is pleased to offer the accredited e-learning module “Screening for Cervical Cancer with the 2013 Canadian Task Force on Preventive Health Care (CTFPHC) Guidelines.”
This e-learning module represents a unique learning opportunity for primary care providers to develop a deeper understanding of the 2013 CTFPHC guidelines on cervical cancer screening (the previous guidelines were released in 1994) and some of the nuances of how they can be applied in clinical practice.
This Self-Learning program has been certified by the College of Family Physicians of Canada for up to 1 Mainpro+ credits.
Annual Evaluation
The CTFPHC invites you to participate in our 2017 annual evaluation! Our evaluation seeks to measure the impact and uptake of our guidelines and tools, and to identify new opportunities for the CTFPHC. We would love to get your input! Please participate in the evaluation by:
- Completing an online survey for a chance to win an iPad; or
- Completing an online survey and participating in a telephone interview for $100 compensation
For more information, please visit our website or email Rossella Scoleri, Research Assistant, at scolerir@smh.ca with the subject line “Annual Evaluation 2017”.
We look forward to hearing from you!
Clinical Prevention Leaders Network Update
The Clinical Prevention Leaders Network is a 2-year pilot initiative and research study aimed at developing and evaluating a network of clinical prevention leaders (CPLs), with expertise in CTFPHC guideline development and implementation, across Canada.
The purpose of this network will be to promote the uptake of evidence-based guidelines and to address barriers to guideline implementation at a local level through educational outreach and other KT activities.
As of this month, 13 CPLs have been selected to undergo training before they administer their educational outreach activities. The CPLs are from across Canada (Ontario, Quebec, Manitoba, Alberta, and Saskatchewan) and include physicians, nurse practitioners, residents, and other allied health professionals. CPLs have attended three introductory training sessions covering the scope of the initiative and their roles, the background of the CTFPHC, and the fundamentals of KT.
For more information on this initiative, please contact Danica Buckland (research coordinator) (BucklandD@smh.ca) with the subject line ‘CPL Network’.
Meet the CTFPHC
Dr. Gabriela Lewin – Vice Chair
Hi, my name is Gaby. I have had the privilege to serve as the Vice-Chair of the CTFPHC since October, 2016. I am a family physician from Buenos Aires, Argentina. After graduating from residency, I had the unique opportunity to move to Ottawa, Canada in 2002. While taking my exams to become a licenced doctor in Canada, I worked at the Children’s Hospital of Eastern Ontario Research Institute doing systematic reviews. In 2005, I had the experience of completing a large systematic review for the U.S. Preventive Services Task Force on Aspirin and NSAIDs to prevent colorectal cancer, which became a guideline in 2007. I also conducted about 22 systematic reviews in all sorts of health topics during that time. In 2006, I completed my residency in family medicine at the University of Ottawa and afterwards I started my own clinical practice. At my clinic, I work with a skilled group of family doctors in a rural area outside of Ottawa called Kemptville, Ontario. I have the privilege of seeing patients of all ages (from 0 to over100) in all life stages. I also get the opportunity to do in-patient care at the Kemptville District Hospital. The experience that I gained as a family doctor in Canada and my systematic review background made me a candidate to become a member of the CTFPHC in 2011. Since then, I have been involved in 8 guidelines, including guidelines on breast, cervical, colorectal, and lung cancer screening, which has helped shape clinical practice in Canada and internationally. As a CTFPHC member, I enjoy our face-to-face meetings which allow us to have productive discussions about multiple health topics and methodologies, vote on recommendations, and brainstorm about future topics and dissemination opportunities. We work with an outstanding team of people from the Public Health Agency of Canada, University of Ottawa, University of Alberta, and Knowledge Translation experts from St. Michael’s Hospital in Toronto. As vice-chair of the CTFPHC, my objective is to make our processes more efficient and have a membership that represents Canadians in the best way possible. On a personal note, I am married and have two wonderful children that keep me busy!
Announcements
NEW – CTFPHC Internship Program
The CTFPHC is committed to providing mentored training opportunities to Canadian healthcare trainees and early career professionals. Opportunities for CTFPHC Interns include short-term training opportunities and longer-term internships. Both short-term and longer-term internships involve working closely with a CTFPHC member who will supervise and provide mentorship to the intern.
- Short-term Internships
- Include projects that can be completed in a period consistent with a residency research rotation and could be used to fulfill rotation requirements.
- Longer-term Internships
- Involve a mentored experience working with the Chair of a CTFPHC guideline working group from the initiation of the guideline process through completion.
Eligible applicants include MDs in residency training programs or who are conducting fellowships, trainees in doctoral programs, and practicing healthcare professionals in the first 5 years of their careers.
For more information regarding specific eligibility for short-term and long-term internships and the application procedure, please visit the CTFPHC Internship Program page.
Opportunities for Engagement
Usability Testing of Practitioner Tools
The CTFPHC produces practitioner tools to support each of its guidelines. To ensure that the content, layout, navigation, and aesthetics of these tools are appropriate and useful for practice, we conduct usability testing with practitioners. If you are interested in reviewing and providing feedback on one of our upcoming guideline tools, please email Rossella Scoleri, research assistant, at scolerir@smh.ca for more information.
Note that we offer $100 compensation for a one-hour telephone interview.
Annual Evaluation
We want to hear from you! The CTFPHC conducts an annual evaluation to measure the impact and uptake of our guidelines and tools, and to identify new opportunities for the CTFPHC. We will be seeking feedback in early 2018. For more information, please visit our website or email Rossella Scoleri, Research Assistant, at scolerir@smh.ca with the subject line “Annual Evaluation 2017”.
Patient Engagement in Guideline Development
The CTFPHC engages patients in its guideline development process. Specifically, the CTFPHC recruits patients to provide input at up to three stages of the guideline development process: (1) when outcomes are selected for inclusion in the systematic review protocol; (2) when the final guideline recommendations and KT tools are developed; and (3) when patient KT tools are usability tested. The CTFPHC uses feedback provided by patients to guide the search for evidence on the harms and benefits of preventive health care interventions and to develop KT tools to accompany the guidelines.
Guidelines in Progress
Upcoming CTFPHC clinical practice guidelines will include the following topics:
- Screening for asymptomatic bacteriuria in pregnancy
- Screening for visual acuity
- Screening for esophageal cancer
For more information about these forthcoming guidelines, please visit our upcoming guidelines website page.
Topic Suggestions
Is there a preventive health topic that you would like to see the CTFPHC develop a clinical practice guideline for? Let us know what you are passionate about! We accept topic suggestions on a rolling basis and would love to hear from you. To submit a suggestion, please complete an online form.
Suggestions for the next newsletter
Is there a subject that you would like to see addressed in the next issue of the CTFPHC newsletter? Let us know what you’d like to see covered! We are always accepting suggestions. To submit a suggestion, please email Rossella Scoleri, research assistant, at scolerir@smh.ca with the subject line “Newsletter Suggestions”.