“Primary Care” is the direct provision of first-contact services. Patients first come into contact with primary care professionals without referral by another health practitioner. Family physicians, nurses and pharmacists are the main providers of primary care.
A great majority of patients with chronic diseases such as hypertension, diabetes, asthma, angina pectoris and arthrosis are seen by family physicians in a primary care setting for follow-up. A majority of patients present not one, but often two, three, or even four distinct diseases or chronic conditions at the same time.
As the population ages, the number of such patients is increasing. Conventional medicine does not yet offer any care model tailored to multiple chronic disease patients. Most pharmacological treatments, practice guidelines and educational programs were indeed developed to manage single chronic conditions.
Professor Fortin and his team have shown that multiple chronic diseases are associated with poorer quality of life, greater psychological distress and additional problems due to medication. Certain studies report clear associations between multiple conditions and mortality, longer hospitals stays as well as additional complications and costs for the health system.
In remote regions, this situation is compounded by a lack of resources. Despite efforts, these mostly rural or semi-urban areas often show a considerably reduced workforce in specialized health services. Paradoxically, in a context of limited resources, populations of remote regions should be able to rely on highly performant primary care services.
Despite the great number of people with multiple chronic diseases and the extent of complications that ensue, research is still scarce and the needs are considerable and pressing. The most recent reorganization of health services in Quebec led to the creation of family medicine groups, a unique opportunity to develop interdisciplinary interventions adapted to primary care and multiple chronic diseases.
The research program proposes three complementary themes that will benefit the population and primary care in rural, semi-urban and urban areas as a whole. These themes, each comprising a series of projects, are presented succinctly. (Click on tabs in left-hand side column for brief descriptions)