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May 2020

Maintaining Regular Primary Care Practice

Introduction

Navigate through patient care in a world where COVID-19 is the “new normal.” Use this resource to provide day-to-day care in a familiar but different environment. From child mental health to opioid use disorder and other conditions, this interactive resource covers topics providers see with their patients every day while considering present-day obstacles due to COVID-19.

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Information

About the tool

This resource is part of the CEP's COVID-19 Resource Centre. For each of the resources, the CEP actively pulls together, rethinks and translates the latest information so family physicians and primary care nurse practitioners can make confident decisions in their practice.

The COVID-19 Resource Centre is intended for family physicians and primary care nurse practitioners in Ontario. It is revised often and new content is added regularly to guarantee that the latest evidence and regulatory recommendations are included. The CEP is committed to ensuring this information is accurate and up to date.

The COVID-19 Resource Centre was developed by the Centre for Effective Practice (CEP) in collaboration with the Department of Family Medicine at McMaster University, the Ontario College of Family Physicians and the Nurse Practitioners’ Association of Ontario using a rapidly modified version of the CEP’s integrated knowledge translation approach. They are some of several clinical resources developed as part of the Knowledge Translation in Primary Care Initiative. Funded by the Ministry of Health and Long-Term Care, this initiative supports primary care providers with the development of a series of clinical tools and health information resources. Learn more about the Knowledge Translation in Primary Care Initiative.

CEP's COVID-19 evidence inclusion/exclusion criteria

CEP’s standard inclusion criteria for evidence is Clinical Practice Guidelines (CPGs) and systematic reviews that pass an AGREE/AMSTAR quality assessment, published within the previous five years from search date. By their nature, systematic reviews are more likely to convey the strength of evidence than individual studies, and high-quality CPGs provide a more comprehensive picture of a clinical area or question than individual studies.

However, due to the rapidly developing COVID-19 information landscape and the incidence of individual studies being reported in the news and shared on social media on a daily basis, CEP will include certain single studies in our COVID-19 Resource Centre, in order to keep Ontario primary care physicians and nurse practitioners informed about the evolving evidence. Our dedication to providing the highest-quality evidence available has not changed but given the pace of research on COVID-19, it is not feasible for us to critically review individual studies. We have set the following inclusion/exclusion criteria to enable readers to understand what research will and will not be incorporated into the resource.

Inclusion

  • Peer-reviewed individual studies, when their inclusion will not confuse or mislead primary care providers about what constitutes validated, evidence-based care. Contextual information about study limitations will be provided for all Emerging Evidence sections.
  • Systematic reviews and rapid guidelines that pass AGREE/AMSTAR criteria.

Exclusion

  • Non-peer-reviewed studies. This includes preprints, original manuscripts, blogs of academic journals, and Letters to the Editor in many academic journals. Once preprint articles and manuscripts are peer-reviewed they will be eligible for inclusion.

For more information on the hierarchy of evidence and study limitations, see The Centre for Evidence-Based Medicine.

Clinical Lead

  • Dr. Derelie Mangin

    MBCHB (OTAGO), DPH (OTAGO), FRNZCGP (NZ)

    Dr. Dee Mangin is a family physician and the David Braley Chair in Family Medicine at McMaster University. She is also the Associate Chair (Research), and Professor in the Department of Family Medicine at McMaster.  She is the Director of MUSIC, the McMaster University Sentinel and Information Collaboration practice-based research network. Dr. Mangin received the Donald I Rice award from The College of Family Physicians of Canada (CFPC) in 2018 for contributions to teaching and leadership in the discipline of family medicine. Dr. Mangin’s research interests are: rational prescribing, innovative models of primary care service delivery, and the influences of science, policy and commerce on the nature of care.

Clinical working group

A clinical working group was established and provides significant input and oversight into the development of this toolkit. Members include:

  • Claudia Mariano, MSc, NP-PHC
  • Darren Larsen, MD, CCFP, MPLc
  • Dominik Nowak, MD, MHSc, CCFP, CHE
  • Jennifer P. Young, MD, FCFP-EM
  • Mira Backo-Shannon, MD, BSc, MHSc
  • Paul Preston, MD, CCFP, CCPE, CHE
  • Rob Annis, MD, CCFP
  • Soreya Dhanji, MD, CCFP

Other providers' feedback

In addition to our clinical working group, the CEP has also obtained feedback from others including:

  • Arun Radhakrishnan, MSC, MD, CM, CCFP
  • David Price, BSC, MD, CCFP, FCFP
  • Jose Silveira, BSC, MD, FRCPC, DIP, ABAM
  • Michael Chang MD, FRCP(C)
  • Payal Agarwal, MD, CCFP
  • Robert Sauls MD, CCFP(PC), FCFP
  • Tara Walton, MPH

Thank you

Thank you to everyone who supported the development of these resources!


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