Projects and Publications
Current Research Projects
- Decision-Making Capacity Assessment (DMCA) Education
Funder: Northern Alberta Academic Family Medicine Fund
Project Leads: Lesley Charles, MBChB, CCFP(COE) − Project Lead; Jasneet Parmar, MBBS; Suzette Brémault-Phillips, PhD; Ashley Pike, PhD; Tara Kilkenny, MSc; Melissa Johnson, MSc; Bonnie Dobbs, PhD; Peter Tian, MD, MPH
Award: $5,000
Dates: September, 2018 - August, 2019
Background
With an increasing elderly population, the number of persons with dementia is expected to increase. Consequently, the number of persons needing decision-making capacity assessments (DMCA) will increase. Many health care professionals do not feel ready to provide DMCA. Since 2006 we have been training allied HCPs and since 2013, we have been training physicians on DMCA. Allied HCPs are offered a 4-hour workshop. Physicians are offered a 3-hour workshop or 2-day training accredited by both the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada. We have accumulated significant data from pre-questionnaires, post questionnaires on core concepts of capacity and evaluations.
Objectives:
1. Quantitatively analyze the pre-questionnaires, and post-questionnaires for allied HCPs (n=822, physicians 3-hour workshop (n=137 ) and physicians 2-day workshop (n=80)
2. Qualitatively analyze the evaluations for physiciansMethodology:
1. Review the current literature on DMCA education
2. Quantitatively and qualitatively analyze the pre/post questionnaire and evaluations.
Previously Funded Research Projects
- Assessment of Decision-Making Capacity in Adults with Diseases and Disabilities: Is the Decision-Making Capacity Assessment Model Appropriate for Alberta?
Funder: Alberta Health Services
Award: $25,000
Dates: February - March 2012
Project Leads: Suzette, Jasneet
Report:
Brémault-Phillips, S., Parmar, J. et. al (July, 2012). Assessment of Decision-Making Capacity in Adults with Diseases and Disabilities: Is the Decision-Making Capacity Assessment Model Appropriate for Alberta? A Project Funded by Alberta Health Services, February - March, 2012; see http://hdl.handle.net/10402/era.38855
- Creation of a Customized Tool to Facilitate Confidence and Ease in Decision-Making Capacity Assessments among Family Physicians: A Pilot Study
Funder: Northern Alberta Academic Family Medicine Fund Committee
Award: $4,917
Project dates: August 1, 2014 - January 31, 2017
Background
Since 2006, we have been conducting workshops on decision-making capacity assessments (DMCA) to healthcare providers in Alberta. We hoped to make DMCA more accessible to families, precluding the need for time-consuming referrals. However, the number of family physicians who attended the workshops have been low. This is ironic since family physicians, having developed long-standing physician-patient relationships, would be most informed in making these assessments. A reason for this could be a lack of confidence among family physicians to do DMCA and the relatively infrequent DMCAs in family practice. Our innovative idea is to make DMCA simple, systematic, and equipped with memory aids.
Objectives
We will customize the DMCA tool to the needs of family physicians with the aim of increasing family physicians' confidence and willingness to perform DMCA in their practice. It is anticipated that the tool for family physicians could be spread nationwide and be adapted across specialties.
Methodology
- Conduct a needs assessment through a focus group among family physicians
- Perform a literature review on DMCA practice among physicians
- Customize the DMCA tool based on the needs assessment and literature review
- Present the above to Alberta College of Family Physicians (ACFP), Alberta Medical Association (AMA), and College of Physicians and Surgeons of Alberta (CPSA) to facilitate a provincial-wide feedback on the DMCA tool.
- Decision Making Capacity Assessment (DMCA) Model: Development and Evaluation of a DMCA Model Implementation and Sustainability Framework
Funder: Covenant Health, Network of Excellence in Seniors' Health and Wellness (NESHW)
Award: $200,000
Dates: January 1, 2015 - March 31, 2018
Objective:
Given the provincial endorsement of the DMCA Model, a Framework is now needed to support sites and organizations within and outside of Alberta to adopt, implement, sustain, and spread the Model.
This project aims to:
- Develop a DMCA Model Implementation and Sustainability Framework based on the experience of those who have both implemented and made efforts to sustain it.
- Evaluate the impact of the Frameworks both at sites that have not as yet adopted the model, and those that are making efforts to sustain it.
Methodology:
This project will utilize a mixed qualitative/quantitative approach in 3 phases:
- Framework Definition and Design (1-4 months)
- Intervention (5-7 months)
- Evaluation and Knowledge Translation (8-12 months)
Publications and Presentations
- DMCA Process - General
Publications
Charles, L., Torti, J., Parmar, J., Brémault-Phillips, S. Tian, G. (2018). A primary care network-based clinical pathway for decision-making capacity assessment. Canadian Family Physician (under review)
Brémault-Phillips, S., Pike, A., Charles, L., Roduta-Roberts, M., Mitra, A., Friesen, S., Moulton, L., Parmar, J., (2018). Facilitating implementation of the Decision-Making Capacity Assessment (DMCA) Model: senior leadership perspectives on the use of the National Implementation Research Network (NIRN) Model and frameworks, BMC ResearchNote, 11:607, 1-10, doi: 10.1186/s13104-018-3714-x; https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-018-3714-x
Brémault-Phillips, S., Parmar, J., Friesen, S., Rogers, L.G., *Pike, A., Sluggett, B. (2016). An Evaluation of the Decision-Making Capacity Assessment Model, Canadian Geriatrics Journal, 19(3), 83-96. doi:http://dx.doi.org/10.5770/cgj.19.222
Parmar, J., Brémault-Phillips, S., Charles, L. (2015). The Development and Implementation of a Decision-Making Capacity Assessment Model; Canadian Geriatrics Journal, 18(1): 15-28; doi: 10.5770/cgj.18.142 Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376225/pdf/cgj-18-15.pdf
Brémault-Phillips, S., Parmar , J. et. al (July 2012). Assessment of Decision-Making Capacity in Adults with Diseases and Disabilities: Is the Decision-Making Capacity Assessment Model Appropriate for Alberta? A Project Funded by Alberta Health Services, February - March, 2012; see http://hdl.handle.net/10402/era.38855
Poster Presentations
Brémault-Phillips, S., Pike, A.,* Charles, L., Roduta-Roberts, M., Mitra, A., Friesen, S., Moulton, L., Weis, J. Poster presentation: Identifying an implementation, spread and sustainability framework of the Decision-Making Capacity Assessment (DMCA) Model through key stakeholder and community engagement, Margaret Scott Wright Research Day 2017, Edmonton, AB, November 3, 2017.
Brémault-Phillips, S., Pike, A.,* Charles, L., Roduta-Roberts, M., Mitra, A., Friesen, S., Moulton, L., Weis, J. Poster presentation: Key stakeholder and community engagement: Identifying an implementation framework to facilitate the spread and sustainability of the Decision-Making Capacity Assessment (DMCA) Model, Integrative Health Institute 2017 Conference, Edmonton, AB, October 27, 2017.
Brémault-Phillips, S., Pike, A., Charles, L., Roduta-Roberts, M., Mitra, A., Friesen, S., Sluggett, B., Moulton, L., Weis, J. (2017). Poster Presentation: Key stakeholder and community engagement in the spread and sustainability of the Decision-Making Capacity Assessment (DMCA) Model. Covenant Health Research Day, Edmonton, AB, February 7, 2017.
DMCA Model Information Banner, 2016
The "Provincialization" of the Covenant Health Decision Making Capacity (DMC) Model - Canadian Geriatrics Society Conference, 2013, April, 2013
Powerpoint Presentations
Brémault-Phillips, S., Parmar, J., Friesen, S., Pike, A., Sluggett, B. Oral presentation: DMCA 2: Key Learnings: An Evaluation of a Decision-Making Capacity Assessment Model, Margaret Scott Wright Research Day 2017, Edmonton, AB, November 3, 2017.
- DMCA Process - Physician Specific
Publications
Charles, L., Parmar, J., Brémault-Phillips, S. (co-lead author), Dobbs, B., Sacrey, L.A., Sluggett, B. (2017). Physician education on decision-making capacity assessment: Current state and future directions, Canadian Family Physician, 63: e21-e30. http://www.cfp.ca/content/63/1/e21.full.pdf+html?sid=5217d7ba-97d3-4b72-ab30-ff1ee6c356f9
Charles, L., Parmar, J., Dobbs, B.M., Brémault-Phillips, S., Babenko, O., Tian, P. (2017). Decision-Making Capacity assessment (DMCA) Training for Physicians. Innovations in Aging, 1(S1): 203. https://academic.oup.com/innovateage/article/1/suppl_1/203/3902693
Charles, L., Parmar, J., Dobbs, B, Brémault-Phillips, S. (co-lead author), Babenko, O., Triscott J., Tian, P. (2015). Decision-Making Capacity Assessment (DMCA) Training for Family Physicians [conference abstract]. Canadian Geriatrics Journal 18(3): 195.
Poster Presentations
Parmar, J., Charles, L., Brémault-Phillips, S., Dobbs, B., Babenko, O., Tian, P. Poster presentation: Decision-Making Capacity Assessments (DMCA) Training for Physicians, Family Medicine Forum, Montréal, QC, November 8-11, 2017.
Charles, L., Parmar, J., Dobbs, BM, Brémault-Phillips, S., Babenko, O., Tian, P. Poster presentation: Decision-Making Capacity Assessment (DMCA) training for Physicians. 21st IAGG (International Association of Gerontology and Geriatrics) World Congress of Gerontology and Geriatrics, San Francisco, CA, July 23-27, 2017.
Decision-Making Capacity Assessment Training for Physicians - NAPCRG 2014
Powerpoint Presentations
Geriatric Update - Capacity Challenges - September 2015
Decision-Making Capacity Assessment (DMCA) Training for Physicians - ASA, February, 2015