Malcolm Maclure
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View article: Pragmatic randomised trial assessing the impact of peer comparison and therapeutic recommendations, including repetition, on antibiotic prescribing patterns of family physicians across British Columbia for uncomplicated lower urinary tract infections
Pragmatic randomised trial assessing the impact of peer comparison and therapeutic recommendations, including repetition, on antibiotic prescribing patterns of family physicians across British Columbia for uncomplicated lower urinary tract infections Open
Objective To evaluate the impact of a personalised audit and feedback prescribing report (AF) and brief educational summary (ES) on empiric treatment of uncomplicated lower urinary tract infections (UTIs) by family physicians (FPs). Design…
View article: Characteristics of walk-in clinic physicians and patients in Ontario
Characteristics of walk-in clinic physicians and patients in Ontario Open
Physicians who primarily work in walk-in clinics saw many patients from historically underserved groups and many patients who were attached to another family physician.
View article: Characteristics of Walk-In Clinic Physicians and Patients in Ontario, Canada: A Cross-Sectional Study
Characteristics of Walk-In Clinic Physicians and Patients in Ontario, Canada: A Cross-Sectional Study Open
Objective We aimed to describe family physicians who primarily practice in a walk-in clinic setting and compare them to family physicians who provide longitudinal care. Design A cross-sectional study that linked results from an annual phys…
View article: A cluster randomized trial assessing the impact of personalized prescribing feedback on antibiotic prescribing for uncomplicated acute cystitis to family physicians
A cluster randomized trial assessing the impact of personalized prescribing feedback on antibiotic prescribing for uncomplicated acute cystitis to family physicians Open
Objective To evaluate the impact of personalized prescribing portraits on antibiotic prescribing for treating uncomplicated acute cystitis (UAC) by Family Physicians (FPs). Design Cluster randomized control trial. Setting The intervention …
View article: Up-to-date on cancer screening among Ontario patients seen by walk-in clinic physicians: A retrospective cohort study
Up-to-date on cancer screening among Ontario patients seen by walk-in clinic physicians: A retrospective cohort study Open
Walk-in clinics are typically viewed as high-volume locations for managing acute issues but also may serve as a location for primary care, including cancer screening, for patients without a family physician. In this population-based cohort…
View article: Comparative effectiveness of urine drug screening strategies alongside opioid agonist treatment in British Columbia, Canada: a population-based observational study protocol
Comparative effectiveness of urine drug screening strategies alongside opioid agonist treatment in British Columbia, Canada: a population-based observational study protocol Open
Introduction Urine drug tests (UDTs) are commonly used for monitoring opioid agonist treatment (OAT) responses, supporting the clinical decision for take-home doses and monitoring potential diversion. However, there is limited evidence sup…
View article: Walk-in clinic patient characteristics and utilization patterns in Ontario, Canada: a cross-sectional study
Walk-in clinic patient characteristics and utilization patterns in Ontario, Canada: a cross-sectional study Open
Our findings suggest that proximity of walk-in clinics and after-hours access may be contributing to walk-in clinic use among patients enrolled with a family physician. These findings have implications for policy development to improve the…
View article: Comparative Analysis of Instrumental Variables on the Assignment of Buprenorphine/Naloxone or Methadone for the Treatment of Opioid Use Disorder
Comparative Analysis of Instrumental Variables on the Assignment of Buprenorphine/Naloxone or Methadone for the Treatment of Opioid Use Disorder Open
Background: Instrumental variable (IV) analysis provides an alternative set of identification assumptions in the presence of uncontrolled confounding when attempting to estimate causal effects. Our objective was to evaluate the suitability…
View article: Development and pilot evaluation of an educational session to support sparing opioid prescriptions to opioid naïve patients in a Canadian primary care setting
Development and pilot evaluation of an educational session to support sparing opioid prescriptions to opioid naïve patients in a Canadian primary care setting Open
Background Prescribing rates of some analgesics decreased during the public health crisis. Yet, up to a quarter of opioid-naïve persons prescribed opioids for noncancer pain develop prescription opioid use disorder. We, therefore, sought t…
View article: The case-crossover design for studying sudden events
The case-crossover design for studying sudden events Open
### Key messages > Dan Lewer and colleagues explain how case-crossover studies can help understand triggers of sudden events The case-crossover method is an epidemiological design used for studying potential causes of sudden events,[1][1] …
View article: The Use of Active Comparators in Self-Controlled Designs
The Use of Active Comparators in Self-Controlled Designs Open
For self-controlled studies of medication-related effects, time-varying confounding by indication can occur if the indication varies over time. We describe how active comparators might mitigate such bias, using an empirical example. Approa…
View article: Control yourself: <scp>ISPE‐endorsed</scp> guidance in the application of <scp>self‐controlled</scp> study designs in pharmacoepidemiology
Control yourself: <span>ISPE‐endorsed</span> guidance in the application of <span>self‐controlled</span> study designs in pharmacoepidemiology Open
Purpose Consensus is needed on conceptual foundations, terminology and relationships among the various self‐controlled “trigger” study designs that control for time‐invariant confounding factors and target the association between transient…
View article: Predicting postoperative surgical site infection with administrative data: a Machine Learning algorithm
Predicting postoperative surgical site infection with administrative data: a Machine Learning algorithm Open
Background: Since primary data collection can be time-consuming and expensive, surgical site infections (SSIs) could ideally be monitored using routinely collected administrative data. We derived and internally validated efficient algorith…
View article: Do proton pump inhibitors increase mortality? A systematic review and in‐depth analysis of the evidence
Do proton pump inhibitors increase mortality? A systematic review and in‐depth analysis of the evidence Open
Proton pump inhibitors (PPIs) were primarily approved for short‐term use (2 to 8 weeks). However, PPI use continues to expand. Widely believed to be safe, we reviewed emerging evidence on increased mortality with PPI long‐term use. Our 201…
View article: Comparative effectiveness of buprenorphine-naloxone versus methadone for treatment of opioid use disorder: a population-based observational study protocol in British Columbia, Canada
Comparative effectiveness of buprenorphine-naloxone versus methadone for treatment of opioid use disorder: a population-based observational study protocol in British Columbia, Canada Open
Introduction Despite a recent meta-analysis including 31 randomised controlled trials comparing methadone and buprenorphine for the treatment of opioid use disorder, important knowledge gaps remain regarding the long-term effectiveness of …
View article: Bias in case‐crossover studies of medications due to persistent use: A simulation study
Bias in case‐crossover studies of medications due to persistent use: A simulation study Open
Purpose The case‐crossover design is increasingly used to evaluate the effects of chronic medications; however, as traditionally implemented in pharmacoepidemiology, with referent period preceding the outcome, it may lead to bias in the pr…
View article: Do proton pump inhibitors increase mortality? A systematic review and in-depth analysis of the evidence
Do proton pump inhibitors increase mortality? A systematic review and in-depth analysis of the evidence Open
Aims: Proton pump inhibitors (PPIs) were primarily approved for short term use (2 to 8 weeks). However, PPI use continues to expand. Widely believed to be safe, we reviewed emerging evidence on increased mortality with PPI long-term use. M…
View article: Policy‐induced selection bias in pharmacoepidemiology: The example of coverage for Alzheimer's medications in British Columbia
Policy‐induced selection bias in pharmacoepidemiology: The example of coverage for Alzheimer's medications in British Columbia Open
Purposes To assess the impact of a government‐sponsored reimbursement policy for cholinesterase inhibitors (ChEIs) on trends in physician visits with a diagnosis of Alzheimer's disease (AD). Methods Longitudinal population‐based study usin…
View article: Outcomes associated with hospital admissions for accidental opioid overdose in British Columbia: a retrospective cohort study
Outcomes associated with hospital admissions for accidental opioid overdose in British Columbia: a retrospective cohort study Open
Objectives To study the association between accidental opioid overdose and neurological, respiratory, cardiac and other serious adverse events and whether risk of these adverse events was elevated during hospital readmissions compared with…
View article: Comparison of cholinesterase inhibitor safety in real‐world practice
Comparison of cholinesterase inhibitor safety in real‐world practice Open
Introduction Cholinesterase inhibitors (ChEIs) are widely used to treat mild to moderate Alzheimer's disease and related dementia. Clinical trials have focused on placebo comparisons, inadequately addressing within‐class comparative safety…
View article: Reflecting on what? The difficulty of noticing formative experiences in the moment
Reflecting on what? The difficulty of noticing formative experiences in the moment Open
Introduction In the spirit of enacting an educational model of guided, collective reflection to support positive professional identity construction in healthcare learners, we implemented a reflection-based course for medical students trans…
View article: 1828. Interrupted Time Series Analysis of a Population-Level Academic Detailing Intervention on UTIs in British Columbia’s Nursing Homes
1828. Interrupted Time Series Analysis of a Population-Level Academic Detailing Intervention on UTIs in British Columbia’s Nursing Homes Open
BACKGROUND: In 2016, an academic detailing (AD) intervention took place in 115 nursing homes in British Columbia. AD meetings, attended by physicians, nurses, and nursing home staff, were organized to reduce unnecessary antibiotic treatmen…