CARPE:  Common Assessments for Repeated Paramedic Service Encounters


Community paramedicine programs use paramedics to provide immediate or scheduled primary, urgent, and/or specialized healthcare to vulnerable patient populations by focusing on improving equity in access to healthcare across the continuum of care.  Identifying vulnerable patient populations and determining the level of care to provide them requires a robust multi-domain assessment.

The primary objective of this study is to investigate outcomes associated with older adults that are assessed in a community paramedicine program. This includes subsequent 9-1-1 calls, functional decline, social isolation, disease progression, and mortality.  We seek to determine if a community paramedic using a standardized assessment tool can identify risk factors associated with these outcomes.

A prospective cohort study will be conducted supplemented with existing region-level clinical and administrative data. A multi-domain assessment battery encompassing physical, cognitive, sensory, environmental, and social function measures will be pilot tested.  Internal, external, and convergent validity will be investigated to determine how the assessment instrument provides useful information to community paramedics. Follow-up with patients will be conducted 90 days after assessment to determine changes in mobility status and health services use.

The evidence base for community paramedicine requires evaluation of outcomes beyond levels of service use.  A standardized assessment tool that captures the full breadth of paramedic observations will be important to improve care planning and for identifying changes in patient status.


Team Lead:

Matthew Leyenaar, A-EMCA, BSc, MA | McMaster University

Research Committee:

Walter Tavares, PhD

Gina Agarwal, MBBS, PhD, MRCGP, CCFP, FCFP

Samir Sinha, MD, DPhil, FRCPC

Eric Mercier, MD, MSc, FRCPC

Andrew Costa, PhD

Brent McLeod, MPH, MHM, ACP

Michael Nolan, MA, CCPF

Audrey-Anne Brousseau, MD, MSc, FRCPC

Team Members:

Ryan Strum, HBSc, BA, PCP

Sarah Penhearow, BSc (c)


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