And so, leaving no stone uncovered, the saga of the ADTI investigation continues. After my last post, I had a few heavy questions that still needed answering: 1) why has there been so little publicity around the ADTI considering the potential benefits for those diagnosed with AD? 2) what were the doctors' response? 3) what are the research projects being designed around this initiative?
Google of course has become my best friend and we spent some quality time together over the past few weeks. Having been involved in my fair share of grant writing, I expected that knowledge translation would be a large component of this initiative. To those of you new to the term, knowledge translation (or KT as it is affectionately referred to these days) takes the literal meaning of its words, "to turn into one's own language". It is the equivalent of taking knowledge from one person and transferring it to another in a language that they understand. As my mother likes to put it (after several failed attempts to read the paper I published and a half hour of explaining caspases, western blots & PCRs) , "its when you explain in normal english the gibbrish that is your thesis". There are three major components to KT: synthesis (taking various studies on a particular subject and integrating it into one report for example), dissemination (dispersing information to the right audience in an appropriate manner) and exchange (an interactive dialogue between the researcher and knowledge user). Our illustrious Canadian Institutes for Health Research (CIHR) has a more detailed definition (http://www.cihr-irsc.gc.ca/e/
As it turns out, I was really only able to find three major references to the initiative outside of the Ministry of Health's webpage:
1) A 2008 article in a newsletter to the BC Pharmacists which was internally circulated and was more focused on having pharmacists help recruit participant caregivers
http://www.bcpharmacists.org/
2) An article in the Alzheimer Society of BC newsletter published Winter 2007 when the initiative first started
http://www.alzheimerbc.org/
3) Dr. Neena Chappell's webpage. She is the scientific lead on the research projects so her webpage mainly related to the research projects
http://web.uvic.ca/~nlc/
Having spoken to a couple of people involved with the research component of ADTI as well as at the Alzheimer's Society of BC, no one seems to have much of an explanation for the lack of enthusiasm. Personally, I would have been jumping out of my seat and running around to all the retirement homes and bingo halls proclaiming the good news that there's a coupon for dementia drugs, but maybe that's just me. I think part of the lack of joyeux de vive may have been because the ADTI is at its heart, a research project. This means very strict criteria and limitations for its participants. So perhaps, in order to only recruit a certain number of participants and not be overwhelmed with requests, the initiative was not advertised too widely. The second reason may have been because enrollment was left to the discretion of the doctors, which leads nicely into my next question...how did the doctors react?
First a little groundwork on the requirements Watson. Participants must meet certain criteria with regards to their score on the Mini Mental State Examination (which tracks their cognitive status). As well, doctors must administer this test every six months and fill out a Special Authority form. Word on the street is that the doctors weren't too pleased with this arrangement, particularly since they got no extra incentive (translated into moolah) to fill our yet more paperwork. In fact, the extra breath of life the ADTI was given was partially to compensate for the time lost convincing doctors who were up in arms that this is a worthwhile initiative. The plot thickens! Through some digging, I found that the BC Medical Association (BCMA) actually issued a directive to its members instructing them not to complete the Special Authority forms. It was only after negotiations that resulted in remunerations to doctors for participating in the program that a reversal of the directive from the BCMA President was issued. Well, I don't know and can't begin to comment on the complex politics involved in these decisions, but it did leave me wondering, if first and foremost primum non nocere (first do no harm), where does all the time lost during this fancy footwork leave all those individuals diagnosed with dementia and looking for treatment options?
Google of course has become my best friend and we spent some quality time together over the past few weeks. Having been involved in my fair share of grant writing, I expected that knowledge translation would be a large component of this initiative. To those of you new to the term, knowledge translation (or KT as it is affectionately referred to these days) takes the literal meaning of its words, "to turn into one's own language". It is the equivalent of taking knowledge from one person and transferring it to another in a language that they understand. As my mother likes to put it (after several failed attempts to read the paper I published and a half hour of explaining caspases, western blots & PCRs) , "its when you explain in normal english the gibbrish that is your thesis". There are three major components to KT: synthesis (taking various studies on a particular subject and integrating it into one report for example), dissemination (dispersing information to the right audience in an appropriate manner) and exchange (an interactive dialogue between the researcher and knowledge user). Our illustrious Canadian Institutes for Health Research (CIHR) has a more detailed definition (http://www.cihr-irsc.gc.ca/e/
As it turns out, I was really only able to find three major references to the initiative outside of the Ministry of Health's webpage:
1) A 2008 article in a newsletter to the BC Pharmacists which was internally circulated and was more focused on having pharmacists help recruit participant caregivers
http://www.bcpharmacists.org/
2) An article in the Alzheimer Society of BC newsletter published Winter 2007 when the initiative first started
http://www.alzheimerbc.org/
3) Dr. Neena Chappell's webpage. She is the scientific lead on the research projects so her webpage mainly related to the research projects
http://web.uvic.ca/~nlc/
Having spoken to a couple of people involved with the research component of ADTI as well as at the Alzheimer's Society of BC, no one seems to have much of an explanation for the lack of enthusiasm. Personally, I would have been jumping out of my seat and running around to all the retirement homes and bingo halls proclaiming the good news that there's a coupon for dementia drugs, but maybe that's just me. I think part of the lack of joyeux de vive may have been because the ADTI is at its heart, a research project. This means very strict criteria and limitations for its participants. So perhaps, in order to only recruit a certain number of participants and not be overwhelmed with requests, the initiative was not advertised too widely. The second reason may have been because enrollment was left to the discretion of the doctors, which leads nicely into my next question...how did the doctors react?
First a little groundwork on the requirements Watson. Participants must meet certain criteria with regards to their score on the Mini Mental State Examination (which tracks their cognitive status). As well, doctors must administer this test every six months and fill out a Special Authority form. Word on the street is that the doctors weren't too pleased with this arrangement, particularly since they got no extra incentive (translated into moolah) to fill our yet more paperwork. In fact, the extra breath of life the ADTI was given was partially to compensate for the time lost convincing doctors who were up in arms that this is a worthwhile initiative. The plot thickens! Through some digging, I found that the BC Medical Association (BCMA) actually issued a directive to its members instructing them not to complete the Special Authority forms. It was only after negotiations that resulted in remunerations to doctors for participating in the program that a reversal of the directive from the BCMA President was issued. Well, I don't know and can't begin to comment on the complex politics involved in these decisions, but it did leave me wondering, if first and foremost primum non nocere (first do no harm), where does all the time lost during this fancy footwork leave all those individuals diagnosed with dementia and looking for treatment options?
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