New study examines primary health care during COVID‑19

- September 28, 2020

COVID-19 has caused disruption to our lives in many ways, including how we access health care. Many walk-in clinics and family practices were closed, pharmacies have restrictions on patient interactions and as a result of public health protocols, many of us are now meeting with our family doctor through a computer screen or by phone call, instead of face-to-face.

A new, multi-province study led by Dal Family Medicine and Dal Health faculty seeks to understand the impact of these changes on primary health care and access, so that care may be improved during and after the COVID-19 pandemic. The study, led locally by Drs. Emily Gard Marshall (Family Medicine) and Jennifer Isenor (Pharmacy), will gather data from the public and frontline health workers to determine how the needs of patients and primary care providers have been and are being met before, during, and after COVID-19.

Drs. Sue Bowles, Andrea Murphy and Natalie Kennie-Kaulbach from the College of Pharmacy are co-investigators/collaborators on the study, Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients in a Pandemic Year — or, PUPPY, for short. The study has received a one-year grant of more than $400,000 through the Canadian Institutes of Health Research (CIHR) COVID-19 Rapid Research Response funding opportunity.

“Things like virtual health care appointments existed before but were rarely used. Since the pandemic began, they have come front and centre and we’ve all had to step up and try these things,” says Dr. Isenor. “We want to see which aspects of these innovations serve the community, what worked and what didn’t from the perspective of the public and healthcare providers through a large, holistic study involving three jurisdictions: Nova Scotia, Quebec, and Ontario.”

Understanding the rapid changes in primary care and how to navigate these is challenging for everyone, but more so for people without a regular primary care provider to help guide them. This is especially true for vulnerable groups (e.g., those with serious mental illness) and those with chronic health conditions that require ongoing, frequent care (e.g., bloodwork, scans, medication changes). COVID-19-related disruptions may lead to significant delays in treatments or unmet health care needs for many of these people, negatively affecting population health outcomes and increasing costs to health and social systems.

With this funding, the research team will undertake a extensive policy scan and series of surveys and interviews to gather insights into the experiences of patients, policymakers and the three most common primary care providers — family doctors, nurse practitioners, and pharmacists. These critical results for strengthening primary care going forward will be shared through a comprehensive knowledge translation strategy including provincial and federal stakeholder dialogues.

The large project consists of an experienced team of 50 researchers spanning three provinces. “We’re all really passionate about the topic, and excited to get the data we need to help connect patients to the best primary care, during COVID-19 and after the pandemic,” Dr. Isenor says.

You can follow updates from the PUPPY-Study on twitter @PUPPY_Study. You can also reach the study team by e-mailing


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