Personne :
Gagnon, Marie-Ève

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Université Laval. École de psychologie
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Voici les éléments 1 - 7 sur 7
  • Publication
    Accès libre
    Polypharmacy and pharmacological treatment of diabetes in older individuals : a population-based study in Quebec, Canada
    (MDPI AG, 2019-12-01) Plante, Céline; Simard, Marc; Gagnon, Marie-Ève; Sirois, Caroline
    Our objectives were to describe the use of pharmacological treatments in older adults with diabetes and to identify the factors associated with the use of a combination of hypoglycemic, antihypertensive and lipid-lowering agents. Using the Quebec Integrated Chronic Disease Surveillance System, we conducted a population-based cohort study among individuals aged 66–75 years with diabetes in 2014-2015. We described the number of medications and the classes of medications used and calculated the proportion of individuals using at least one medication from each of these classes: hypoglycemics, antihypertensives and lipid-lowering agents. We identified the factors associated with the use of this combination of treatments by performing robust Poisson regressions. The 146,710 individuals used an average of 12 (SD 7) different medications, mostly cardiovascular (91.3% of users), hormones, including hypoglycemic agents (84.5%), and central nervous system medications (79.8%). The majority of individuals (59%) were exposed to the combination of treatments and the factor most strongly associated was the presence of cardiovascular comorbidities (RR: 1.29; 99% CI: 1.28-1.31). Older individuals with diabetes are exposed to a large number of medications. While the use of the combination of treatments is significant and could translate into cardiovascular benefits at the population level, the potential risk associated with polypharmacy needs to be documented.
  • Publication
    Accès libre
    Normative data for the clock drawing test for French-Quebec mid- and older aged healthy adults
    (Swets Pub. Service, 2018-05-09) Turcotte, Valérie; Potvin, Olivier; Gagnon, Jean-François; Joubert, Sven; Gagnon, Marie-Ève; Rouleau, Isabelle.; Macoir, Joël; Escudier, Frédérique; Hudon, Carol; Koski, Lisa
    Objective: The Clock Drawing Test (CDT) is frequently used to screen for cognitive impairment, however, normative data for Rouleau et al.’s (1992) scoring system are scarce. The present study aims to provide norms for Rouleau et al.’s (1992) scoring system that are tailored to Quebec French-speaking mid and older-aged healthy adults. Methods: Six researchers from various research centers across the Province of Quebec (Canada) sent anonymous data for 593 (391 women) healthy community-dwelling volunteers (age range: 43-93 years; education range: 5-23 years) who completed the CDT “drawing on command” version. This command version (setting the clock hands to 11:10, without a pre-drawn circle) was administrated as part of a more extensive neuropsychological assessment, or along with cognitive screening instruments. Each drawn clock was scored according to the quantitative criteria set by Rouleau et al.’s (1992) scoring system. Results: CDT scores were significantly correlated with age (r(592) = -.132, p = .001) and years of education (r(592) = .116, p = .005), but not with sex (r(592) = .065, p = .112). Since data were skewed towards higher test scores, the percentiles method was used for analysis. Percentile ranks stratified by age and education are presented. Conclusion: These normative data for Rouleau et al.’s (1992) scoring system will contribute towards adequately screening for cognitive decline in Quebec French-speaking healthy adults, by also taking into account individual characteristics such as age and education.
  • Publication
    Accès libre
    L'applicabilité du Test d'intelligence émotionnelle Mayer-Salovey-Caruso (MSCEIT) chez les personnes âgées : étude de la compréhension des consignes et des items, de la validité apparente de la cohérence interne et de la distribution des scores
    (2009) Gagnon, Marie-Ève; Gauthier, Janel G.
    Cette recherche porte sur l'applicabilité de la version belge-française du Mayer Salovey Caruso Emotional Intelligence Test (MSCEIT; Mayer, Salovey, & Caruso, 2002) (Logan, 2006) chez les personnes âgées. Elle avait pour objet d'étudier la compréhension des consignes et des items, d'évaluer la validité apparente et la cohérence interne du test, d'examiner la dispersion des scores et de comparer de façon exploratoire les scores obtenus dans ce groupe à ceux qui ont été observés par Mayer et al. (2002) pour différents groupes d'âges lors de l'étalonnage du test. Le MSCEIT-BF (version belge-française) ainsi qu'un questionnaire mesurant la validité apparente du MSCEIT-BF et un questionnaire portant sur la compréhension des consignes et des tâches ont été complétés par 140 personnes âgées de 60-85 ans. Les analyses statistiques révèlent une validité apparente adéquate et une cohérence interne élevée (alpha de Cronbach = 0,93). Le nombre de problèmes rencontrés par les personnes âgées lors de l'administration du test semblerait être supérieur à celui qu'on devrait normalement retrouver. Ceci pourrait partiellement expliquer pourquoi elles ont obtenu des scores significativement moins élevés au MSCEIT (p < 0, 001) par rapport à l'échantillon utilisé pour l'étalonnage du test. Des recommandations sont proposées pour améliorer la validité des résultats des personnes âgées au MSCEIT.
  • Publication
    One-year persistence of potentially inappropriate medication use in older adults: a population-based study
    (Macmillan Journals, 2020-01-09) Roux, Barbara; Gagnon, Marie-Ève; Simard, Marc; Sirois, Caroline
    Aims: To assess the 1-year persistence of potentially inappropriate medication (PIM) use and identify associated factors in community-dwelling older adults in Quebec, Canada. Methods: A population-based cohort study was conducted using the Quebec Integrated Chronic Disease Surveillance System. Individuals insured by the public drug plan and aged ≥66 years who initiated a PIM between 1 April 2014 and 31 March 2015 were followed-up for 1 year. PIMs were identified using the 2015 Beers criteria. One-year persistence of PIM use was defined as continuous treatment with any PIM, without interruption for more than 60 days between prescriptions refills. Poisson regression models were performed to identify factors associated with 1-year persistence of any PIM. Results: In total, 25.1% of PIM initiators were persistent at 1 year. In non-persistent individuals, the median time to PIM discontinuation was 31 days (interquartile range 21-92). Individuals were more persistent at 1 year with antipsychotics (43.9%), longduration sulphonylureas (40.2%), antiarrhythmics/immediate-release nifedipine (36.5%) and proton pump inhibitors (36.0%). Factors significantly associated with persistence were an increased age, being a man and having a high number of medications and chronic diseases, especially dementia, diabetes and cardiovascular diseases. Conclusions: One-quarter of community-dwelling older adults are continuously exposed to PIMs. To optimize medication prescribing in the older population, further interventions are needed to limit the use of PIMs most likely to be continued, especially in individuals most at risk of being persistent and also particularly vulnerable to adverse events.
  • Publication
    Accès libre
    Mixed bag “polypharmacy”: methodological pitfalls and challenges of this exposure definition
    (Springer International Publishing, 2019-07-22) Simard, Marc; Gagnon, Marie-Ève; Gosselin, Emmanuelle; Sirois, Caroline
    Purpose of Review The use of multiple medications is common in older adults but is associated with negative health outcomes. However, polypharmacy is not uniformly defined, and there is scant data on how the variety of definitions and their limitations hinder the development of sound scientific knowledge. The article intends to illustrate the challenges of this exposure definition. Recent Findings The array of thresholds for defining polypharmacy renders comparisons between results difficult. Few studies take into account the fact that polypharmacy is a changing exposure over time. In addition, although studies tend to recognize the confounding effect of multimorbidity, residual bias remains a concern. Summary Current studies in polypharmacy often ignore basic epidemiological principles for defining exposure. Future research should integrate time-varying exposure and methods to better control confounding bias. This will help determine the positive/negative impacts of polypharmacy and help establish if polypharmacy conveys information beyond being a marker of health status.
  • Publication
    Potentially inappropriate medication use in older adults : a population-based cohort study
    (Fampra, 2019-10-11) Roux, Barbara; Gagnon, Marie-Ève; Simard, Marc; Sirois, Caroline; Laroche, Marie-Laure
    Background: Non-optimal medication use among older adults is a public health concern. A concrete picture of potentially inappropriate medication (PIM) use is imperative to ensure optimal medication use. Objective: To assess the prevalence of PIMs in community-dwelling older adults and identify associated factors. Methods: A retrospective population-based cohort study was conducted using the Quebec Integrated Chronic Disease Surveillance System (QICDSS). The QICDSS includes data on drug claims for community-dwelling older adults with chronic diseases or at risk of developing chronic diseases aged ≥65 years who are insured by the public drug insurance plan. Individuals aged ≥66 years who were continuously insured with the public drug plan between 1 April 2014 and 31 March 2016 were included. PIMs were defined using the 2015 Beers criteria. We conducted multivariate robust Poisson regression analyses to explore factors associated with PIM use. Results: A total of 1 105 295 individuals were included. Of these, 48.3% were prescribed at least one PIM. The most prevalent PIMs were benzodiazepines (25.7%), proton-pump inhibitors (21.3%), antipsychotics (5.6%), antidepressants (5.0%) and long-duration sulfonylureas (3.3%). Factors associated with PIM exposure included being a woman [rate ratio (RR): 1.20; 95% confidence interval (CI): 1.20-1.21], increased number of medications and having a high number of chronic diseases, especially mental disorders (RR: 1.50; 95% CI: 1.49-1.51). Conclusion: Almost one out of two community-dwelling older adults use a PIM. It is imperative to reduce the use of PIMs, by limiting their prescription and by promoting their deprescribing, which necessitates not only the active involvement of prescribers but also patients.
  • Publication
    Utilisation des médicaments potentiellement inappropriés chez les aînés québécois présentant des maladies chroniques ou leurs signes précurseurs : portrait 2014-2015.
    (Institut national de santé publique, 2019-08-15) Simard, Marc; Gagnon, Marie-Ève; Sirois, Caroline
    On considère qu’un médicament est inapproprié si les risques sont supérieurs au bénéfice attendu, en particulier lorsque des alternatives thérapeutiques plus sûres existent pour la même indication. L’utilisation de médicaments potentiellement inappropriés est problématique au sein de la population âgée puisqu’elle est associée à la survenue d’effets indésirables et d’interactions médicamenteuses, et à une potentielle augmentation de la morbidité, du recours aux soins et de la mortalité. En 2014, près de la moitié (49 %) des aînés québécois présentant des maladies chroniques ou leurs signes précurseurs ont reçu au moins un médicament potentiellement inapproprié. Parmi les utilisateurs de ces médicaments, la proportion de nouveaux utilisateurs est de 16 %. Par conséquent, la vaste majorité des aînés exposés à ceux-ci l’étaient déjà l’année précédente.