%0 Journal Article
%@ 1929-0748
%I JMIR Publications
%V 10
%N 10
%P e29984
%T Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year (the PUPPY Study): Protocol for a Longitudinal Mixed Methods Study
%A Marshall,Emily Gard
%A Breton,Mylaine
%A Cossette,Benoit
%A Isenor,Jennifer
%A Mathews,Maria
%A Ayn,Caitlyn
%A Smithman,Mélanie Ann
%A Stock,David
%A Frymire,Eliot
%A Edwards,Lynn
%A Green,Michael
%+ Primary Care Research Unit, Dalhousie Family Medicine, 1465 Brenton Street Suite 402, Halifax, NS, B3J 3T4, Canada, 1 902 473 4155, emily.marshall@dal.ca
%K primary care
%K health services research
%K health policy
%K mixed methods research
%K COVID-19
%K protocol
%K policy
%K longitudinal
%K coordination
%K access
%K impact
%K virtual care
%K virtual health
%K Canada
%D 2021
%7 13.10.2021
%9 Protocol
%J JMIR Res Protoc
%G English
%X Background: The COVID-19 pandemic has significantly disrupted primary care in Canada, with many walk-in clinics and family practices initially closing or being perceived as inaccessible; pharmacies remaining open with restrictions on patient interactions; rapid uptake of virtual care; and reduced referrals for lab tests, diagnostics, and specialist care. Objective: The PUPPY Study (Problems in Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year) seeks to understand the impact of the COVID-19 pandemic across the quadruple aims of primary care, with particular focus on the effects on patients without attachment to a regular provider and those with chronic health conditions. Methods: The PUPPY study builds on an existing research program exploring patients’ access and attachment to a primary care practice, pivoted to adapt to the emerging COVID-19 context. We intend to undertake a longitudinal mixed methods study to understand critical gaps in primary care access and coordination, as well as compare prepandemic and postpandemic data across 3 Canadian provinces (Quebec, Ontario, and Nova Scotia). Multiple data sources will be used such as a policy review; qualitative interviews with primary care policymakers, providers (ie, family physicians, nurse practitioners, and pharmacists), and patients (N=120); and medication prescriptions and health care billing data. Results: This study has received funding by the Canadian Institutes of Health Research COVID-19 Rapid Funding Opportunity Grant. Ethical approval to conduct this study was granted in Ontario (Queens Health Sciences & Affiliated Teaching Hospitals Research Ethics Board, file 6028052; Western University Health Sciences Research Ethics Board, project 116591; University of Toronto Health Sciences Research Ethics Board, protocol 40335) in November 2020, Québec (Centre intégré universitaire de santé et de services sociaux de l'Estrie, project 2020-3446) in December 2020, and Nova Scotia (Nova Scotia Health Research Ethics Board, file 1024979) in August 2020. Conclusions: To our knowledge, this is the first study of its kind to explore the effects of the COVID-19 pandemic on primary care systems, with particular focus on the issues of patient’s attachment and access to primary care. Through a multistakeholder, cross-jurisdictional approach, the findings of the PUPPY study will inform the strengthening of primary care during and beyond the COVID-19 pandemic, as well as have implications for future policy and practice. International Registered Report Identifier (IRRID): DERR1-10.2196/29984 
%M 34559672
%R 10.2196/29984
%U https://www.researchprotocols.org/2021/10/e29984
%U https://doi.org/10.2196/29984
%U http://www.ncbi.nlm.nih.gov/pubmed/34559672