Early Lyme Disease Management Clinical Tool

Together with the College of Family Physicians of Canada (CFPC), the Centre for Effective Practice (CEP) launched the Early Lyme Disease Management in Primary Care Tool in 2020 to help family physicians and other health care providers diagnose and treat early localized Lyme disease. Blacklegged tick populations in Canada continue to spread, and the incidence of Lyme disease is increasing in part due to climate change. As a result, primary care providers will be exposed to more patients who have been bitten by blacklegged ticks, and more who have contracted Lyme disease. With funding through the Public Health Agency of Canada’s Infectious Disease and Climate Change Fund, the Lyme Disease Tool was developed to improve the capacity of family physicians and health care providers to diagnosis and manage Lyme disease by helping to recognize symptoms of early Lyme disease, develop treatment plans for patients with early Lyme disease, and manage patients’ symptoms during and after treatment. The tool contains information for both health care providers and for patients, free of charge, and is available in both English and French.

Understanding and Assessing Impacts

Lyme disease is the most common tick-borne illness in Canada and cases are increasing due to blacklegged tick population growth, due in part to climate change. Over the past few decades, as blacklegged ticks have been spreading northward into new territory, reported cases of Lyme disease in Canada have grown from about 150 in 2009 to over 2,000 in 2017. Longer, hotter summers and more mild winters associated with climate change is increasing the ticks’ rates of survival, growth and reproduction, and allowing them to survive and establish populations in areas where they previously couldn’t, and increase their numbers where they were already established. Longer summers also mean a longer season where ticks are active and people are outdoors – increasing the window of opportunity for the two to meet. Additionally, climate change is expected to increase the range, abundance, and activity of rodent, bird, and deer hosts that carry the disease. In response to demand by clinicians and with current and projected increases in Lyme disease cases in Canada, the Centre for Effective Practice’s (CEP’s) developed the Lyme Disease Tool to help family physicians and other health care providers understand that Lyme disease is a treatable illness that is increasing in incidence in Canada.

Identifying Actions

The Early Lyme Disease Management in Primary Care Tool was developed using the CEP’s integrated knowledge translation approach. This approach ensures that providers are engaged throughout the development processes through the application of user-centered design methodology. The focus of the tool on early Lyme disease was identified through a scoping exercise of grey and academic literature and through engagement with health care providers and health care organizations. Clinical leadership of the resource was provided by Dr. Cecilia Newton, CCFP, as well as a working group of 8 people, including a patient with lived experience. Additional engagement with end users, patient representatives and clinical experts provided feedback to the draft prototype. The tool was revised, finalized and translated into French.

Implementation

The Lyme Disease Tool became available for download in February 2020, followed by a dissemination process in early Spring 2020. Dissemination activities leveraged the CEP and CFPC’s established dissemination and communication mechanisms, reaching thousands of healthcare providers across the country.

Outcomes and Monitoring Progress

Monitoring and evaluation of the toolkit currently involves tracking web downloads. Since its launch in February 2020, the toolkit has been downloaded around 9500 times. Providers and patients anywhere in Canada can download the toolkit in PDF format at no cost, in both English and French.

Next Steps

The CEP continues to seek additional project funding to further this work, including the development of a more robust monitoring program.

Resources

Link to Full Case Study

Additional Resources:

Further understand how climate information can be applied in decision-making by exploring the Health Module on ClimateData.ca