D1.393 - Building Local Capacity and Improving Access to Specialist Allergist Care for Indigenous Patients in Northern Quebec, Canada

Indigenous communities in Canada face a higher burden of atopic diseases, with access to care being the primary barrier to diagnosis and management. In Quebec's Indigenous health regions—Nunavik (region 17) and Cree Territory of James Bay (region 18) an area encompassing 500,000km²—access to allergy care is limited, resulting in long wait times, cultural disconnection, and missed appointments. Residents must travel over 1,400 kilometers to Montreal for advanced care. In 2021, the Nunavut budget allocated $124.6 million for medical travel alone.

Connexion Nordique is a quality improvement initiative designed to enhance primary allergy care access for Indigenous populations in Northern Quebec. The project’s educational component builds local capacity through community partnerships and programming. This report shares preliminary findings from this collaborative initiative.

Connexion Nordique began with site visits to build relationships with healthcare providers, community leaders, and patients in Regions 17 and 18. Based on these interactions, reference materials for common allergy presentations were developed, complemented by live educational sessions.

Four site visits were conducted between January 2023 and February 2024. Site visits revealed several barriers to care, including geographic isolation, poor telecommunication access, limited healthcare resources, and a shortage of healthcare providers.

Protocols for managing anaphylaxis and penicillin allergies were locally adapted and distributed across communities to ensure that primary care providers had up-to-date, culturally appropriate guidance and facilitated de-labelling low-risk patients with suspected drug allergies. Two live educational seminars on chronic urticaria and drug allergies were held, with 16-18 primary care physicians from Nunavik in attendance. A focus group provided positive feedback, highlighting that severe or refractory cases are unsuitable for local management.

Rural and Indigenous health disparities are well-documented, with ongoing knowledge gaps in allergic disorders. Future directions include developing a centralized educational platform with locally adapted resources for both healthcare providers and patients. A key goal is to empower local providers to de-label drug allergies with allergist support. Similarly, a monthly dedicated telemedicine clinic will be piloted to facilitate access to specialist care.