Deprescribing for Older Dialysis Patients

取消老年透析患者的处方

• 批准号: 10408111
• 负责人: Rasheeda K Hall
• 金额: $ 22.28万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408111
• 关键词: Address; Adrenergic alpha-Antagonists; Adverse effects; Adverse event; Affect; Aging; Agonist; Antihypertensive Agents; Area; Attitude; Award; Capsicum; Caregivers; Caring; Categories; Cerebrovascular Disorders; Client satisfaction; Clinical; Clinical Trials; Clinical Trials Design; Communities; Data; Decision Making; Dialysis patients; Dialysis procedure; Diffusion of Innovation; Elderly; Elements; End stage renal failure; Environment; Face; Focus Groups; Frequencies; Future; Goals; Health; Health system; Hospitalization; Hypotension; Impaired cognition; Individual; Information Systems; Institutes; Intervention; Interview; K-Series Research Career Programs; Kidney; Kidney Diseases; Knowledge; Lead; Leadership; Medicare; Mental Depression; Mentors; Methods; Mission; Nephrology; Opioid; Outcome; Patient Preferences; Patients; Pattern; Pharmaceutical Preparations; Pharmacists; Pharmacoepidemiology; Physicians; Physiological; Pilot Projects; Predisposition; Prevalence; Provider; Quality of Care; Quality of life; Registries; Renal function; Research; Research Design; Resources; Risk; Scientist; Structure; Syndrome; Time; Transient Ischemic Attack; United States; Universities; Vocational Guidance; Withdrawal; Work; adverse outcome; beneficiary; care providers; career development; case-based; cognitive function; cohort; contextual factors; design; effective intervention; effectiveness evaluation; evidence base; experience; falls; feasibility testing; health care quality; health care service utilization; hospitalization rates; improved; leadership development; novel; patient engagement; pilot test; preference; primary outcome; recruit; research study; shared decision making; skill acquisition; skills; standard of care; theories

ABSTRACT This is a Beeson Emerging Leaders in Aging career development award (K76) for Dr. Rasheeda Hall, MD, MBA, MHS. Dr. Hall is a nephrologist who conducts aging research at Duke University, and her long-term goal is to become a leader in geriatric nephrology and develop effective interventions targeting geriatric conditions in older dialysis patients. Compared to older adults without kidney disease, older dialysis patients are more likely develop severe cognitive impairment, experience more falls, and have more frequent hospitalizations. These adverse outcomes are also known to be associated with potentially inappropriate medications, and older dialysis patients are highly susceptible to adverse effects of potentially inappropriate medications because of altered medication clearance due to absent kidney function and common occurrences of hypotension and mini- strokes. Given this susceptibility, reduction of potentially inappropriate medications is a logical goal for improving quality of care for these vulnerable patients. The objective of Dr. Hall’s proposed research is to develop an evidence-based strategy to reduce inappropriate prescribing in older dialysis patients. The research aims are to: 1) identify the prevalence of specific potentially inappropriate medications and the extent to which there is an association with hospitalization risk in prevalent older dialysis patients, 2) identify elements of a deprescribing intervention that are acceptable to nephrologists, primary care providers, and patients, and 3) determine the feasibility of a deprescribing intervention tailored for older dialysis patients. This work will provide evidence to support a definitive clinical trial of deprescribing in dialysis units. Effective deprescribing interventions have the potential to reduce hospitalizations and ameliorate geriatric syndromes in dialysis patients which is consistent with NIA’s mission. Complementary to this research, this career development award will solidify Dr. Hall’s transition to research independence through coursework and mentoring to: a) fill knowledge gaps in directing a team of statisticians, interpretation of pharmacoepidemiologic data, advanced methods in handling bias in observational data, timely qualitative analyses, execution of a pilot study, and clinical trial design; b) enhance her leadership skills; and c) successfully compete for a R01. Duke University is the ideal environment for Dr. Hall to pursue this research career development because of the strong aging research expertise housed in its Center for Aging and affiliated Pepper Center, as well as, rich resources available through Duke’s Clinical and Translational Institute.

摘要

项目成果

Drawing Attention to Potentially Inappropriate Medications for Older Adults Receiving Dialysis.

提请注意对于接受透析的老年人可能不合适的药物。

• DOI: 10.1111/jgs.15741
• 发表时间: 2019
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Hall,Rasheeda

Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study.

• DOI: 10.1186/s12882-021-02594-6
• 发表时间: 2021-11-11
• 期刊: BMC nephrology
• 影响因子: 2.3
• 作者: Bhavsar NA;Davenport CA;Yang LZ;Peskoe S;Scialla JJ;Hall RK;Tyson CC;Strigo T;Sims M;Pendergast J;Curtis LH;Boulware LE;Diamantidis CJ
• 通讯作者: Diamantidis CJ

Medication Reconciliation: The Foundation of Medication Safety for Patients Requiring Dialysis.

• DOI: 10.1053/j.ajkd.2020.07.021
• 发表时间: 2020-12
• 期刊: American journal of kidney diseases : the official journal of the National Kidney Foundation
• 作者: Frament J;Hall RK;Manley HJ
• 通讯作者: Manley HJ

Clin-Star corner: What is new at the interface of geriatrics and nephrology?

• DOI: 10.1111/jgs.17942
• 发表时间: 2022-08
• 期刊: JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
• 影响因子: 6.3
• 作者: Nair, Devika;Hall, Rasheeda K.
• 通讯作者: Hall, Rasheeda K.