Implementation and Evaluation of Patient Priorities Care-North Carolina for Older Adults with Multiple Chronic Conditions

北卡罗来纳州针对患有多种慢性病的老年人实施患者优先护理的实施和评估

• 批准号: 10447595
• 负责人: CRYSTAL WILEY CENE
• 金额: $ 54.59万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2022-10-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447595
• 关键词: Address; Adoption; Adult; Caregivers; Caring; Characteristics; Chronic; Clinic; Clinical; Clinical Engineering; Cluster randomized trial; Communities; Complex; Conflict (Psychology); Connecticut; Decision Making; Diabetes Mellitus; Diagnostic tests; Disease; Elderly; Electronic Health Record; Elements; Ensure; Evaluation; Family; Family Caregiver; Glycosylated hemoglobin A; Goals; Guidelines; Health; Health Priorities; Health care facility; Healthcare; Healthcare Systems; Hour; Incentives; Individual; Intervention; Lead; Life Support Care; Medical; Medicare; Medicine; Modeling; National Institute on Aging; North Carolina; Nurses; Outcome; Patient Care; Patient Preferences; Patient-Centered Care; Patient-Focused Outcomes; Patients; Penetration; Performance; Persons; Pharmaceutical Preparations; Physical Function; Population; Prevalence; Primary Health Care; Procedures; Process; Program Research Project Grants; Provider; Qualitative Methods; Quality of life; Research; Resources; Rural; Social Workers; Taxonomy; Testing; Texas; Visit; base; beneficiary; care outcomes; care preference; clinical decision-making; compliance behavior; cost; design; effectiveness evaluation; effectiveness implementation design; effectiveness implementation study; health care model; health care service utilization; health service use; implementation evaluation; implementation outcomes; implementation process; implementation protocol; improved; individual patient; innovation; medical specialties; multiple chronic conditions; novel strategies; preference; primary outcome; racial and ethnic; satisfaction; secondary outcome; shared decision making; socioeconomics; success; treatment as usual

Project Summary/Abstract The long-term goal of this research is to re-engineer clinical decision-making for older adults with multiple chronic conditions (MCC) to center within the health priorities of patients. The overall objective of this Research Project Grant Program (R01) study is to implement and evaluate a Patient priorities care (PPC) intervention in primary care practices in North Carolina (NC) using a hybrid effectiveness-implementation design. Guided by the Minimally Disruptive Medicine model, our central hypothesis is that clinical decision-making guided by patients' priorities will result in less burdensome care for patients and their families, increase patient goal setting, facilitate patient-provider shared decision-making, and improve patient quality of life and satisfaction with care. As the prevalence, costs, and treatment burden of MCC continue to rise, new approaches to care are urgently needed in this growing population. Findings from this study will inform practical approaches for aligning clinical decision-making in older adults with MCC with their health priorities. This project is highly relevant to priorities of the National Institute on Aging (NIA) which call for research to develop and evaluate health care models and approaches aligned with patient values, preferences, and goals in older adults with MCC.

项目总结/摘要 这项研究的长期目标是重新设计老年人的临床决策， 慢性病（MCC）的中心内的患者的健康优先事项。本研究的总体目标 项目资助计划（R 01）研究是实施和评估患者优先护理（PPC）干预， 北卡罗来纳州（NC）的初级保健实践，采用混合有效性-实施设计。指导 最小破坏医学模型，我们的中心假设是，临床决策的指导下， 患者的优先事项将减少患者及其家属的护理负担，增加患者的目标 设置，促进患者-提供者共享决策，并提高患者的生活质量和满意度 小心。随着MCC的患病率、成本和治疗负担的持续上升， 在这个不断增长的人口中是迫切需要的。这项研究的结果将为以下方面的实际做法提供信息： 使老年MCC患者的临床决策与他们的健康优先事项保持一致。该项目高度 与国家老龄问题研究所（NIA）的优先事项有关，这些优先事项要求进行研究， 医疗保健模式和方法与老年人的患者价值观、偏好和目标相一致， MCC。