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Medication risks and challenges among people with dementia who live alone

独居痴呆症患者的用药风险和挑战

基本信息

批准号：
10516667
负责人：
Matthew Evan Growdon
金额：
$ 16.15万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10516667
关键词：
Adverse drug event Advocate Affect Aging Alzheimer&apos s disease related dementia American Anti-Cholinergics Anticoagulants Award Classification Clinical Cognitive Cohort Studies Communities Community Services Data Data Element Dementia Disease Drug Prescriptions Effectiveness Elderly Exposure to Face Future Geriatrics Goals Health Health system High Prevalence Hospitalization Hypoglycemic Agents Impaired cognition Insulin Intervention K-Series Research Career Programs Knowledge Link Low income Medicare Medicare claim Medication Management Mission National Institute on Aging Neurology Opioid Analgesics Participant Patient Care Patients Pattern Persons Pharmaceutical Preparations Policies Polypharmacy Population Prevalence Primary Health Care Proxy Psychiatry Public Health Quality of Care Quality of life Reporting Research Research Personnel Research Project Grants Risk Risk Factors Safety Seminal Services Social support Specialist Therapeutic Index Ursidae Family Vulnerable Populations Work base career development cohort common treatment contextual factors design drug misuse experience high risk improved innovation medication safety prescription opioid programs rural setting shared decision making social factors social vulnerability trend

项目摘要

PROJECT SUMMARY/ABSTRACT One-third of older adults with dementia live alone. A crucial challenge facing this vulnerable, growing, and understudied population is the safe and effective use of medications. Due to cognitive impairment, people with dementia (PWD) are more likely to misuse medications and face a threefold increased risk of medication- related hospital admissions compared to those without dementia. For older adults with dementia who live alone, the situation is even more dire. PWD living alone are more likely to lack support with medication management than those living with others. They are therefore potentially at higher risk of adverse drug events, particularly when exposed to certain high-risk medications. Despite recognition of the vulnerability of PWD who live alone, we lack reliable national data regarding medication use in this population. The objective of this study is to characterize high-risk medication use (defined as medications with adverse cognitive effects and medications with a low tolerance of misuse, including anticoagulants, hypoglycemics such as insulin, and opioid medications) and medication management supports and challenges among PWD who live alone. Using a nationally representative US cohort derived from merged National Health and Aging Trends Study (NHATS) data and Medicare claims, we will investigate two specific aims: (1) To determine the prevalence of and risk factors for high-risk medication use among PWD living alone and to compare this to PWD living with others and (2) To characterize medication management supports and challenges among PWD who live alone compared to those who live with others. We will determine medication use from Medicare Part D claims and will elucidate medication management supports and challenges from NHATS self and proxy reports. Significance & Innovation: Results from the proposed research project will directly inform clinical and policy interventions to support community-dwelling PWD, including a sizeable fraction who are living alone. This aligns with the National Institute on Aging's mission of promoting better quality of life for older Americans, including those with Alzheimer's Disease and Related Dementias, and improving the safe use of medications by older adults. This project is innovative because it will be the first to provide reliable national data regarding what high-risk medications are prescribed in this vulnerable group and to identify health system, patient/clinical, and social factors associated with these prescribing patterns. Describing medication management supports and challenges will identify populations in greatest need of supportive interventions. Future directions of this work include designing targeted interventions to improve the quality and safety of medication prescribing and provision of supportive services for community-dwelling PWD who live alone.

项目总结/文摘