Primary care based collaborative approach to care management for older adults with dementia

基于初级保健的痴呆症老年人护理管理协作方法

基本信息

批准号：
10595590
负责人：
Stephanie Nothelle
金额：
$ 18.87万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-15 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10595590
关键词：
Accident and Emergency department Acute Address Aging Alzheimer&apos s disease related dementia Area Baltimore Behavioral Bioinformatics Caring Case Manager Clinic Collaborations Complex Comprehensive Health Care Data Data Set Dementia Development Discipline Disease Management Elderly Enrollment Environment Family Caregiver Fostering Frequencies Funding Future Goals Grant Health Health system Heart failure Hospital Departments Hospitals Individual Intervention Interview Lead Link Managed Care Managed Care Programs Matched Group Medical Mentors Older Population Operative Surgical Procedures Outcome Persons Prevalence Primary Care Publications Research Research Methodology Research Personnel Resources Role Scholarship Services Social support Statistical Methods Structure Symptoms Testing Training Activity Work acceptability and feasibility care coordination care delivery career development collaborative approach collaborative care comorbidity dementia care design experience feasibility testing health information technology improved intervention refinement medical specialties multidisciplinary novel pilot test population health primary care clinician programs systematic review therapy design

项目摘要

Care for the growing population of older adults with Alzheimer's Disease and Related Dementias (ADRD) is challenging. Care management programs are a common approach to streamlining care for persons with conditions such as ADRD. Care management programs are typically siloed in individual settings; however, as older adults with ADRD utilize care in many settings, they are often contacted by multiple care management programs. Simultaneous enrollment in more than one care management program (hereafter “simultaneous enrollment”) may paradoxically lead to less coordinated care if the programs do not collaborate. The prevalence and consequences of simultaneous enrollment in ADRD are unclear. This K23 proposal builds upon the candidates' work funded by the Grants for Early Medical/Surgical Subspecialists' Transitioning to Aging Research (GEMSSTAR, R03) to advance understanding of the consequences of simultaneous enrollment and the acceptability and potential design of a primary care-based collaborative approach to care management for older adults with ADRD. Aim 1 will result use a novel linked dataset that includes care management enrollment data from two health systems in Baltimore and statewide hospital and emergency department utilization data to determine whether simultaneous enrollment in care management is: (1) more common among older adults with ADRD and (2) associated with preventable hospital and emergency department use. Aim 2 will use qualitative interviews with four groups of stakeholders (care management program leaders and staff, primary care clinicians and office staff, health information technology experts, older adults with ADRD and their family caregivers) to identify barriers and facilitators to and the design of a primary care-based collaborative approach to care management for older adults with ADRD. Aim 3 will pilot test a primary care based collaborative approach to care management for older adults with ADRD focused on feasibility and acceptability. The proposed research will contribute needed evidence about how to best approach care for older adults with ADRD in the context of population health initiatives such as care management. The candidate is a geriatrician who has already demonstrated a strong track record of academic scholarship with numerous publications and early investigator grants. She has proposed a comprehensive set of training activities that are geared toward her development as a clinician investigator and national leader who informs improvements to care delivery for older adults with ADRD. The project will foster her continued career development in the following ways (1) additional coursework and experience in advanced statistical methods, (2) developing a foundational understanding of bioinformatics, (3) applied experience in intervention design in the context of ADRD care, (4) improving her understanding of population health initiatives. She has assembled an exemplary mentoring team with expertise in the subject area and the relevant research methods and works in a rich research environment with tremendous resources to support her development.

护理老年人患有阿尔茨海默氏病和相关痴呆症（ADRD）的人口不断增长的人口是具有挑战性的。护理管理计划是简化患有护理的人的常见方法诸如ADRD等条件。护理管理计划通常在各个环境中孤立；但是，如患有ADRD的老年人在许多情况下都使用护理，经常通过多个护理管理与他们联系程序。同时参加多个护理管理计划（以下是“同时如果这些计划不合作，则可能会矛盾地导致较少的协调护理。简单入学在ADRD中的患病率和后果尚不清楚。这个K23提案建立在候选人的工作中，由早期医学/外科专科医生的赠款资助衰老研究（Gemsstar，R03），以提高对简单的后果的理解招生以及基于初级保健的协作方法的可接受性和潜在设计 ADRD老年人的管理。 AIM 1将使用包括护理在内的新型链接数据集使用来自巴尔的摩和全州医院和紧急情况的两个卫生系统的管理招生数据部门利用数据以确定护理管理中的简单注册是否是：（1）更多在患有ADRD的老年人和（2）与可预防的医院和紧急情况有关的老年人中很常见部门使用。 AIM 2将对四组利益相关者进行定性访谈（护理管理计划负责人和员工，初级保健临床医生和办公室工作人员，健康信息技术专家，年龄较大 ADRD及其家庭护理人员的成年人）确定障碍和促进者的设计基于护理的协作方法为ADRD的老年人提供护理管理。 AIM 3将试行测试基于初级保健的协作方法针对ADRD的老年人的护理管理方法着重于可行性和可接受性。拟议的研究将为如何做到最好的证据做出贡献在人口健康计划（例如护理）的背景下，为老年人提供ADRD的老年人护理管理。候选人是一位老年医生，他已经证明了学术的良好记录奖学金和众多出版物和早期研究人员赠款。她提出了一套全面的套装培训活动旨在她担任临床调查员和国家领导者的发展告知ADRD老年人的护理服务的改进。该项目将促进她持续的职业以以下方式开发（1）高级统计方法中的其他课程和经验，（2）发展对生物信息学的基本理解，（3）在干预设计中应用的经验 ADRD护理的背景，（4）提高她对人口健康计划的理解。她已经组装了一个典范的心理团队，拥有主题领域的专家以及相关的研究方法和工作在丰富的研究环境中，拥有巨大的资源来支持她的发展。