Predicting Transitions Among Community-Dwelling Elders

预测社区老年人的转变

• 批准号: 6873628
• 负责人: ILENE HARRIS
• 金额: $ 12.93万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6873628
• 关键词: behavior prediction; behavioral /social science research tag; community; comorbidity; data collection methodology /evaluation; drug adverse effect; extended care facility; functional ability; geriatrics; health care model; health services research tag; health surveys; home for elderly; home health care; human data; human old age (65+); human population dynamics; model design /development; patient care management; patient safety /medical error; residential care facility; self care; socioenvironment; therapy compliance

DESCRIPTION (provided by applicant): This application is a request for a Mentored Research Scientist Development Award (K01) to further Dr. Ilene Zuckerman's research in the area of epidemiology of aging and long-term care, with a focus on medication-related issues. Adverse drug events are risk factors for elders transitioning from independent community living to dependent environments such as nursing homes. Medication-related behaviors that lead to adverse drug events and subsequent transitions are preventable with effective intervention. Screening for transitions can identify high-risk elders for interventions to avoid preventable transitions. Dr. Zuckerman's goal for this application is to build a research agenda that examines factors associated with transitions in the elderly. The central hypothesis is that socio-demographic, clinical, behavioral and medication use factors can discriminate elders who experience transitions from independent to dependent settings from those who do not. The objective of the proposed research will be accomplished by pursuing three specific aims: 1) estimate the association between transitions from independent to dependent living and medication use factors in the elderly; 2) develop a predictive model for transitioning from independent to dependent living; and 3) develop and pilot test a screening instrument, based on the predictive model, to discriminate older adults who will experience a transition from those who will not. To accomplish the first two aims, multivariable analysis of survey and administrative claims data will be performed. Qualitative methods will be used to develop and pilot test the screening instrument in Aim #3. In addition to experience gained from completing the proposed research, Dr. Zuckerman will engage in learning activities to enhance her quantitative and qualitative research skills. The proposed training and research are based on her professional interests and build on current work and previous experience. The project represents her continuing efforts to improve the safety of drug use for older adults by understanding the association between drug use factors and elder transitions from independent to dependent environments. Dr. Zuckerman is particularly well prepared to undertake this proposed research, with clinical experience in geriatric pharmacotherapy and epidemiological training. In addition, the mentor and co-mentors have extensive epidemiology of aging research expertise. This research is significant in that it bridges the disparate literature that has separately examined medication use factors and transitions. It is an incremental and important step to building a research agenda that examines socio-demographic, clinical and behavioral factors that affect medication use and transitions in the elderly. Thus, the findings will allow Dr. Zuckerman to build a research agenda that addresses her long term goal to reduce the incidence and prevalence of preventable adverse drug events in the elderly, and to design and evaluate interventions that are targeted toward preventable risk factors for transitions.

描述（由申请人提供）：本申请是一个指导研究科学家发展奖（K 01）的请求，以进一步博士伊琳祖克曼在老龄化和长期护理流行病学领域的研究，重点是与药物相关的问题。药物不良事件是老年人从独立社区生活过渡到依赖环境（如养老院）的风险因素。通过有效的干预，可以预防导致药物不良事件和随后的过渡的药物相关行为。过渡筛查可以识别高风险的老年人进行干预，以避免可预防的过渡。Zuckerman博士的目标是建立一个研究议程，检查与老年人过渡相关的因素。中心假设是，社会人口统计学，临床，行为和药物使用因素可以区分老年人谁的经验，从独立到依赖的设置从那些谁不。拟议的研究目标将通过追求三个具体目标来实现：1）估计从独立生活到依赖生活的过渡之间的关联， 2）开发一个从独立生活向依赖生活过渡的预测模型; 3）基于预测模型开发并试点测试一种筛选工具，以区分将经历过渡的老年人和不会经历过渡的老年人。为了实现前两个目标，将对调查和行政索赔数据进行多变量分析。将使用定性方法来开发和试点测试目标3中的筛选工具。除了从完成拟议的研究中获得的经验外，Zuckerman博士还将参与学习活动，以提高她的定量和定性研究技能。拟议的培训和研究以她的专业兴趣为基础，并以目前的工作和以往的经验为基础。该项目代表了她通过了解药物使用因素与老年人从独立到依赖环境的过渡之间的关联来提高老年人药物使用安全性的持续努力。朱克曼博士特别愿意承担 本研究拟结合临床经验进行老年药物治疗和流行病学培训。此外，导师和共同导师有广泛的流行病学老化研究的专业知识。这项研究的重要性在于，它弥合了不同的文献，这些文献分别研究了药物使用因素和过渡。这是一个渐进的和重要的一步，以建立一个研究议程，审查社会人口，临床和行为因素，影响药物使用和过渡的老年人。因此，这些发现将使Zuckerman博士能够建立一个研究议程，以实现她的长期目标，即减少老年人可预防的药物不良事件的发生率和患病率，并设计和评估针对可预防的风险因素的干预措施。