University of Iowa Older Adults CERT

爱荷华大学老年人 CERT

• 批准号: 7221848
• 负责人: Elizabeth A Chrischilles
• 金额: $ 80万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-14 至 2011-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7221848
• 关键词: University; Iowa; Older; Adults; CERT

DESCRIPTION (Provided by the Applicant): Between 14 and 23% of the elderly receive a medication they should not have been prescribed. Up to 40% of patients do not take their medications as prescribed. Under-use of certain medications like beta blockers or ACE inhibitors is also of concern. Whereas clinical practice guidelines exist and departures from optimal practice are well-documented for specific diseases, it is not known whether such guidelines generalize to the elderly with multiple co-morbidities. In the limited clinical situations where clinical trial evidence of therapeutic benefit among the elderly is strong, barriers to guideline adherence are more prevalent in the elderly including drug-to-drug interactions, drug-disease contraindications, alterations in decision-making capacities, and compounded adverse event risk due to multiple medications. The University of Iowa Older Adults CERTs (UIOAC) offers the CERTs program research expertise for (1) making policy-relevant estimates of treatment effects and cost-effectiveness among subsets of the elderly defined by important characteristics such as function status, co-morbidity, and age and (2) identifying and designing interventions to address barriers to optimal therapeutics in the elderly in community care settings. Our collaborative spirit is indicated by our projects with community-based physician and pharmacist research networks and collaborations with state and federal funding agencies as well as end-users including health plans and a national chain pharmacy organization. The specific aims of the UIOAC are to: 1. Improve safety and effectiveness of medication use among older adults by a. A quasi-experimental intervention study of translating a collaborative model of hypertension management into community care of elderly patients. b. Three database studies and one prospective study of age disparities in chemotherapy treatments and function status, survival, and cost-effectiveness outcomes. c. A longitudinal survey of the effect of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) on patient medication safety and access. d. Three studies of age-related changes in patient decision making and their effect on health outcome. 2. Expand existing collaborations to new partnerships with private and public entities by a. A developmental project to formulate a structured procedure for identifying and resolving geriatric medication problems in the community with the goal of implementing the procedure in diverse public and private practice settings. 3. Educate providers, patients, and policy makers about therapeutic decision-making in the elderly.

描述（由申请人提供）：14% 至 23% 的老年人接受了不应该开处方的药物。高达 40% 的患者不按处方服药。 β受体阻滞剂或血管紧张素转换酶抑制剂等某些药物的使用不足也令人担忧。尽管存在临床实践指南，并且对特定疾病偏离最佳实践的情况有详细记录，但尚不清楚这些指南是否适用于患有多种合并症的老年人。在有限的临床情况下，临床试验证据表明老年人的治疗益处很强，但老年人中遵循指南的障碍更为普​​遍，包括药物间相互作用、药物与疾病禁忌症、决策能力的改变以及多种药物导致的复合不良事件风险。爱荷华大学老年人 CERT (UIOAC) 提供 CERT 项目研究专业知识，用于 (1) 对由功能状态、共病和年龄等重要特征定义的老年人子集进行与政策相关的治疗效果和成本效益估计，以及 (2) 确定和设计干预措施，以解决社区护理环境中老年人获得最佳治疗的障碍。我们与基于社区的医生和药剂师研究网络的项目以及与州和联邦资助机构以及最终用户（包括健康计划和全国连锁药房组织）的合作体现了我们的合作精神。 UIOAC 的具体目标是： 1. 通过以下方式提高老年人用药的安全性和有效性 一个。将高血压管理协作模式转化为老年患者社区护理的准实验干预研究。 b.三项数据库研究和一项前瞻性研究涉及化疗治疗的年龄差异以及功能状态、生存率和成本效益结果。 c.关于《医疗保险处方药、改进和现代化法案》(MMA) 对患者用药安全和可及性影响的纵向调查。 d.三项关于患者决策与年龄相关的变化及其对健康结果影响的研究。 2. 将现有合作扩展到与私营和公共实体的新伙伴关系 一个。一个开发项目，旨在制定一个结构化程序，用于识别和解决社区中的老年用药问题，目标是在不同的公共和私人诊所环境中实施该程序。 3. 对医疗服务提供者、患者和政策制定者进行有关老年人治疗决策的教育。