Pharmaceutical Case Management and Living Well with a Disability

药品案例管理和残疾人的美好生活

• 批准号: 7492329
• 负责人: Elizabeth A Chrischilles
• 金额: $ 32.5万
• 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: 2006-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7492329
• 关键词: Pharmaceutical; Case; Management; Living; Well

DESCRIPTION (provided by applicant): The United States state-specific age-adjusted disability prevalence ranges from 13.6% to 21.8%. A third to half of people with disability have drug therapy problems, 25 to 45% have an adverse drug effect each year, and virtually all regularly experience at least one secondary condition. The purpose of this randomized controlled trial is to test the effectiveness of the eight-week group-session health promotion program Living Well with a Disability (LW) augmented with a cooperative care model of medication management (Pharmaceutical Case Management; PCM). We theorize that the complementary mechanisms of the combined interventions will result in greater reduction in secondary conditions than the Living Well program alone. By reducing symptoms from secondary conditions our overall goal is to improve the health and quality of life of people with activity limitations. This research expands and replicates two promising evidence-based interventions in a broader population than they have previously been studied: we will test the interventions in a population-based sample of 252 adults with activity limitations who may or may not identify themselves as disabled. By combining the two interventions, this research also evaluates a new integrated intervention. Our primary specific aim is to compare the 6 and 12 month mean symptoms of secondary conditions among adults randomized to participate in the Living Well program augmented with PCM with those randomized to the traditional Living Well program and with those randomized to a no- intervention control group. Secondary aims are to compare the medication use quality, attitudes and adverse effects between the study groups. A population-based sample of adults with activity limitations will be identified by mailing a screening questionnaire to an age-stratified random sample of adults (18-44,45- 64, 65+) from the Iowa voters registration list living within 30 miles of the study facilities in three Iowa counties. To be eligible for our study, a person must report: (1) activity limitations according to the two BRFSS disability screening questions; (2) a physical impairment, including an anatomical loss or musculoskeletal, neurological, respiratory, or cardiovascular impairment which results from injury, disease, or congenital disorder; and (3) three or more symptoms from secondary conditions. Those randomized to traditional LW will participate in 8 weekly LVV sessions. The augmented LW group will additionally receive four one-on-one in-person sessions with a study pharmacist to create a medication therapy action plan in cooperation with the subject's primary care physician. Questionnaires will be administered at baseline and 6 and 12 months and will be the source of the primary study outcome variable as well as measures of attitudes and adverse medication effects. Prescription dispensing records and medical records will be the data source for rating medication use quality using standardized guidelines.

描述（由申请人提供）：美国特定州的年龄调整残疾患病率范围为13.6%至21.8%。三分之一至一半的残疾人有药物治疗问题，25%至45%的人每年有药物不良反应，几乎所有人都定期经历至少一种继发性疾病。这项随机对照试验的目的是测试为期八周的小组会议健康促进计划的有效性生活良好的残疾人（LW）与合作护理模式的药物管理（药物病例管理; PCM）。我们的理论是，相结合的干预措施的互补机制将导致更大的减少继发性疾病比单独的生活良好计划。通过减少继发性疾病的症状，我们的总体目标是改善活动受限者的健康和生活质量。这项研究扩展并复制了两个有前途的循证干预措施，在更广泛的人群中比以前研究的更广泛：我们将在252名活动受限的成年人中测试干预措施，这些成年人可能会或可能不会认为自己是残疾人。通过结合这两种干预措施，本研究还评估了一种新的综合干预措施。我们的主要具体目标是比较随机参加PCM增强的Living Well计划的成年人与随机参加传统Living Well计划的成年人以及随机参加无干预对照组的成年人的继发性疾病的6个月和12个月平均症状。次要目的是比较研究组之间的药物使用质量，态度和不良反应。将通过邮寄筛选调查问卷给居住在爱荷华州三个县研究设施30英里范围内的爱荷华州选民登记名单中的年龄分层随机成人样本（18- 44、45 - 64、65+），确定活动受限成人的基于人群的样本。要符合我们的研究资格，一个人必须报告：（1）根据两个BRFSS残疾筛查问题的活动限制;（2）身体损伤，包括解剖损失或肌肉骨骼，神经，呼吸或心血管损伤，这是由损伤，疾病或先天性疾病引起的;和（3）三个或更多的继发性疾病症状。随机分配至传统LW组的患者将参加8次每周一次的LVV治疗。增强LW组还将与研究药剂师进行4次一对一面对面的会议，以与受试者的初级保健医生合作制定药物治疗行动计划。将在基线、6个月和12个月时进行问卷调查，问卷调查将作为主要研究结果变量以及态度和药物不良反应指标的来源。处方配药记录和医疗记录将是使用标准化指南对药物使用质量进行评级的数据源。

项目成果

Older adults' views about "Managing Your Medications" booklet.

老年人对“管理您的药物”小册子的看法。

• DOI: 10.1177/0733464811421910
• 发表时间: 2013
• 期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society
• 作者: Robertson,Jill;Farris,KarenB;Schultz,SusanK;Carnahan,RyanM;Gryzlak,Brian;Chrischilles,ElizabethA
• 通讯作者: Chrischilles,ElizabethA

Concern beliefs in medications: changes over time and medication use factors related to a change in beliefs.

关注对药物的信念：随时间的变化以及与信念变化相关的药物使用因素。

• DOI: 10.1016/j.sapharm.2012.07.003
• 发表时间: 2013
• 期刊: Research in social & administrative pharmacy : RSAP
• 作者: Shiyanbola,OlayinkaO;Farris,KarenB;Chrischilles,Elizabeth
• 通讯作者: Chrischilles,Elizabeth

Living with disability: patterns of health problems and symptom mediation of health consequences.

残疾生活：健康问题的模式和健康后果的症状中介。

• DOI: 10.1016/j.dhjo.2012.03.001
• 发表时间: 2012
• 期刊: Disability and health journal
• 影响因子: 4.5
• 作者: Patterson,BrandonJ;Doucette,WilliamR;Lindgren,ScottD;Chrischilles,ElizabethA
• 通讯作者: Chrischilles,ElizabethA

Medication therapy management and complex patients with disability: a randomized controlled trial.

药物治疗管理和复杂的残疾患者：一项随机对照试验。

• DOI: 10.1177/1060028013512472
• 发表时间: 2014
• 期刊: The Annals of pharmacotherapy
• 作者: Chrischilles,ElizabethA;Doucette,William;Farris,Karen;Lindgren,Scott;Gryzlak,Brian;Rubenstein,Linda;Youland,Kelly;Wallace,RobertB
• 通讯作者: Wallace,RobertB