Pilot/Experimental Studies Core (PESC)

试点/实验研究核心（PESC）

• 批准号: 9490112
• 负责人: Rosa Baier
• 金额: $ 25.23万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9490112
• 关键词: Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Americas; Assisted Living Facilities; Award; Berry; Caring; Clinical; Clinical assessments; Community Healthcare; Data; Data Set; Data Sources; Databases; Development; Disease; Effectiveness; Elderly; Family; Feedback; Foundations; Funding; Future; Health Policy; Healthcare Systems; Industry; Infrastructure; Institution; Integrated Delivery Systems; Intervention; Intervention Trial; Link; Medicare claim; Mentors; Mentorship; Methodology; Modeling; Monitor; Nursing Homes; Outcome; Patients; Pennsylvania; Pharmaceutical Preparations; Physicians; Pilot Projects; Policies; Population; Principal Investigator; Procedures; Program Research Project Grants; Protocols documentation; Provider; Quality of Care; Randomized; Randomized Controlled Trials; Research; Research Personnel; Research Project Grants; Resources; Seeds; System; Testing; Time; Treatment outcome; Universities; Vulnerable Populations; Work; base; cost effective; dementia care; experience; experimental study; falls; health care settings; improved; individual patient; industry partner; innovation; medical schools; response; social

Project Summary The program project grant’s (PPG’s) broad focus is to examine how healthcare policies impact the care of people with Alzheimer’s disease and related dementias (ADRD). Interventions to help providers deliver high-quality ADRD care in response to these emerging policies are critically needed. Pragmatic cluster randomized, controlled trials (RCTs), where the unit of randomization is the system or facility, are ideally suited to rigorously evaluate such interventions in the real-world conditions in which they are routinely implemented. Over the past five years, our group acquired expertise conducting cluster RCTs in a variety of healthcare settings that serve older adults. These trials are facilitated by the unique infrastructure of administrative and national databases that are the cornerstone of this PPG (e.g., linked mandatory clinical assessments and Medicare claims). Leveraging this foundation, the over-riding objective of the Pilot/Experimental Studies Core (PESC) is to provide catalytic support for innovative pilot research projects that will generate the feasibility data needed to conduct cluster RCTs of interventions aimed at improving care for people with ADRD and their families. The Aims are to: Aim 1: Solicit, select, and fund the preliminary work needed to support the future funding and conduct of cluster RCTs that evaluate interventions to improve care of ADRD patients. Aim 2: Integrate the PESC studies and investigators into the PPG infrastructure of data, research networks, and researchers. Aim 3: Provide the monitoring, mentorship, and resources to transform PESC-funded studies into successful, independently-funded cluster RCTs. The PESC will be co-directed by Susan Mitchell, MD, MPH (Principal Investigator) and Rosa Baier, MPH. Dr. Mitchell has a strong track record of mentoring, independent funding, and conducting cluster RCTs with people with ADRD. Ms. Baier leads a broader initiative at Brown conducting pragmatic research in older adults. Two new pilot studies will be funded in each of years 1-4 of the PPG. Applications will be solicited from the PGG’s senior investigators’ academic institutions. Rigorous procedures will be followed for PES selection, monitoring, and development into independently-funded research awards. For the first year of the PPG, we received four applications and, after formal review, selected two for inclusion in this application. Dr. Kira Ryskina (University of Pennsylvania) will develop and pilot test a social comparison feedback intervention to reduce physician prescribing of potentially-harmful medications among hospitalized ADRD patients. Dr. Sarah Berry (Harvard Medical School) will conduct a pilot project to assess the feasibility of an intervention to optimize medication prescription to reduce injurious falls in nursing home residents with ADRD. IMPACT: The research and intellectual resources within this PPG are uniquely suited as a platform to support pilot work to enable future pragmatic RCTs among people with ADRD. In this way, this proposed PESC has the potential to improve the quality of care provided to this rapidly growing and vulnerable population.

项目摘要 该计划项目赠款(PPG)的主要重点是检查医疗政策如何影响人们的护理 患有阿尔茨海默病和相关痴呆症(ADRD)。帮助提供商提供高质量的干预措施 针对这些新出现的政策，ADRD的关怀是迫切需要的。语用集群随机化， 对照试验(RCT)，其中随机单位是系统或设施，非常适合于严格 在实际情况下评估这些干预措施，这些干预措施经常在其中实施。在过去的时间里 五年来，我们的团队获得了在各种医疗保健环境中执行群集RCT的专业知识 上了年纪的人。这些试验由行政和国家数据库的独特基础设施提供便利，这些数据库 是这一PPG的基石(例如，关联的强制性临床评估和联邦医疗保险索赔)。利用 在这个基础上，试点/实验研究核心(PESC)的压倒一切的目标是提供催化 支持创新的试点研究项目，这些项目将产生进行分组所需的可行性数据 旨在改善对ADRD患者及其家人的护理的干预措施的RCT。目标是：瞄准 1：征集、挑选和资助必要的前期工作，以支持未来资助和开展分组区域协调机制 评估改善ADRD患者护理的干预措施。目标2：整合PESC研究和 调查人员对数据、研究网络和研究人员的PPG基础设施进行调查。目标3：提供 监测、指导和资源，以将PESC资助的研究转化为成功的、独立资助的研究 集群RCT。PESC将由医学博士、公共卫生硕士苏珊·米切尔和罗莎·拜尔共同指导， 时速。米切尔博士在指导、独立资助和实施集群随机对照试验方面有着良好的记录 和患有ADRD的人一起。拜尔在布朗大学领导了一个更广泛的倡议，在老年人问题上进行实用主义研究 成年人。两项新的试点研究将在PPG的第1-4年每年得到资助。申请将从以下地点征集 PGG的高级调查人员的学术机构。PES的选拔将遵循严格的程序， 监测，并发展为独立资助的研究奖项。在PPG的第一年，我们 收到了四份申请，经正式审查后，选择了两份列入这份申请。基拉·瑞斯金娜博士 (宾夕法尼亚大学)将开发和试点测试一种社会比较反馈干预措施，以减少 医生在住院的ADRD患者中开出潜在有害药物的处方。莎拉·贝瑞博士 (哈佛医学院)将进行试点项目，以评估干预措施的可行性，以优化 减少ADRD疗养院居民伤害性跌倒的药物处方。影响：研究 此PPG中的智力资源非常适合作为支持试点工作的平台，以实现未来 ADRD患者中的务实RCT。通过这种方式，建议的PESC有可能改善 向这一快速增长的弱势群体提供的护理质量。