Sedative-hypnotic use in US older adults: Recent trends and associated outcomes

美国老年人使用镇静催眠药：最新趋势和相关结果

• 批准号: 8592531
• 负责人: Christopher Norfleet Kaufmann
• 金额: $ 4.22万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-20 至 2016-08-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8592531
• 关键词: Address; Adverse effects; Affect; Anxiety; Awareness; Beer; Benzodiazepines; Biometry; Clinical; Clinical Trials; Complement; Data; Development; Disincentive; Drug Insurance; Drug Prescriptions; Effectiveness; Elderly; Epidemiology; Eszopiclone; Exclusion; Fellowship; Formularies; Future; Gerontology; Goals; Guidelines; Health; Health Policy; Health Services; Hip Fractures; Hospitalization; Impaired cognition; Insurance; Internal Medicine; Internist; Knowledge; Label; Laws; Light; Medicare; Mentorship; National Ambulatory Medical Care Survey; Nursing Homes; Outcome; Patients; Pattern; Personal Satisfaction; Pharmaceutical Preparations; Physicians; Policies; Population; Population Characteristics; Principal Investigator; Psychiatrist; Psychiatry; Psychologist; Public Health; Publishing; Research; Research Methodology; Research Personnel; Research Project Grants; Retirement; Risk; Sampling; Side; Sleep; Sleep disturbances; Staging; Statistical Methods; Subgroup; Time; Training; Training Programs; Zaleplon; adverse outcome; beneficiary; career; experience; falls; functional decline; functional disability; functional outcomes; health care service utilization; health economics; hypnotic; improved; mortality; population based; professor; programs; prospective; public health relevance; sedative; service utilization; skills; trend; zolpidem

DESCRIPTION (provided by applicant): The goal of this fellowship is to prepare the applicant, Christopher Kaufmann, for an academic research career in geriatric pharmaco-epidemiology, focusing on issues related to [prescribing trends of psychiatric medication to older adults,] and associated health, economic, and societal outcomes. The proposed fellowship consists of two complementary components: a) a research project examining recent trends in the use of sedative-hypnotic medications among older adults, and associated health outcomes and health service utilization in this population; and b) a training plan comprised of formal coursework and mentorship, and other didactic and professional development activities. In the proposed research project, we will examine recent trends in the prescription of sedative-hypnotic medications to older adults, in the context of recent clinical and policy initiatives tackling inappropriate prescription of these medications in this population. [More specifically, we will explore changes in physician prescribing patterns of these medications and patient outcomes in light of the recent introduction of non-benzodiazepine sleep-aid medications and the implementation of Medicare Part D in 2006. We will use data from the National Ambulatory Medical Care Survey (NAMCS) to study physician prescribing trends, and the Health and Retirement Study (HRS) to study the association between sedative- hypnotic use and both adverse health outcomes and service utilization in older adults. This project is supported by a strong interdisciplinary mentorship team with expertise in gerontology, clinical psychiatry, internal medicine, health policy, and statistical methods. Associate Professor Ramin Mojtabai, a practicing psychiatrist with expertise in the pharmaco-epidemiology of psychiatric medications, Professor Joseph Gallo, an established gerontology researcher with extensive mentorship experience, and Assistant Professor Adam Spira, a clinical psychologist with expertise in functional outcomes of late life sleep-disturbances and in anxiety in older adults, will serve as the sponsors of this application. Their mentorship will be complemented by that of Associate Professor Caleb Alexander, an internist with expertise in pharmaco-epidemiology in the Department of Epidemiology, Professor Karen Bandeen-Roche, a statistician with expertise in gerontology in the Department of Biostatistics, and Assistant Professor Lainie Rutkow, from the Department of Health Policy and Management who has expertise in public health law and policy.] The research project and the complementary training plan will provide the applicant with hands-on experience applying pharmaco-epidemiological research methods to answer health-related questions of great relevance to the growing population of older adults. Further, the proposed fellowship will provide Mr. Kaufmann with the skills that he requires to move on to the next stage of his career as an independent researcher.

描述（由申请人提供）：该奖学金的目标是为申请人Christopher Kaufmann在老年药物流行病学方面的学术研究做好准备，重点关注与[老年人精神药物处方趋势]相关的问题，以及相关的健康，经济和社会结果。拟议的研究金由两个互补部分组成：a)一个研究项目，审查老年人使用镇静催眠药物的最新趋势，以及这一人群的相关健康结果和卫生服务利用情况；b)培训计划，包括正式的课程和指导，以及其他教学和专业发展活动。在拟议的研究项目中，我们将在最近的临床和政策举措的背景下，研究老年人镇静催眠药物处方的最新趋势，以解决这些药物在这一人群中的不当处方。更具体地说，我们将根据最近引入的非苯二氮卓类助眠药物和2006年实施的医疗保险D部分，探索这些药物的医生处方模式和患者结果的变化。我们将使用国家门诊医疗调查（NAMCS）的数据来研究医生处方趋势，并使用健康与退休研究（HRS）的数据来研究镇静催眠药物的使用与老年人不良健康结果和服务利用之间的关系。该项目由一个强大的跨学科指导团队提供支持，该团队在老年学、临床精神病学、内科、卫生政策和统计方法方面具有专业知识。Ramin Mojtabai副教授是精神病学药物流行病学方面的执业精神病学家，Joseph Gallo教授是具有丰富指导经验的资深老年学研究员，Adam Spira助理教授是临床心理学家，擅长研究晚期睡眠障碍和老年人焦虑的功能结果，他们将担任这项申请的发起人。他们的指导将得到流行病学系具有药物流行病学专业知识的内科医生Caleb Alexander副教授、生物统计系具有老年学专业知识的统计学家Karen Bandeen-Roche教授以及卫生政策和管理系具有公共卫生法律和政策专业知识的助理教授Lainie Rutkow的补充。研究项目和补充培训计划将为申请人提供应用药物流行病学研究方法的实践经验，以回答与日益增长的老年人人口密切相关的与健康有关的问题。此外，拟议的奖学金将为考夫曼先生提供他作为独立研究员进入职业生涯下一阶段所需的技能。