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

描述(由申请人提供)：该奖学金的目标是为申请者Christopher Kaufmann在老年药物流行病学方面的学术研究生涯做好准备，重点关注与[为老年人开出精神药物的趋势]相关的问题以及相关的健康、经济和社会后果。拟议的研究金由两个相辅相成的部分组成：(A)一个研究项目，探讨老年人使用镇静催眠药的最新趋势，以及这一群体的相关健康结果和保健服务利用情况；(B)一个培训计划，包括正规课程和辅导，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倡议的背景下，审查向老年人开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适当处方。[更具体地说，我们将根据最近推出的非苯二氮卓类睡眠辅助药物和2006年联邦医疗保险D部分的实施情况，探索这些药物的医生处方模式和患者结果的变化。我们将使用国家动态医疗护理调查(NAMCS)的数据来研究医生开处方的趋势，并使用健康和退休研究(HRS)来研究镇静剂-催眠药的使用与老年人不良健康结果和服务利用之间的关系。这个项目得到了一个强大的跨学科指导团队的支持，该团队拥有老年学、临床精神病学、内科、卫生政策和统计方法方面的专业知识。在精神科药物药物流行病学方面有专长的执业精神病学家拉明·莫伊塔拜副教授、具有丰富指导经验的资深老年学研究员约瑟夫·加洛教授和在老年人睡眠障碍和焦虑症方面有专长的临床心理学家亚当·斯皮拉助理教授将作为这项申请的发起人。他们的指导将得到流行病学系具有药物流行病学专长的内科医生Caleb Alexander副教授、生物统计学系具有老年学专长的统计学家Karen Bandeen-Roche教授以及卫生政策和管理部具有公共卫生法和政策专长的助理教授Lainie Rutkow的补充。]研究项目和补充培训计划将为申请者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提供他进入独立研究人员职业生涯下一阶段所需的技能。

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.