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）：该奖学金的目标是让申请人克里斯托弗·考夫曼（Christopher Kaufmann）为老年药物流行病学的学术研究生涯做好准备，重点关注与[向老年人开出精神科药物的趋势]以及相关的健康、经济和社会结果相关的问题。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，审查老年人使用镇静催眠药物的最新趋势，以及该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，我们将在最近针对老年人群中不适当处方这些药物的临床和政策举措的背景下，研究向老年人开出镇静催眠药物的最新趋势。 [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 Medicare D 部分的实施，探讨医生开出这些药物的模式和患者结果的变化。我们将使用国家流动医疗调查 (NAMCS) 的数据来研究医生开出处方的趋势，并使用健康与退休研究 (HRS) 来研究镇静催眠药的使用与睡眠之间的关系。 老年人的不良健康结果和服务利用。该项目得到了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。 Ramin Mojtabai 副教授是一位执业精神科医生，在精神药物的药物流行病学方面拥有专业知识；Joseph Gallo 教授是一位拥有丰富指导经验的老年学研究员；Adam Spira 助理教授是一位临床心理学家，在晚年睡眠障碍和老年人焦虑方面具有专业知识，他们将担任该申请的赞助商。他们的指导将得到流行病学系药物流行病学专业内科医生 Caleb Alexander 副教授、生物统计学系老年学专业统计学家 Karen Bandeen-Roche 教授以及卫生政策与管理系公共卫生法律和政策专业知识 Lainie Rutkow 助理教授的补充。] 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，以回答与不断增长的老年人口密切相关的健康相关问题。此外，拟议的奖学金将为考夫曼先生提供作为独立研究员进入职业生涯下一阶段所需的技能。