Facilitating adoption of COPD evidence-based care in outpatient settings (FACES)

促进在门诊环境中采用慢性阻塞性肺病循证护理 (FACES)

• 批准号: 9301630
• 负责人: Laura Cecere Feemster
• 金额: $ 4.64万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9301630
• 关键词: Academic Detailing; Academic Medical Centers; Adherence; Adoption; Adult; Affect; American; Award; Belief; Caring; Characteristics; Chronic Care; Chronic Disease; Chronic Obstructive Airway Disease; Chronic lung disease; Clinic; Clinical; Clinical Medicine; Clinical Sciences; Clinical Trials; Clinical Trials Design; Community Medicine; Comorbidity; Critical Care; Cross-Sectional Studies; Data; Data Analyses; Development; Development Plans; Diagnosis; Disease Management; Educational Background; Effectiveness; Environment; Funding; Future; Goals; Guidelines; Health; Health Expenditures; Health behavior; Heterogeneity; Hospitalization; Institutes; Institution; Insurance Coverage; Internal Medicine; Intervention; Intervention Trial; Interview; Knowledge; Lead; Lung; Medical Records; Medical center; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Modeling; Motivation; Outcome; Outpatients; Patient Care; Patient Self-Report; Patient-Focused Outcomes; Patients; Phase; Physicians; Practice Guidelines; Protocols documentation; Provider; Public Health Schools; Publications; Qualitative Research; Quality of Care; Quality of life; Records; Research; Research Design; Research Methodology; Research Personnel; Research Proposals; Research Training; Resources; Scientist; Severity of illness; Socioeconomic Status; Structure; Time; Training; Translating; Translational Research; Treatment Efficacy; Universities; Variant; Washington; Work; base; care delivery; career; career development; clinical practice; cohort; community based practice; demographics; design; disease diagnosis; efficacy testing; evidence base; evidence based guidelines; experience; health care service utilization; health related quality of life; improved; improved outcome; innovation; multi-component intervention; patient oriented research; patient population; primary care setting; provider intervention; success; therapy design; translational health science

DESCRIPTION (provided by applicant): This K23 award will provide an opportunity for Dr. Cecere to achieve her long-term goal of transitioning to an independently-funded physician-scientist with a focus on improving outcomes for patients with chronic lung diseases. The proposed project builds on her previous work investigating the effects of patient health behaviors and characteristics on health outcomes for patients with COPD and studying heterogeneity in delivered COPD care. Through this project, Dr. Cecere will achieve her immediate goals of attaining expertise in clustered and correlated data analysis, qualitative research methods, and designing and conducting intervention trials. This will be accomplished through an integrated career development plan consisting of formal coursework, guidance from highly skilled mentors, and protected time to gain practical research experience. Environment: The rich academic environment at the University of Washington (UW) is an ideal place for Dr. Cecere's continued training. The UW Division of Pulmonary and Critical Care Medicine Clinical Research Training Track prides itself on a collegial environment in which investigators are encouraged to collaborate with one another. The UW also offers a broad range of educational and research resources, including the School of Public Health and Community Medicine and the Institute of Translational Health Sciences (the UW's Clinical and Translational Science Awards (CTSA) institution). In addition, Dr. Cecere has assembled a mentoring team with expertise in health delivery and quality improvement interventions, strong records of funding and publication, and success in training early-investigators who have gone on to have careers as physician-scientists at major academic medical centers. Research: In this patient-oriented research proposal, Dr. Cecere will identify specific patient and provider characteristics associated with best-practice COPD care and intervene to improve delivery of that care in the outpatient setting. To accomplish this, she has identified a cohort of COPD patients and their providers at the two internal medicine clinics associated with the University of Washington Medical Center in Seattle. Dr. Cecere will: 1) conduct a cross-sectional study to determine patient and provider characteristics associated with adherence to evidence-based best-practice guidelines for COPD management; 2) perform a qualitative study to better understand patient and provider perspectives influencing the delivery of recommended care for patients with COPD; and 3) test the efficacy of a multi-faceted intervention for providers designed to improve the delivery of best practice care to COPD patients in the primary care setting, using a quasi-experimental clinical trial design. The proposed project is innovative in that it explores the interface between Phase 2 (T2) and Phase 3 (T3) research by examining the efficacy of an intervention designed to disseminate and implement evidence-based guidelines into clinical practice as a means of improving quality of care. This study has the potential to lead to additional intervention and dissemination studies designed to improve health outcomes for the growing population of patients with COPD. This model can also be translated to improve outcomes for patients with other chronic diseases.

描述（由申请人提供）：这个K23奖将为Cecere博士提供一个机会，实现她的长期目标，即过渡到一个独立资助的医师-科学家，专注于改善慢性肺部疾病患者的预后。拟议的项目建立在她之前的工作基础上，调查了患者健康行为和特征对COPD患者健康结果的影响，并研究了COPD护理的异质性。通过这个项目，Cecere博士将实现她在集群和相关数据分析、定性研究方法以及设计和实施干预试验方面的专业知识的直接目标。这将通过一个综合的职业发展计划来完成，包括正式的课程，高技能导师的指导，以及获得实际研究经验的保护时间。环境：华盛顿大学（UW）丰富的学术环境是Cecere博士继续培训的理想场所。华盛顿大学肺部和重症医学临床研究培训部门以鼓励研究人员相互合作的学院环境而自豪。华盛顿大学还提供广泛的教育和研究资源，包括公共卫生和社区医学学院和转化健康科学研究所（华盛顿大学临床和转化科学奖（CTSA）机构）。此外，Cecere博士还组建了一个指导团队，他们在医疗服务和质量改善干预措施方面具有专业知识，在资助和出版方面有着良好的记录，并成功培训了早期研究人员，这些研究人员后来在主要学术医疗中心担任医生和科学家。研究：在这项以患者为导向的研究计划中，Cecere博士将确定与最佳COPD护理实践相关的特定患者和提供者特征，并进行干预以改善门诊护理的提供。为了实现这一目标，她在西雅图华盛顿大学医学中心附属的两家内科诊所确定了一组COPD患者及其提供者。Cecere博士将：1)开展一项横断面研究，以确定与COPD管理循证最佳实践指南依从性相关的患者和提供者特征；2)进行定性研究，以更好地了解患者和提供者的观点对COPD患者推荐护理的影响；3)测试旨在改善最佳交付的提供者的多方面干预的有效性

项目成果

Assessment and Management of Symptoms for Outpatients Newly Diagnosed With Lung Cancer.

• DOI: 10.1177/1049909114557635
• 发表时间: 2016-03
• 期刊: The American journal of hospice & palliative care
• 作者: Reinke LF;Feemster LC;Backhus LM;Gylys-Colwell I;Au DH
• 通讯作者: Au DH

It's Bad-Really Bad-But Does it Matter? Medication Adherence in Chronic Obstructive Pulmonary Disease.

这很糟糕——真的很糟糕——但这有关系吗？

• DOI: 10.1164/rccm.201608-1592ed
• 发表时间: 2017
• 期刊: American journal of respiratory and critical care medicine
• 影响因子: 24.7
• 作者: Au,DavidH;Feemster,LauraC
• 通讯作者: Feemster,LauraC

The long term impact of an end-of-life communication intervention among veterans with COPD.

• DOI: 10.1016/j.hrtlng.2016.10.003
• 发表时间: 2017-01
• 期刊: Heart & lung : the journal of critical care
• 作者: Reinke LF;Feemster LC;McDowell J;Gunnink E;Tartaglione EV;Udris E;Curtis JR;Au DH
• 通讯作者: Au DH

Reply: chronic obstructive pulmonary disease readmissions and medicare reimbursement.

回复：慢性阻塞性肺疾病再入院和医疗报销。

• DOI: 10.1164/rccm.201404-0635le
• 发表时间: 2014
• 期刊: American journal of respiratory and critical care medicine
• 影响因子: 24.7
• 作者: Feemster,LauraC;Au,DavidH
• 通讯作者: Au,DavidH

Thiazolidinediones and the risk of asthma exacerbation among patients with diabetes: a cohort study.

• DOI: 10.1186/1710-1492-10-34
• 发表时间: 2014
• 期刊: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology
• 作者: Rinne ST;Feemster LC;Collins BF;Au DH;Perkins M;Bryson CL;O'Riordan TG;Liu CF
• 通讯作者: Liu CF