Pilot Study of Standardized PatiEnt-CenTered medicatiOn Review (SPECTORx) in Home Hospice

家庭临终关怀标准化以患者为中心的药物审查 (SPECTORx) 试点研究

基本信息

  • 批准号:
    9764235
  • 负责人:
  • 金额:
    $ 20.26万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2018
  • 资助国家:
    美国
  • 起止时间:
    2018-08-15 至 2022-06-30
  • 项目状态:
    已结题

项目摘要

PROJECT SUMMARY/ABSTRACT A tremendous challenge in home hospice care is ensuring that medication prescribing is appropriately aligned to patients’ goals of care and that medications are appropriately managed by family caregivers. Therefore, we propose a novel intervention that trains hospice staff to 1. regularly review, simplify, and align patients’ prescribed medications with their goals of care as their illness progresses, and 2. support family caregivers with education that empowers them to understand each medication’s use, develop skills for safe administration, and understand when stopping medications may be beneficial. This program is called Standardized PatiEnt- CenTered medicatiOn Review (SPECTORx) in Home Hospice, and is based on a combination of 3 existing, complementary, educational programs that, together, train hospice staff to create a comprehensive, patient-centered, medication management care plan. The program also creates an online learning community that promotes ongoing education and practice change for hospice clinicians. This R21 pilot study aims to demonstrate the feasibility of conducting a clinical trial to evaluate the efficacy of SPECTORx. The long-term objective is to test the hypothesis that SPECTORx reduces inappropriate medication prescribing and improves family caregiver reported quality of care. However, to accomplish this, we must first address challenging questions regarding the design, feasibility, and execution of trials in home hospice. We will accomplish this using a stakeholder engagement process to refine the SPECTORx intervention and trial protocol. We will then conduct a pilot cluster randomized trial and compare outcomes within and across 2 large, multi-office, hospice agencies from Utah and Massachusetts. Within each hospice agency, we will randomize 1 office to intervention and 1 office to attention control. Target enrollment is n=60 family caregiver-patient dyads of patients aged ≥65 years with advanced, life-limiting illness. Primary outcomes are acceptability and feasibility of the SPECTORx intervention by hospice stakeholders, and acceptability, burden and completion of family caregiver assessments (Family Caregiver Medication Administration Hassle Scale at baseline, 2 weeks, 4 weeks, 12 weeks, and quarterly). The overarching goal of this research is to align patient’s prescribed medications with their goals of care at each stage of their advanced illness and to support family caregivers’ medication management challenges. Ultimately, we want to improve the quality of medication prescribing, reduce treatment complexity and medication-related harm, and improve family caregiver outcomes for the almost 600,000 million elderly Americans who receive home hospice services annually.
项目概要/摘要 家庭临终关怀的一个巨大挑战是确保药物处方是正确的 与患者的护理目标适当一致,并且药物得到适当管理 由家庭照顾者。因此,我们提出了一种新颖的干预措施,对临终关怀人员进行培训: 1. 定期审查、简化患者的处方药物并使其与他们的护理目标保持一致: 他们的病情恶化,并且 2. 通过教育支持家庭照顾者,使他们能够 了解每种药物的用途,培养安全给药的技能,并了解何时 停止用药可能会有所帮助。该计划称为标准化患者- 家庭临终关怀中心的药物审查 (SPECTORx),基于 结合 3 个现有的、互补的教育计划,共同培训临终关怀 工作人员制定全面的、以患者为中心的药物管理护理计划。这 该计划还创建了一个在线学习社区,促进持续教育和 临终关怀临床医生的实践改变。这项 R21 试点研究旨在证明 进行临床试验来评估 SPECTORx 的功效。长期目标是 检验 SPECTORx 减少不适当药物处方并改善的假设 家庭护理人员报告了护理质量。然而,要实现这一目标,我们首先必须解决 有关家庭临终关怀试验的设计、可行性和执行的挑战性问题。 我们将通过利益相关者参与流程来完善 SPECTORx 来实现这一目标 干预和试验方案。然后我们将进行试点集群随机试验并进行比较 来自犹他州和犹他州的 2 个大型、多办公室临终关怀机构内部和之间的成果 马萨诸塞州。在每个临终关怀机构内,我们将随机分配 1 个办公室进行干预,1 个办公室进行干预。 办公室注意力控制。目标入组人数为 n=60 名家庭护理者-患者二人组 年龄≥65岁,患有晚期、危及生命的疾病。主要结果是可接受性和 临终关怀利益相关者 SPECTORx 干预的可行性、可接受性、负担 并完成家庭看护者评估(家庭看护者药物管理局) 基线、2 周、4 周、12 周和季度的麻烦量表。总体目标是 这项研究的目的是使患者的处方药物与他们在每个阶段的护理目标保持一致 他们的晚期疾病并支持家庭护理人员应对药物管理挑战。 最终,我们希望提高药物处方的质量,减少治疗次数 复杂性和药物相关的伤害,并改善家庭护理人员的结果 每年有 6000 亿美国老年人接受家庭临终关怀服务。

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Nurses' Perspectives on Family Caregiver Medication Management Support and Deprescribing.
护士对家庭护理人员药物管理支持和取消处方的看法。
Stakeholder-engaged process for refining the design of a clinical trial in home hospice.
  • DOI:
    10.1186/s12874-021-01275-0
  • 发表时间:
    2021-04-30
  • 期刊:
  • 影响因子:
    4
  • 作者:
    Tjia J;Clayton M;Chiriboga G;Staples B;Puerto G;Rappaport L;DeSanto-Madeya S
  • 通讯作者:
    DeSanto-Madeya S
Shared Medication PLanning In (SIMPLIfy) Home Hospice: An Educational Program to Enable Goal-Concordant Prescribing In Home Hospice.
  • DOI:
    10.1016/j.jpainsymman.2021.05.015
  • 发表时间:
    2021-11
  • 期刊:
  • 影响因子:
    4.7
  • 作者:
    Tjia J;Clayton MF;Fromme EK;McPherson ML;DeSanto-Madeya S
  • 通讯作者:
    DeSanto-Madeya S
Avoiding Adverse Drug Withdrawal Events When Stopping Unnecessary Medications According to the STOPPFrail Criteria.
根据停工标准,避免停止不必要的药物时避免不良药物提取事件。
  • DOI:
    10.4140/tcp.n.2021.136
  • 发表时间:
    2021-03-01
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Hanlon JT;Tjia J
  • 通讯作者:
    Tjia J
Feasibility and Acceptability of Digital Legacy-Making: An Innovative Story-Telling Intervention for Adults With Cancer.
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JENNIFER TJIA其他文献

JENNIFER TJIA的其他文献

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{{ truncateString('JENNIFER TJIA', 18)}}的其他基金

Longitudinal Patterns of Symptoms, Medication and Hospice Use in Nursing Home Residents Approaching End of Life
临终疗养院居民的症状、药物治疗和临终关怀服务的纵向模式
  • 批准号:
    10039637
  • 财政年份:
    2020
  • 资助金额:
    $ 20.26万
  • 项目类别:
Longitudinal Patterns of Symptoms, Medication and Hospice Use in Nursing Home Residents Approaching End of Life
临终疗养院居民的症状、药物治疗和临终关怀服务的纵向模式
  • 批准号:
    10264797
  • 财政年份:
    2020
  • 资助金额:
    $ 20.26万
  • 项目类别:
Longitudinal Patterns of Symptoms, Medication and Hospice Use in Nursing Home Residents Approaching End of Life
临终疗养院居民的症状、药物治疗和临终关怀使用的纵向模式
  • 批准号:
    10662447
  • 财政年份:
    2020
  • 资助金额:
    $ 20.26万
  • 项目类别:
Longitudinal Patterns of Symptoms, Medication and Hospice Use in Nursing Home Residents Approaching End of Life
临终疗养院居民的症状、药物治疗和临终关怀服务的纵向模式
  • 批准号:
    10447119
  • 财政年份:
    2020
  • 资助金额:
    $ 20.26万
  • 项目类别:
COmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT-BP)
社区参与的血压控制模拟培训 (CONSULT-BP)
  • 批准号:
    10084714
  • 财政年份:
    2017
  • 资助金额:
    $ 20.26万
  • 项目类别:
Optimizing Chronic Disease Prevention and Management in Advanced Dementia
优化晚期痴呆症的慢性病预防和管理
  • 批准号:
    8015841
  • 财政年份:
    2010
  • 资助金额:
    $ 20.26万
  • 项目类别:
Prescription Drug Coverage and Health Outcomes in Elders
老年人的处方药覆盖率和健康结果
  • 批准号:
    6724381
  • 财政年份:
    2004
  • 资助金额:
    $ 20.26万
  • 项目类别:
Prescription Drug Coverage and Health Outcomes in Elders
老年人的处方药覆盖率和健康结果
  • 批准号:
    7265105
  • 财政年份:
    2004
  • 资助金额:
    $ 20.26万
  • 项目类别:
Prescription Drug Coverage and Health Outcomes in Elders
老年人的处方药覆盖率和健康结果
  • 批准号:
    7481073
  • 财政年份:
    2004
  • 资助金额:
    $ 20.26万
  • 项目类别:
Prescription Drug Coverage and Health Outcomes in Elders
老年人的处方药覆盖率和健康结果
  • 批准号:
    6887742
  • 财政年份:
    2004
  • 资助金额:
    $ 20.26万
  • 项目类别:
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