Leveraging large-scale administrative claims data to evaluate prescription opioid use, risks, and outcomes in older adults living with HIV
利用大规模行政索赔数据来评估老年艾滋病毒感染者的处方阿片类药物使用、风险和结果
基本信息
- 批准号:10406363
- 负责人:
- 金额:$ 19.56万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-06-01 至 2026-04-30
- 项目状态:未结题
- 来源:
- 关键词:Accident and Emergency departmentAddressAdverse eventAffectAgeAge-YearsAgingAnti-Retroviral AgentsAreaArea Under CurveBenzodiazepinesDataData SetDatabasesDementiaDevelopment PlansDiseaseDoseDrug InteractionsDrug PrescriptionsDrug UtilizationDrug usageElderlyEnvironmentEpidemicEpidemiologyFoundationsFractureGeneral PopulationGoalsHIVHIV InfectionsHIV riskHealthHospitalizationIndividualInjecting drug userInpatientsInterdisciplinary StudyInterventionLongevityMachine LearningMedicareMedicare claimMental HealthMentored Research Scientist Development AwardMentorsMethodsMorbidity - disease rateOlder PopulationOpioidOutcomeOutpatientsPatternPersonsPharmaceutical PreparationsPharmacoepidemiologyPolypharmacyPopulationPositioning AttributePreventionPrevention programProtease InhibitorQuality of lifeReadingReportingResearchResearch InfrastructureResearch PersonnelResearch PriorityResearch SupportRiskSamplingTechniquesTrainingUnited States National Institutes of HealthUniversitiesVisitadverse event riskadverse outcomeantiretroviral therapybasebeneficiarycareer developmentchronic painclinical decision supportclinical practiceco-infectioncomorbidityexperiencefallshealth care service utilizationhigh riskimprovedinfection riskinsightmachine learning methodmortalitymultidisciplinarynon-nucleoside reverse transcriptase inhibitorsnovelopioid useprescription opioidprofiles in patientsprogramsresearch and developmentsedativesubstance usesymposiumtooltreatment program
项目摘要
PROJECT SUMMARY
The purpose of this Mentored Research Scientist Development Award (K01) is to provide support for me to
become an independent investigator with a multidisciplinary research program in HIV at the intersection of
prescription drug use, comorbidities, and aging. In this project, I propose to leverage existing administrative
claims data from Medicare beneficiaries ≥65 years of age from 2007-2018 to determine how high-risk prescription
opioid use, e.g. high dose use (≥120 mg/day) or prolonged use (≥90 days), affects health outcomes and health
care utilization in older people living with HIV (PLWH). Building on my strong foundation in HIV epidemiology
and HIV comorbidities across the lifespan, the training from this K01 will allow me to (1) obtain proficiency in the
analysis of large-scale, longitudinal administrative claims data; (2) attain content expertise in prescription drug
utilization research and pharmacoepidemiology; and (3) develop expertise in the application of machine learning
methods. My career development plan includes specific coursework, seminars, conferences, directed readings,
and tailored mentoring from a multidisciplinary team comprised of experts in administrative claims data,
substance use epidemiology, pharmacoepidemiology, and machine learning methods. Rutgers University
provides an exceptional environment for completion of this training, with research support and infrastructure for
analyzing large, multiyear datasets (including Medicare claims) and conducting high-impact HIV research. The
proposed research is significant given that a substantial gap exists in understanding how prescription opioid use
affects a growing population of aging PLWH who commonly report chronic pain, and have multiple comorbidities,
increasing polypharmacy, and increased risk for untoward drug-drug interactions. This research is critical to
target appropriate prevention and treatment programs to optimize health outcomes for this population. To fill this
gap, specific aims are to: (1) Assess the associations between HIV infection and a) adverse health outcomes
(e.g. falls/fractures, dementia, mortality) and b) health care utilization (e.g. emergency department use, inpatient
hospitalizations, and outpatient visits) among older adults, and estimate the interaction between HIV infection
and high-risk prescription opioid use on adverse outcomes and utilization; (2) Among older PLWH, estimate
drug-drug interactions between high-risk prescription opioid use and specific antiretroviral drug classes or
sedatives (e.g. benzodiazepines) on risk of adverse health outcomes and health care utilization; and (3) Examine
the feasibility of applying existing machine learning approaches to predict adverse health outcomes and high
health care utilization among older PLWH based on patient profiles and opioid prescription patterns in a large
administrative claims database. Findings from this project will generate valuable new information and tools to
support clinical decisions and more precisely target prevention and treatment interventions to improve health for
older PLWH who are prescribed opioids, and directly inform an R01 application to study drug-drug and drug-
disease interactions between widely used prescription drugs and common comorbidities among older PLWH.
项目摘要
这个指导研究科学家发展奖(K 01)的目的是为我提供支持,
成为一名独立的研究人员,在艾滋病毒的交叉点进行多学科研究计划,
处方药使用、合并症和衰老。在这个项目中,我建议利用现有的行政
2007年至2018年期间,医疗保险受益人≥65岁的索赔数据,以确定高风险处方
阿片类药物使用,例如高剂量使用(≥120 mg/天)或长期使用(≥90天),影响健康结局和健康
老年艾滋病毒感染者(PLWH)的护理利用率。凭借我在艾滋病毒流行病学方面的坚实基础
和艾滋病毒合并症在整个生命周期,从这个K 01的培训将使我(1)获得熟练的
分析大规模、纵向的行政索赔数据;(2)获得处方药的内容专业知识
利用研究和药物流行病学;(3)开发机器学习应用方面的专业知识
方法.我的职业发展计划包括具体的课程,研讨会,会议,指导阅读,
以及由行政索赔数据专家组成的多学科团队的量身定制指导,
物质使用流行病学、药物流行病学和机器学习方法。罗格斯大学
提供了一个特殊的环境,完成这一培训,与研究支持和基础设施,
分析大型的多年数据集(包括医疗保险索赔)并进行高影响力的艾滋病毒研究。的
拟议的研究是重要的,因为在了解处方阿片类药物的使用如何存在巨大的差距,
影响越来越多的老年PLWH人群,他们通常报告慢性疼痛,并患有多种合并症,
增加了多种药物的使用,并增加了药物间不良相互作用的风险。这项研究对于
有针对性地制定适当的预防和治疗方案,以优化这一人群的健康结果。填补这一
具体目标是:(1)评估艾滋病毒感染与a)不良健康结果之间的关系
(e.g.福尔斯/骨折、痴呆、死亡率)和B)卫生保健利用(例如急诊使用、住院
住院和门诊),并估计艾滋病毒感染之间的相互作用
和高风险处方阿片类药物使用对不良结局和利用的影响;(2)在老年PLWH中,估计
高风险处方阿片类药物使用与特定抗逆转录病毒药物类别之间的药物相互作用,或
镇静剂(如苯二氮卓类)对不良健康后果风险和医疗保健使用的影响;以及(3)检查
应用现有机器学习方法预测不良健康结果的可行性,
根据患者概况和阿片类药物处方模式,
行政索赔数据库。该项目的结果将产生有价值的新信息和工具,
支持临床决策,更准确地针对预防和治疗干预措施,以改善
使用阿片类药物的老年PLWH,并直接告知R 01申请研究药物-药物和药物-
广泛使用的处方药与老年PLWH常见合并症之间的疾病相互作用。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Stephanie Shiau其他文献
Stephanie Shiau的其他文献
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{{ truncateString('Stephanie Shiau', 18)}}的其他基金
Maternal inflammation in relation to offspring epigenetic aging and neurodevelopment
与后代表观遗传衰老和神经发育相关的母体炎症
- 批准号:
10637981 - 财政年份:2023
- 资助金额:
$ 19.56万 - 项目类别:
Leveraging large-scale administrative claims data to evaluate prescription opioid use, risks, and outcomes in older adults living with HIV
利用大规模行政索赔数据来评估老年艾滋病毒感染者的处方阿片类药物使用、风险和结果
- 批准号:
10161305 - 财政年份:2021
- 资助金额:
$ 19.56万 - 项目类别:
Leveraging large-scale administrative claims data to evaluate prescription opioid use, risks, and outcomes in older adults living with HIV
利用大规模行政索赔数据来评估老年艾滋病毒感染者的处方阿片类药物使用、风险和结果
- 批准号:
10917538 - 财政年份:2021
- 资助金额:
$ 19.56万 - 项目类别:
Leveraging NICHD DASH biospecimens to isolate the effects of HIV infection and HIV exposure on epigenetic profiles in infants
利用 NICHD DASH 生物样本来分离 HIV 感染和 HIV 暴露对婴儿表观遗传特征的影响
- 批准号:
10267747 - 财政年份:2020
- 资助金额:
$ 19.56万 - 项目类别:
Leveraging NICHD DASH biospecimens to isolate the effects of HIV infection and HIV exposure on epigenetic profiles in infants
利用 NICHD DASH 生物样本来分离 HIV 感染和 HIV 暴露对婴儿表观遗传特征的影响
- 批准号:
10161102 - 财政年份:2020
- 资助金额:
$ 19.56万 - 项目类别:
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