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Testing the Effectiveness of Individualized Disease Prevention for Middle-Aged Adults

检验中年个体化疾病预防的有效性

基本信息

批准号：
10671243
负责人：
Glen Taksler
金额：
$ 16.1万
依托单位：
CLEVELAND CLINIC LERNER COM-CWRU
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10671243
关键词：
Adherence Adult Advisory Committees Age Age Factors Arthritis Asthma Behavior Benefits and Risks Characteristics Chronic Disease Clinic Clinical Clinical Research Colonoscopy Decision Aid Electronic Health Record Ensure Foundations Goals Guidelines Health Immunization Individual Information Technology Intervention Life Life Expectancy Life Style Mammography Measures Medical History Medicine Methods Modeling Patient Preferences Patients Persons Physicians Prevention Prevention Guidelines Preventive care Preventive service Primary Health Care Process Provider Publishing Quality of life Quality-Adjusted Life Years Race Recommendation Risk Factors Savings Screening for cancer Services Standardization Testing Time United States Visit Weight aged aging population base blood pressure reduction care delivery care systems comorbidity cost diabetic disorder prevention effectiveness testing evidence base health care service hypertensive individualized medicine mathematical model middle age prevent randomized trial sex shared decision making side effect smoking cessation successful intervention tool

项目摘要

Project Summary/Abstract This proposal seeks to help middle-aged adults (aged 50-64 y) make an informed decision about the health care services that are most likely to promote a longer, healthier life. There are currently 26 evidence-based services to prevent or manage chronic disease in middle-age, but it is difficult to follow them all. Patients need help to better understand the tradeoffs between services. To overcome these barriers, we are currently conducting an R21 that identifies the preventive services with the greatest impact on life expectancy, and engages patients and providers in shared decision-making. Patients and providers highly value the framework. We also are developing proof-of-concept to access and print the results in the electronic health record. Additionally, we will consider our framework’s assessment of the impact of COVID-19 on preventive care needs in the general population. This proposal has 5 aims. First, we will adapt a previously-published analytic model to measure the gain in quality-adjusted life expectancy associated with adherence to 24 of 26 major preventive care services. Results will be individualized for a patient’s age and risk factors. Second, we will integrate a previously-developed decision aid with the electronic health record. We will conduct iterative testing to ensure accuracy and usefulness. Third, we will conduct a randomized trial to test the effectiveness of the decision aid on middle- aged patient behavior in diverse primary care clinics. During clinical visits, patients and physicians will discuss the decision aid and engage in shared decision making, to prioritize preventive care goals. We will measure the change in preventive care utilization between intervention and control patients. Fourth, utilizing a large database of electronic health records, we will assess the impact of COVID-19 on patient-level disease risk factors and resulting need for disease prevention. Fifth, we will develop nationally-representative priorities to improve disease prevention, both pre- and post-COVID-19 social distancing. This proposal builds upon our inter-disciplinary team’s strong foundation in clinical research, mathematical modeling, shared decision-making and information technology. A successful intervention should help to fundamentally change preventive care delivery in the United States, to maximize health and prevent illness in the middle-aged population.

项目总结/文摘