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Medications and the Risk of Motor Vehicle Crashes in Older Adults

Medications and the Risk of Motor Vehicle Crashes in Older Adults
老年人的药物和车祸风险
批准号:
10633192
负责人:
Andrew Reis Zullo
金额:
$44.18万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2020
资助国家:
美国
项目状态:
已结题
起止时间:
2020-09-15 至 2024-05-31
关键词:
Accident and Emergency departmentAcetylcholinesterase InhibitorsAddressAdherenceAdultAffectAgeAgingAlzheimer&aposs disease related dementiaAntidepressive AgentsAntipsychotic AgentsAutomobile DrivingBeliefBiologicalCentral Nervous SystemCentral Nervous System StimulantsCessation of lifeCharacteristicsCholinesterase InhibitorsCounselingDataData SetDatabasesDoseDrowsinessDrug PrescriptionsDrug usageElderlyEnsureEquilibriumFrequenciesFutureGoalsHealthHealth InsuranceImpairmentIndividualInjuryInterventionLicensingLinkMedicalMedicareMedication ManagementMental DepressionMental disordersMethodsMorbidity - disease rateMotor VehiclesMusculoskeletal DiseasesNational Institute on AgingNon-Steroidal Anti-Inflammatory AgentsObservational StudyOpioidOpioid AnalgesicsOutcomePatientsPersonal SatisfactionPharmaceutical PreparationsPhysical FunctionPhysiologicalPlayPolicy MakingPolypharmacyPopulationPrevalencePsychomotor ImpairmentsPsychotropic DrugsRandomized, Controlled TrialsRecording of previous eventsResearchRiskRoleSafetySchizophreniaSedation procedureSensorySleepSleep DisordersSocial isolationSourceStimulantSubgroupTestingTimeVehicle crashWorkage relatedaging in placecognitive functiondata resourcedriving safetyepidemiologic dataevidence baseexperiencehuman old age (65+)hypnoticimprovedinnovationlongitudinal databasemedication compliancemortalitymultiple chronic conditionsnervous system disordernovelolder driverpreservationprimary outcomeresponsesedativetherapy developmenttime usetransportation accessunsafe driving

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英文摘要
PROJECT SUMMARY Despite the common belief that prescription drug use is a leading cause of motor vehicle crashes, data are scarce and controversy remains about the effects of medications on crashes in older adults aged ≥65 years. Unlike other determinants of crashes (e.g., medical conditions), medications are one of few modifiable potential determinants of the 6,800 crash-related deaths and 191,000 crash-related non-fatal injuries that occur annually among older adults. In particular, psychoactive drugs are commonly used among older drivers, but may interfere with safe driving. As more adults continue to drive into older age, there is an urgent need to understand the effects of medications and distinguish them from the effects of contemporaneous age-related medical conditions, impairments, and physiological changes. The overall objective of this proposal is to examine the causal effects of medications on crashes in older drivers, and the extent to which these medications disproportionately affect crash risk across subgroups [e.g., Alzheimer's disease and related dementias (ADRD), polypharmacy] and by medication adherence status. The central hypothesis is that sedating psychoactive medications (opioids, nonbenzodiazepine hypnotics, antidepressants, and antipsychotics) will increase crash risk while central nervous system (CNS)-activating drugs (cholinesterase inhibitors, CNS simulants) and others (non-steroidal anti- inflammatory drugs) will decrease the risk, and that these effects will be greatest among individuals with ADRD and those who are adherent to their medications. This hypothesis will be tested by pursuing three specific aims: 1) Estimate the effect of initiating sedating psychoactive, CNS-activating, and other medications, including dose, on crashes in older adults; 2) Quantify the effect of initiating sedating psychoactive, CNS-activating, and other medications on crashes across important subgroups of older adults, including those with ADRD; polypharmacy; multimorbidity; and sleep, psychiatric, neurological, and musculoskeletal disorders; and 3) Evaluate the effect of non-adherence to sedating psychoactive, CNS-activating, and other medications, each separately compared to adherence, on crash risk. To accomplish the three aims, our team will develop a unique database that combines data on older drivers' licensing and crash histories; Medicare health insurance and drug claims; and data on important determinants of medication use and crashes (e.g., access to transportation alternatives). This approach is innovative because it is the first to compile high-quality U.S. data on all three domains necessary to study the effect of medications on crashes—1) medical conditions (covariates); 2) medication use (exposure); and 3) crashes (outcome)—in a dataset that is large enough to precisely estimate effects using causal inference methods while accounting for differential driving frequency between drivers. The proposed research is significant because: 1) it will provide empirical evidence to help guide the management of medications to maximize older adults' ability to maintain safe mobility; and 2) it will establish a unique large data resource that can be used to conduct important future medication-related studies of older drivers. This proposal is responsive to PA-17-088.
期刊论文(18)
专著(0)
科研奖励(0)
会议论文
Post-Acute Care Setting After Hip Fracture Hospitalization and Subsequent Opioid Use in Older Adults.
老年人髋部骨折住院和随后使用阿片类药物后的急性后护理环境。
DOI: 10.1016/j.jamda.2023.03.012
发表时间: 2023
期刊: Journal of the American Medical Directors Association
影响因子: 7.6
作者: [Cupp,MeghanA, Beaudoin,FrancescaL, Hayes,KaleenN, Riester,MelissaR, Berry,SarahD, Joshi,Richa, Zullo,AndrewR]
通讯作者: Zullo,AndrewR
DOI: 10.1186/s12877-022-03540-3
发表时间: 2022-11-04
期刊: BMC GERIATRICS
影响因子: 4.1
作者: [O'Neill, Emily T., Bosco, Elliott, Persico, Erin, Silva, Joe B., Riester, Melissa R., Moyo, Patience, van Aalst, Robertus, Loiacono, Matthew M., Chit, Ayman, Gravenstein, Stefan, Zullo, Andrew R.]
通讯作者: Zullo, Andrew R.
Geospatial Distribution of Racial Disparities in Influenza Vaccination in Nursing Homes.
疗养院流感疫苗接种种族差异的地理空间分布。
DOI: 10.1016/j.jamda.2023.08.018
发表时间: 2023
期刊: Journal of the American Medical Directors Association
影响因子: 7.6
作者: [Silva,JoeBB, Howe,ChanelleJ, Jackson,JohnW, Bardenheier,BarbaraH, Riester,MelissaR, vanAalst,Robertus, Loiacono,MatthewM, Zullo,AndrewR]
通讯作者: Zullo,AndrewR
Distance From Home to Motor Vehicle Crash Location: Implications for License Restrictions Among Medically-At-Risk Older Drivers.
从家到机动车事故地点的距离:对有医疗风险的老年驾驶员的驾照限制的影响。
DOI: 10.1080/08959420.2022.2145791
发表时间: 2022
期刊: Journal of aging & social policy
影响因子: 5.1
作者: [Joyce,NinaR, Khan,MarzanA, Zullo,AndrewR, Pfeiffer,MelissaR, Metzger,KristinaB, Margolis,SethA, Ott,BrianR, Curry,AllisonE]
通讯作者: Curry,AllisonE
共 12 条
    Clinically Significant Drug Interactions among Nursing Home Residents with ADRD
    • 批准号:
      10704029
    • 项目类别:
    • 资助金额:
      $70.74万
    • 财政年份:
      2022
    • 负责人:
      Andrew Reis Zullo
    • 依托单位:
    Clinically Significant Drug Interactions among Nursing Home Residents with ADRD
    • 批准号:
      10448110
    • 项目类别:
    • 资助金额:
      $71.13万
    • 财政年份:
      2022
    • 负责人:
      Andrew Reis Zullo
    • 依托单位:
    Medications and the Risk of Motor Vehicle Crashes in Older Adults
    • 批准号:
      10260401
    • 项目类别:
    • 资助金额:
      $44.27万
    • 财政年份:
      2020
    • 负责人:
      Andrew Reis Zullo
    • 依托单位:
    Medications and the Risk of Motor Vehicle Crashes in Older Adults
    • 批准号:
      10624520
    • 项目类别:
    • 资助金额:
      $36.85万
    • 财政年份:
      2020
    • 负责人:
      Andrew Reis Zullo
    • 依托单位:
    海外基金