Pilot/Experimental Studies Core (PESC)

试点/实验研究核心 (PESC)

• 批准号: 10675019
• 负责人: Rosa Baier
• 金额: $ 12.24万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675019
• 关键词: Alzheimer' s disease care; Alzheimer' s disease related dementia; American; Assisted Living Facilities; Award; Berry; Caring; Clinical; Clinical assessments; Community Healthcare; Data; Data Set; Data Sources; Databases; Development; Drug Prescriptions; Elderly; Family; Feedback; Foundations; Funding; Future; Health Policy; Healthcare Systems; Hospitalization; Industry; Infrastructure; Institution; Integrated Delivery Systems; Intervention; Intervention Trial; KRAS2 gene; Link; Medicare claim; Mentors; Mentorship; Methodology; Modeling; Monitor; Nursing Homes; Outcome; Patients; Pennsylvania; Persons; Pharmaceutical Preparations; Physicians; Pilot Projects; Policies; Population; Principal Investigator; Procedures; Program Research Project Grants; Protocols documentation; Provider; Quality of Care; Randomized; Randomized, Controlled Trials; Research; Research Personnel; Research Project Grants; Resources; System; Testing; Time; Universities; Vulnerable Populations; Work; cost effective; data infrastructure; dementia care; effectiveness evaluation; effectiveness testing; experience; experimental study; fall injury; health care settings; improved; individual patient; industry partner; innovation; medical schools; pilot test; response; social; treatment and outcome

Project Summary The program project grant’s (PPG’s) broad focus is to examine how healthcare policies impact the care of people with Alzheimer’s disease and related dementias (ADRD). Interventions to help providers deliver high-quality ADRD care in response to these emerging policies are critically needed. Pragmatic cluster randomized, controlled trials (RCTs), where the unit of randomization is the system or facility, are ideally suited to rigorously evaluate such interventions in the real-world conditions in which they are routinely implemented. Over the past five years, our group acquired expertise conducting cluster RCTs in a variety of healthcare settings that serve older adults. These trials are facilitated by the unique infrastructure of administrative and national databases that are the cornerstone of this PPG (e.g., linked mandatory clinical assessments and Medicare claims). Leveraging this foundation, the over-riding objective of the Pilot/Experimental Studies Core (PESC) is to provide catalytic support for innovative pilot research projects that will generate the feasibility data needed to conduct cluster RCTs of interventions aimed at improving care for people with ADRD and their families. The Aims are to: Aim 1: Solicit, select, and fund the preliminary work needed to support the future funding and conduct of cluster RCTs that evaluate interventions to improve care of ADRD patients. Aim 2: Integrate the PESC studies and investigators into the PPG infrastructure of data, research networks, and researchers. Aim 3: Provide the monitoring, mentorship, and resources to transform PESC-funded studies into successful, independently-funded cluster RCTs. The PESC will be co-directed by Susan Mitchell, MD, MPH (Principal Investigator) and Rosa Baier, MPH. Dr. Mitchell has a strong track record of mentoring, independent funding, and conducting cluster RCTs with people with ADRD. Ms. Baier leads a broader initiative at Brown conducting pragmatic research in older adults. Two new pilot studies will be funded in each of years 1-4 of the PPG. Applications will be solicited from the PGG’s senior investigators’ academic institutions. Rigorous procedures will be followed for PES selection, monitoring, and development into independently-funded research awards. For the first year of the PPG, we received four applications and, after formal review, selected two for inclusion in this application. Dr. Kira Ryskina (University of Pennsylvania) will develop and pilot test a social comparison feedback intervention to reduce physician prescribing of potentially-harmful medications among hospitalized ADRD patients. Dr. Sarah Berry (Harvard Medical School) will conduct a pilot project to assess the feasibility of an intervention to optimize medication prescription to reduce injurious falls in nursing home residents with ADRD. IMPACT: The research and intellectual resources within this PPG are uniquely suited as a platform to support pilot work to enable future pragmatic RCTs among people with ADRD. In this way, this proposed PESC has the potential to improve the quality of care provided to this rapidly growing and vulnerable population.

项目摘要 该计划项目赠款（PPG的）广泛的重点是研究医疗保健政策如何影响人们的照顾 阿尔茨海默病和相关痴呆症（ADRD）。帮助提供者提供高质量服务的干预措施 迫切需要针对这些新兴政策的ADRD护理。语用聚类随机化， 对照试验（RCT），其中随机化的单位是系统或设施，非常适合于严格的 在日常实施的现实世界条件下评估这些干预措施。过去 五年来，我们的团队获得了在各种医疗保健环境中进行集群RCT的专业知识， 老年人这些试验得到了行政和国家数据库的独特基础设施的便利， 是PPG的基石（例如，相关的强制性临床评估和医疗保险索赔）。利用 在此基础上，试点/实验研究核心（PESC）的首要目标是提供催化剂 支持创新试点研究项目，这些项目将产生开展集群所需的可行性数据， 旨在改善ADRD患者及其家庭护理的干预措施的RCT。目标：Aim 1：征集、选择和资助支持未来资助和开展集群RCT所需的初步工作 评估改善ADRD患者护理的干预措施。目标2：整合PESC研究， 研究人员进入PPG的数据基础设施，研究网络和研究人员。目标3：提供 监督、指导和资源，将PESC资助的研究转化为成功的、独立资助的研究 集群RCT。PESC将由Susan Mitchell，MD，MPH（主要研究者）和Rosa Baier共同指导， 每小时Mitchell博士在指导、独立资助和开展集群RCT方面有着良好的记录 与ADRD患者的关系拜尔女士在布朗大学领导了一项更广泛的计划，在老年人中进行务实的研究。 成年人了在PPG的第1-4年，每年将资助两项新的试点研究。申请将由 PGG高级研究员的学术机构。将遵循严格的程序进行PES选择， 监督，并发展成为独立资助的研究奖项。在PPG的第一年，我们 收到四份申请，经过正式审查后，选出两份列入本申请。Kira Ryskina博士 （宾夕法尼亚大学）将开发和试点测试社会比较反馈干预，以减少 在住院的ADRD患者中，医生处方可能有害的药物。Sarah Berry博士 （哈佛医学院）将进行一个试点项目，以评估干预的可行性，以优化 药物处方，以减少护理之家居民的伤害性福尔斯与ADRD。影响：研究 该PPG中的知识和智力资源非常适合作为支持试点工作的平台， ADRD患者中的实用RCT。以这种方式，所提出的PESC具有改善 为这一迅速增长的弱势群体提供的护理质量。