Understanding alcohol use and alcohol-related care among older adults with heart failure

了解患有心力衰竭的老年人的饮酒情况和酒精相关护理

• 批准号: 10723567
• 负责人: Aryn Phillips
• 金额: $ 40.63万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-03 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723567
• 关键词: Acceleration; Accounting; Address; Aging; Alcohol consumption; Alcohols; Behavior; Biological; Blood Pressure; Cardiovascular system; Caring; Characteristics; Chronic; Clinical; Clinical Management; Cognitive; Consumption; Data; Data Sources; Diet; Disease; Dose; Elderly; Emergency department visit; Family Practice; Fee-for-Service Plans; Frequencies; Future; General Practices; Goals; Guidelines; Health; Health and Retirement Study; Healthcare; Heart; Heart failure; Heavy Drinking; Hospitalization; Intervention; Knowledge; Length; Longevity; Maintenance; Measures; Medicare; Medicare claim; Mental Health Services; Methodology; Methods; Minor; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outpatients; Patient Self-Report; Patients; Pharmaceutical Preparations; Physical activity; Play; Policies; Population; Prevalence; Provider; Quality of life; Recommendation; Regimen; Research; Risk Factors; Role; Sampling; Self Management; Sensory; Services; Smoking; Source; Structure; Surveys; Symptoms; Testing; Time; accountable care organization; adverse outcome; age group; alcohol effect; alcohol misuse; alcohol research; behavioral outcome; binge drinking; care burden; care coordination; drinking; evidence base; evidence based guidelines; experience; healthspan; high reward; high risk; hospital readmission; human old age (65+); improved; innovation; interest; machine learning method; medical specialties; medication compliance; mortality; motor impairment; payment; response; screening and brief intervention; secondary analysis; service utilization; sociodemographics

Project Summary Rates of alcohol use and misuse are increasing faster among older adults than among any other age group. Simultaneously, the prevalence of heart failure (HF), a major cause of reduced lifespan and health span among older adults, has also been increasing. It is possible that alcohol use and misuse exacerbate and accelerate HF, both directly via biological mechanisms and indirectly by hindering the ability to engage in the rigorous self-management required to avoid adverse health outcomes. If so, addressing alcohol use and misuse among older adults with HF has the potential to substantially improve morbidity, mortality, and quality of life for this population. Yet, despite these hypotheses, little is known about the effects of alcohol use and misuse among older adults with HF nor about the alcohol-related care received by this population. The specific aims of this application are to use rigorous causal inference and machine learning methods to 1) estimate the relationships of alcohol use and misuse with HF self-management behaviors for the first time and 2) produce less biased and more generalizable estimates of the relationships between alcohol use and misuse and adverse HF outcomes, which are currently poorly understood. In addition, we will 3) characterize the quantity and sources (venue, provider specialty, length of patient-provider relationship, provider participation in Accountable Care Organizations) of documented alcohol-related care currently received by older adults with HF. To accomplish these aims, we will utilize a linkage of two existing data sources: Medicare fee-for-service claims and the Health and Retirement Study (HRS), a nationally representative longitudinal panel of 22,000+ older adults. The research will be accomplished by a strong team of experts in alcohol use and misuse, cardiovascular conditions, aging populations, mental health care coordination, and analyses of Medicare claims and HRS. This research has the potential to inform critically needed evidence-based guidelines for clinical management of HF patients as well as future research developing interventions and policies that will improve the delivery of alcohol-related care and overall health outcomes among this population. As such, it helps advance NIAAA’s strategic goal of identifying and reducing alcohol’s influence on health and disease throughout the lifespan. It also responds directly to NIAAA Notice of Special Interest NOT-AA-20-018 “Secondary Analyses of Existing Alcohol Research Data.”

项目摘要 在老年人中，饮酒率和误用率的增长速度比其他任何年龄段都要快。 同时，心力衰竭(HF)的流行，这是缩短寿命和健康寿命的主要原因 在老年人中，这一比例也一直在上升。酒精的使用和滥用可能会加剧和 通过直接通过生物机制和间接通过阻碍参与的能力来加速HF 需要严格的自我管理，以避免不利的健康后果。如果是这样的话，解决酒精使用和 老年心力衰竭患者滥用药物有可能显著改善发病率、死亡率和质量。 这群人的生活。然而，尽管有这些假设，人们对酒精使用的影响和 患有心力衰竭的老年人中的滥用，以及这一人群接受的与酒精有关的护理。具体的 这个应用程序的目的是使用严格的因果推理和机器学习方法来1)估计 首次饮酒和误用与HF自我管理行为的关系2)生产 对酒精使用和滥用之间关系的较少偏见和更普遍的估计，以及 不良的心衰结局，目前对此知之甚少。此外，我们还将对数量进行表征 和来源(地点、提供者专业、患者与提供者关系的持续时间、提供者参与 责任护理组织)记录的与酒精相关的护理目前由患有以下疾病的老年人接受 高频。为了实现这些目标，我们将利用两个现有数据源的链接：Medicare按服务收费 索赔和健康与退休研究(HRS)，一个由22,000+人组成的具有全国代表性的纵向小组 上了年纪的人。这项研究将由一支强大的酒精使用和滥用专家团队完成， 心血管疾病、人口老龄化、精神卫生保健协调以及医疗保险分析 索赔和HRS。这项研究有可能为迫切需要的循证指南提供信息 心力衰竭患者的临床管理以及未来研究开发的干预措施和政策，将 改善这一人群中与酒精有关的护理的提供情况和总体健康结果。因此，它 有助于推进NIAAA确定和减少酒精对健康和疾病的影响的战略目标 在整个生命周期中。它还直接响应NIAAA特别利益通知NOT-AA-20-018 “对现有酒精研究数据的二次分析。”