Developing and Testing a Population Health Approach to Deprescribing and Optimizing Medications in Older Adults

开发和测试人口健康方法以减少和优化老年人的药物治疗

基本信息

批准号：
10624255
负责人：
Michelle Sophie Keller
金额：
$ 12.4万
依托单位：
CEDARS-SINAI MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-01 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10624255
关键词：
Accountability Address Adult Adverse event Age Agreement Alzheimer&apos s disease related dementia Appointment Caregivers Caring Case Manager Cessation of life Cholesterol Chronic Chronic Disease Clinical Trials Contracts Data Data Analyses Data Element Development Diabetes Mellitus Doctor of Philosophy Elderly Electronic Health Record Emergency department visit Enrollment Environment Exclusion Future Geriatrics Health Care Costs Health Personnel Health Services Health system Healthcare Systems Hemorrhage High Prevalence Hospitalization Hypertension Impaired cognition Informatics Infrastructure Inpatients Institution Intervention K-Series Research Career Programs Life Style Limited English Proficiency Measures Medicare Medication Management Mentors Modeling Monitor Outcome Patient Care Patients Pharmaceutical Preparations Pharmacists Pharmacoepidemiology Pharmacy facility Physicians Polypharmacy Population Pragmatic clinical trial Primary Care Physician Provider Quality of life Randomized Controlled Clinical Trials Randomized, Controlled Trials Registries Reproducibility Research Research Personnel Resources Risk Risk Factors Science Testing Time Training Validation Visit Work acceptability and feasibility accountable care organization adverse drug reaction beneficiary career career development community intervention cost cost effective design diabetes management effectiveness evaluation experience fall risk falls feasibility testing frailty health care service utilization high risk improved mortality multidisciplinary outreach participant enrollment pilot test population health pressure prevent primary outcome professor programs risk prediction model side effect

项目摘要

PROJECT SUMMARY Michelle S. Keller, PhD, MPH is a health services researcher with Assistant Professor appointments at Cedars- Sinai Health System (CSHS) and UCLA. Dr. Keller’s research focuses on reducing inappropriate medication use in older adults, particularly in populations with high levels of medication use, such as older adults with Alzheimer’s Disease and Related Dementias (ADRD). Reducing inappropriate medication use in older adults has been shown to reduce mortality, but evidence is limited on whether interventions that reduce inappropriate medications reduce hospitalizations and emergency department visits. More than half of older adults in the U.S. receive their care from health systems and provider groups which contract with Medicare Advantage plans or are part of Accountable Care Organizations, organizations which are financially accountable for Medicare beneficiaries’ health costs. These organizations proactively manage chronic conditions such as diabetes, hypertension, and high cholesterol to prevent unnecessary avoidable hospitalizations. This proposal aims to create a similar approach to managing medication use through the development and validation of a risk prediction model and registry that identifies older adults with a large number of potentially inappropriate medications and other conditions that place older adults at risk for hospitalization, including age, cognitive decline, frailty, and risk of falls. This proposal will use this registry and risk model as part of a feasibility and acceptability study to identify, refer, and enroll older adults with ADRD in a pharmacist-led medication review intervention aimed at reducing inappropriate medications. Dr. Keller’s career development and training plan includes coursework in embedded, pragmatic clinical trials and geriatrics. Dr. Keller will accomplish the proposed research and training aims with the support of a strong multi-disciplinary mentoring team from UCLA and CSHS: Catherine Sarkisian (geriatrics and deprescribing), Zaldy Tan (ADRD) Teryl Nuckols (health systems science), Joshua Pevnick (medication management), and Nicole Brandt (pharmacy and deprescribing). These efforts will be supported by the outstanding research environment and infrastructure of CSHS and UCLA. Given the strong mentoring, institutional, and infrastructure supports in place, the proposed K award program is ideally designed to provide the PI with the experience needed to launch her career as an independent investigator and future leader in deprescribing research.

项目摘要 Michelle S. Keller博士，MPH是一名卫生服务研究人员，在Cedars任命助理教授任命西奈卫生系统（CSHS）和UCLA。凯勒博士的研究重点是减少不适当的药物使用在老年人中，特别是在使用高水平药物的人群中，例如老年人患有老年人疾病和相关痴呆症（ADRD）。减少老年人的不适当药物使用已有证明可以降低死亡率，但证据限制了减少不适当药物的干预措施减少住院和急诊室就诊。美国一半以上的老年人接受了他们的与Medicare Advantage计划合同的卫生系统和提供者团体的护理，或者是负责任的护理组织，对医疗保险受益人负责的组织健康成本。这些组织主动管理糖尿病，高血压和高胆固醇可预防不必要的住院。该建议旨在创建类似的通过开发和验证风险预测模型和验证药物使用的方法识别大量可能不适当的药物和其他成年人的注册表使老年人处于住院风险的状况，包括年龄，认知能力下降，脆弱和风险瀑布。该建议将使用此注册表和风险模型作为可行性和可接受性研究的一部分，以识别，请参阅旨在减少药物的药物审查干预措施中的老年人。不当药物。凯勒博士的职业发展和培训计划包括嵌入式课程，务实的临床试验和老年医学。凯勒博士将完成拟议的研究和培训目的来自加州大学洛杉矶分校和CSHS的强大多学科指导团队的支持：凯瑟琳·萨基斯（Catherine Sarkisian）（老年） Zaldy Tan（Adrd）Teryl Nuckols（卫生系统科学），Joshua Pevnick（药物治疗）管理）和妮可·勃兰特（Nicole Brandt）（药房和分类）。这些努力将得到 CSHS和UCLA的杰出研究环境和基础设施。考虑到强烈的心理机构和基础设施支持，拟议的K奖奖计划的理想旨在提供 PI具有经验，需要启动她作为独立调查员和未来领导者的职业分类研究。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Design, implementation, and evaluation of a pharmacist-led outpatient benzodiazepine-tapering clinic.

DOI：
10.1016/j.japh.2022.09.025
发表时间：
2023-01
期刊：
JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION
影响因子：
2.1
作者：
Gregorian, Tania;Bradley, Kristin;Campbell, Scott;Mashburn, Rachel;Beuttler, Richard;Keller, Michelle S.
通讯作者：
Keller, Michelle S.