Tanslating Research into Action for Diabetes (TRIAD) Legacy Study

将研究转化为糖尿病行动 (TRIAD) 遗产研究

• 批准号: 8111268
• 负责人: CAROL M MANGIONE
• 金额: $ 14.8万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-12 至 2013-07-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8111268
• 关键词: Tanslating; Research; into; Action; Diabetes

DESCRIPTION OF THE PROJECT: The goal of the Translating Research into Action for Diabetes (TRIAD) legacy studies is to examine the system- and patient-level factors that are associated with long-term processes of care, morbidity, costs, and mortality of persons with diabetes. To address this goal this Legacy Study application proposes five specific aims. The first aim will generate two reports from the multi-site TRIAD cohort that was recruited in 2001 and the remaining aims will extend our work on the TRIAD Part D Medicare Study with 4 new reports that will analyze recently acquired 2007 claims data from 50 states from one of the largest providers of the Part D benefit in the nation. Our specific aims are: 1) To examine whether there is an association between depression and under-use of medications for depression with medical costs and mortality for persons in the TRIAD cohort; 2) To use 2007 data from Medicare Advantage Part D (MAPD) beneficiaries who reside in 50 states to examine the role of chronic medical conditions such as diabetes, dementia, and depression on out-of-pocket costs, gap entry and adherence to medications; 3) To determine the potential cost savings in the Medicare Part D program from generic and therapeutic substitution using data from a 50-state sample of MAPD beneficiaries collected in 2007; 4) To examine the impact of mail-order use on out-of-pocket costs, total medication costs, and medication adherence for the poorest Medicare beneficiaries with diabetes in the Part D program; 5) To compare the out-of-pocket medication costs, total drug costs, and adherence to chronic medications for beneficiaries in Low Income Qualifier (LIQ) versus commercial plans and for persons with diabetes. Many of the reports that either have UCLA faculty as first or senior author have focused on studying underserved and/or high risk populations with diabetes. During the Legacy Study, the 6 analyses proposed will continue to emphasize how benefit design, cost sharing, and co-morbidities such as depression may disproportionately affect the most vulnerable persons with diabetes. A second objective of the Legacy Study is to continue to develop emerging investigators. To this end, the proposed team will continue our 11-year track record of successful mentorship and advancement of junior investigators with a strong focus on women and minority investigators by continuing to mentor Dr. O. Kenrik Duru, Assistant Professor at UCLA, and Rui Li, Ph.D., an economist at the CDC who has recently joined our team and will continue to work with us during the proposed Legacy where she will be mentored by Dr. Susan Ettner, our senior health economist, and Dr. Carol Mangione, the principal investigator of the UCLA Translational Research Center (TRC). Additionally, we expect to continue our mentoring relationships with a number of investigators from the other TRIAD TRCs. Finally, during the TRIAD Legacy phase we expect to be full participants in the steering and publication committee activities that will be vital to the success of the final stage of this ground-breaking study.

项目描述：将研究转化为糖尿病行动（TRIAD）遗产研究的目标是检查与糖尿病患者的长期护理过程、发病率、成本和死亡率相关的系统和患者水平因素。为了实现这一目标，遗产研究申请提出了五个具体目标。第一个目标将从2001年招募的多地点TRIAD队列中生成两份报告，其余目标将扩展我们在TRIAD D部分医疗保险研究中的工作，其中4份新报告将分析最近从全国最大的D部分福利提供者之一的50个州获得的2007年索赔数据。我们的具体目标是：1）检查抑郁症和抑郁症药物使用不足与TRIAD队列中的医疗费用和死亡率之间是否存在关联; 2）使用2007年居住在50个州的医疗保险优势D部分（MAPD）受益人的数据来研究糖尿病，痴呆症和抑郁症等慢性疾病对自付费用的作用，3）使用2007年收集的来自50个州的MAPD受益人样本的数据，确定医疗保险D部分计划从仿制药和治疗替代中节省的潜在成本; 4）检查邮购使用对自付费用、总药物费用、D部分计划中最贫困的糖尿病医疗保险受益人的药物依从性; 5）比较自付药物费用、总药物费用、以及低收入家庭（LIQ）受益人与商业计划和糖尿病患者的慢性药物依从性。许多以加州大学洛杉矶分校教师为第一作者或资深作者的报告都专注于研究服务不足和/或糖尿病高危人群。在遗产研究期间，建议的6项分析将 继续强调福利设计、费用分摊和抑郁症等合并症如何对最脆弱的糖尿病患者产生不成比例的影响。 遗产研究的第二个目标是继续培养新兴的研究人员。为此，拟议的团队将继续我们11年的成功指导和初级研究人员的进步记录，重点关注女性和少数民族研究人员，继续指导O博士。加州大学洛杉矶分校助理教授Kenrik Duru和博士Rui Li，CDC的一位经济学家最近加入了我们的团队，并将在拟议的遗产期间继续与我们合作，她将由我们的高级健康经济学家Susan Ettner博士和UCLA转化研究中心（TRC）的首席研究员Carol Mangione博士指导。此外，我们希望继续我们的指导关系，与一些调查员从其他三合会的储税券。最后，在TRIAD遗产阶段，我们希望充分参与指导和出版委员会的活动，这对这项开创性研究的最后阶段的成功至关重要。