A Clinical Prediction Tool to Guide Treatment of Osteoporosis in the Nursing Home

指导疗养院骨质疏松症治疗的临床预测工具

基本信息

  • 批准号:
    9053410
  • 负责人:
  • 金额:
    $ 40.01万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2014
  • 资助国家:
    美国
  • 起止时间:
    2014-09-30 至 2018-04-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION: Major osteoporotic fractures are common, morbid, and costly among long-stay nursing home residents. Despite the importance of this problem, there are no guidelines to screen nursing home residents for osteoporosis, and it is unclear which osteoporosis medications prevent fractures in long-stay residents. To address these gaps of knowledge we propose the following specific aims: 1) develop and validate a prediction tool using clinical risk factors for falls and fracture that will estimate the 2 year absolute risk of hip fracture and the year absolute risk of major osteoporotic fracture (hip, humerus, and wrist combined) in long-stay nursing home residents; 2) determine whether osteoporosis medications (i.e., bisphosphonates, calcitonin, estrogen, raloxifene, and teriparatide) reduce the incidence of hip and major osteoporotic fracture in long-stay nursing home residents; and 3) determine the clinical thresholds of risk at which osteoporosis medications reduce the incidence of hip and major osteoporotic fracture by e 20% in long-stay residents. This project will leverage an existing database that has previously linked claims data from Medicare Parts A and B with pharmacy data (Medicare Part D), clinical characteristics (Minimum Data Set), and facility level characteristics (OSCAR). Using this database we will conduct a prospective analysis on all U.S. nursing home residents enrolled in a Medicare fee-for-service plan and with e 90 day length of stay between the years 2006-2011 (>700,000 residents annually). For specific aim 1, the prediction tools will be developed entirely from clinical information that is available for all U.S long-stay residents, such as cognitive and functional status, non-osteoporosis medication use, and recent history of falls. The prediction tools will account for the high mortality in nursing home residents. For specific aim 2a, we will determine whether osteoporosis medications reduce the incidence of hip and major osteoporotic fracture in long-stay residents by comparing the incidence of fracture among "new users" of an osteoporosis medication with the incidence of fracture in "non-users," matched by propensity scores. For specific aim 2b, we will determine a threshold for pharmacologic intervention by examining the efficacy of osteoporosis drugs according to baseline fracture risk, as estimated by the fracture prediction tool. The research team has experience in pharmacoepidemiology, geriatrics, and analysis of Medicare claims data and Minimum Data Set characteristics necessary to complete this project. Our findings will be highly significant as they will provide the first guidance on screening and treatment of osteoporosis in the nursing home setting. We anticipate that our findings will be easy for providers to implement because the fracture prediction tools will be comprised of clinical information that is already available for all U.S. nursing home residents. Knowledge gained from this study could ultimately result in a decreased rate of major osteoporotic fractures in the nursing home setting, with a subsequent reduction in morbidity and health care costs.
描述:在长期入住疗养院的居民中,严重的骨质疏松性骨折是常见的、病态的、昂贵的。尽管这个问题很重要,但目前还没有指导方针来筛选养老院居民的骨质疏松症,目前还不清楚哪些骨质疏松症药物可以预防长期住院居民的骨折。为了解决这些知识的差距,我们提出了以下具体目标:1)开发和验证一种预测工具,使用福尔斯和骨折的临床风险因素,估计长期入住疗养院居民髋部骨折的2年绝对风险和严重骨质疏松性骨折(髋部、肱骨和手腕合并)的1年绝对风险; 2)确定骨质疏松症药物(即,二膦酸盐、降钙素、雌激素、雷洛昔芬和特立哌酮)降低长期入住疗养院居民的髋部和主要骨质疏松性骨折的发生率;和3)确定骨质疏松药物降低长期入住居民的髋部和主要骨质疏松性骨折发生率20%的临床风险阈值。本项目将利用现有数据库,该数据库先前已将Medicare Part A和B的索赔数据与药房数据(Medicare Part D)、临床特征(最小数据集)和机构级特征(OSCAR)相关联。使用该数据库,我们将对2006年至2011年期间参加医疗保险按服务收费计划且住院时间为90天的所有美国养老院居民(每年超过70万居民)进行前瞻性分析。对于具体目标1,预测工具将完全根据所有美国长期居住居民的临床信息开发,例如认知和功能状态、非骨质疏松症药物使用和近期福尔斯病史。预测工具将解释养老院居民的高死亡率。对于具体目标2a,我们将通过比较骨质疏松症药物“新使用者”与“非使用者”的骨折发生率,确定骨质疏松症药物是否降低长期住院居民髋部和主要骨质疏松性骨折的发生率,并与倾向评分相匹配。对于具体目标2b,我们将根据骨折预测工具估计的基线骨折风险,通过检查骨质疏松症药物的疗效来确定药物干预的阈值。该研究团队在药物流行病学,老年病学,医疗保险索赔数据和最小数据集特征分析方面具有完成该项目所需的经验。我们的研究结果将是非常重要的,因为他们将提供第一个指导筛选和治疗骨质疏松症的养老院设置。我们预计,我们的研究结果将很容易为供应商实施,因为骨折预测工具将包括临床信息,已经为所有美国养老院居民。从这项研究中获得的知识可能最终导致在疗养院设置的主要骨折的发生率降低,随后降低发病率和医疗保健费用。

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

数据更新时间:{{ journalArticles.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ monograph.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ sciAawards.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ conferencePapers.updateTime }}

{{ item.title }}
  • 作者:
    {{ item.author }}

数据更新时间:{{ patent.updateTime }}

Sarah Dyer Berry其他文献

Sarah Dyer Berry的其他文献

{{ item.title }}
{{ item.translation_title }}
  • DOI:
    {{ item.doi }}
  • 发表时间:
    {{ item.publish_year }}
  • 期刊:
  • 影响因子:
    {{ item.factor }}
  • 作者:
    {{ item.authors }}
  • 通讯作者:
    {{ item.author }}

{{ truncateString('Sarah Dyer Berry', 18)}}的其他基金

Mentoring Patient-Oriented Research to Prevent Injury in Older Adults
指导以患者为导向的研究以防止老年人受伤
  • 批准号:
    10312142
  • 财政年份:
    2020
  • 资助金额:
    $ 40.01万
  • 项目类别:
Mentoring Patient-Oriented Research to Prevent Injury in Older Adults
指导以患者为导向的研究以防止老年人受伤
  • 批准号:
    10532744
  • 财政年份:
    2020
  • 资助金额:
    $ 40.01万
  • 项目类别:
Nursing Home Prevention of Injury in Dementia (NH PRIDE)
疗养院预防痴呆症伤害 (NH PRIDE)
  • 批准号:
    9922194
  • 财政年份:
    2019
  • 资助金额:
    $ 40.01万
  • 项目类别:
Nursing Home Prevention of Injury in Dementia (NH PRIDE)
疗养院预防痴呆症伤害 (NH PRIDE)
  • 批准号:
    10092886
  • 财政年份:
    2019
  • 资助金额:
    $ 40.01万
  • 项目类别:
A Clinical Prediction Tool to Guide Treatment of Osteoporosis in the Nursing Home
指导疗养院骨质疏松症治疗的临床预测工具
  • 批准号:
    8930041
  • 财政年份:
    2014
  • 资助金额:
    $ 40.01万
  • 项目类别:
A Clinical Prediction Tool to Guide Treatment of Osteoporosis in the Nursing Home
指导疗养院骨质疏松症治疗的临床预测工具
  • 批准号:
    8697322
  • 财政年份:
    2014
  • 资助金额:
    $ 40.01万
  • 项目类别:
Medications as Acute Precipitants of Falls in the Nursing Home Setting
疗养院环境中作为跌倒急性诱因的药物
  • 批准号:
    7989314
  • 财政年份:
    2010
  • 资助金额:
    $ 40.01万
  • 项目类别:
Medications as Acute Precipitants of Falls in the Nursing Home Setting
疗养院环境中作为跌倒急性诱因的药物
  • 批准号:
    8128529
  • 财政年份:
    2010
  • 资助金额:
    $ 40.01万
  • 项目类别:
Medications as Acute Precipitants of Falls in the Nursing Home Setting
疗养院环境中作为跌倒急性诱因的药物
  • 批准号:
    8292028
  • 财政年份:
    2010
  • 资助金额:
    $ 40.01万
  • 项目类别:
Medications as Acute Precipitants of Falls in the Nursing Home Setting
疗养院环境中作为跌倒急性诱因的药物
  • 批准号:
    8489232
  • 财政年份:
    2010
  • 资助金额:
    $ 40.01万
  • 项目类别:

相似海外基金

Rational design of rapidly translatable, highly antigenic and novel recombinant immunogens to address deficiencies of current snakebite treatments
合理设计可快速翻译、高抗原性和新型重组免疫原,以解决当前蛇咬伤治疗的缺陷
  • 批准号:
    MR/S03398X/2
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Fellowship
CAREER: FEAST (Food Ecosystems And circularity for Sustainable Transformation) framework to address Hidden Hunger
职业:FEAST(食品生态系统和可持续转型循环)框架解决隐性饥饿
  • 批准号:
    2338423
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Continuing Grant
Re-thinking drug nanocrystals as highly loaded vectors to address key unmet therapeutic challenges
重新思考药物纳米晶体作为高负载载体以解决关键的未满足的治疗挑战
  • 批准号:
    EP/Y001486/1
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Research Grant
Metrology to address ion suppression in multimodal mass spectrometry imaging with application in oncology
计量学解决多模态质谱成像中的离子抑制问题及其在肿瘤学中的应用
  • 批准号:
    MR/X03657X/1
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Fellowship
CRII: SHF: A Novel Address Translation Architecture for Virtualized Clouds
CRII:SHF:一种用于虚拟化云的新型地址转换架构
  • 批准号:
    2348066
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Standard Grant
The Abundance Project: Enhancing Cultural & Green Inclusion in Social Prescribing in Southwest London to Address Ethnic Inequalities in Mental Health
丰富项目:增强文化
  • 批准号:
    AH/Z505481/1
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Research Grant
ERAMET - Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
ERAMET - 快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10107647
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    EU-Funded
BIORETS: Convergence Research Experiences for Teachers in Synthetic and Systems Biology to Address Challenges in Food, Health, Energy, and Environment
BIORETS:合成和系统生物学教师的融合研究经验,以应对食品、健康、能源和环境方面的挑战
  • 批准号:
    2341402
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Standard Grant
Ecosystem for rapid adoption of modelling and simulation METhods to address regulatory needs in the development of orphan and paediatric medicines
快速采用建模和模拟方法的生态系统,以满足孤儿药和儿科药物开发中的监管需求
  • 批准号:
    10106221
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    EU-Funded
Recite: Building Research by Communities to Address Inequities through Expression
背诵:社区开展研究,通过表达解决不平等问题
  • 批准号:
    AH/Z505341/1
  • 财政年份:
    2024
  • 资助金额:
    $ 40.01万
  • 项目类别:
    Research Grant
{{ showInfoDetail.title }}

作者:{{ showInfoDetail.author }}

知道了