Primary care based collaborative approach to care management for older adults with dementia

对日益增长的老年阿尔茨海默病和相关痴呆症（ADRD）患者的护理是 挑战性护理管理计划是一种常见的方法，以简化护理的人， 如ADRD。护理管理计划通常孤立于个人环境中;然而， 患有ADRD的老年人在许多环境中使用护理，他们经常接触多种护理管理 程序.同时参加一个以上的护理管理计划（以下简称“同时 登记”）可能会矛盾地导致不太协调的护理，如果程序不合作。的 同时入组ADRD的患病率和后果尚不清楚。此K23提案旨在 在候选人的工作资助的早期医疗/外科专科医生的过渡到 老龄化研究（GEMSSTAR，R 03），以促进对同时 注册和可接受性和潜在的设计，以初级保健为基础的合作方法，以照顾 老年ADRD患者的管理。Aim 1将使用一个新的链接数据集，包括护理 来自巴尔的摩两个卫生系统以及全州医院和急诊室的管理登记数据 部门利用率数据，以确定是否同时登记在护理管理是：（1）更多 常见于ADRD老年人，（2）与可预防的医院和急诊相关 部门使用。目标2将使用与四组利益相关者（护理管理 项目负责人和工作人员、初级保健临床医生和办公室工作人员、卫生信息技术专家、老年人 成人ADRD及其家庭照顾者），以确定主要障碍和促进因素，并设计一个 以护理为基础的协作方法，以护理管理老年人与ADRD。目标3将试点测试a 以初级保健为基础的合作方法，对老年ADRD患者进行护理管理，重点是 可行性和可接受性。拟议中的研究将为如何最好地 在人口健康倡议的背景下， 管理候选人是一位老年病学家，他已经展示了良好的学术记录。 奖学金与许多出版物和早期研究赠款。她提出了一套全面的 培训活动，是面向她的发展，作为一个临床研究者和国家领导人， 为改善ADRD老年人的护理提供信息。该项目将促进她继续职业生涯 在以下方面的发展（1）额外的课程和经验，在先进的统计方法， (2)发展对生物信息学的基本理解，（3）干预设计的应用经验， ADRD护理的背景，（4）提高她对人口健康举措的理解。她集合了 一个具有学科领域专业知识和相关研究方法和作品的模范指导团队 在一个丰富的研究环境与巨大的资源，以支持她的发展。

Care for the growing population of older adults with Alzheimer's Disease and Related Dementias (ADRD) is challenging. Care management programs are a common approach to streamlining care for persons with conditions such as ADRD. Care management programs are typically siloed in individual settings; however, as older adults with ADRD utilize care in many settings, they are often contacted by multiple care management programs. Simultaneous enrollment in more than one care management program (hereafter “simultaneous enrollment”) may paradoxically lead to less coordinated care if the programs do not collaborate. The prevalence and consequences of simultaneous enrollment in ADRD are unclear. This K23 proposal builds upon the candidates' work funded by the Grants for Early Medical/Surgical Subspecialists' Transitioning to Aging Research (GEMSSTAR, R03) to advance understanding of the consequences of simultaneous enrollment and the acceptability and potential design of a primary care-based collaborative approach to care management for older adults with ADRD. Aim 1 will result use a novel linked dataset that includes care management enrollment data from two health systems in Baltimore and statewide hospital and emergency department utilization data to determine whether simultaneous enrollment in care management is: (1) more common among older adults with ADRD and (2) associated with preventable hospital and emergency department use. Aim 2 will use qualitative interviews with four groups of stakeholders (care management program leaders and staff, primary care clinicians and office staff, health information technology experts, older adults with ADRD and their family caregivers) to identify barriers and facilitators to and the design of a primary care-based collaborative approach to care management for older adults with ADRD. Aim 3 will pilot test a primary care based collaborative approach to care management for older adults with ADRD focused on feasibility and acceptability. The proposed research will contribute needed evidence about how to best approach care for older adults with ADRD in the context of population health initiatives such as care management. The candidate is a geriatrician who has already demonstrated a strong track record of academic scholarship with numerous publications and early investigator grants. She has proposed a comprehensive set of training activities that are geared toward her development as a clinician investigator and national leader who informs improvements to care delivery for older adults with ADRD. The project will foster her continued career development in the following ways (1) additional coursework and experience in advanced statistical methods, (2) developing a foundational understanding of bioinformatics, (3) applied experience in intervention design in the context of ADRD care, (4) improving her understanding of population health initiatives. She has assembled an exemplary mentoring team with expertise in the subject area and the relevant research methods and works in a rich research environment with tremendous resources to support her development.