Treatment Burden in Older Adults with Diabetes and Multimorbidity

美国老龄化人口中慢性病的日益流行对 提供既以患者为中心又符合循证指南的医疗服务。Dr。 博伊德之前的工作表明，对老年患者应用针对疾病的指南 多发病受到推荐治疗方案的复杂性、费用和负担的限制。 和监控要求。对我们老龄化社会的最佳关怀需要发展实用的 允许灵活设定目标的医学复杂老年患者的循证治疗模式 根据患者的喜好和感知的治疗负担。因此，该项目的总体目标是 开发一种实用的工具来评估老年多发病患者的治疗负担，以帮助 在医疗决策中。为此，博伊德博士建议用一个指数来研究老年人 糖尿病合并其他合并症的诊断作为检查治疗的模式 多发性疾病的负担。我们建议表征治疗负担的领域和调节因素。 通过对指导性护理项目的数据进行二次分析，这是一项对患有 多发病(目标1)，以及通过一系列重点群体(目标2)。我们将综合这些数据 和文献中的数据，以开发临床上实用的治疗负担衡量标准(目标3)，最后， 我们将在临床环境中对该仪器进行试点测试(目标4)，作为评估ROL研究的准备 该仪器在更广泛的人群中改善患者依从性和结果的临床实用价值 患者多发病。这项工作将为专注于以下方面的临床研究生涯奠定基础 改善患有多发病的老年人的决策和结果。博伊德博士的目标是成为 独立的临床调查员，致力于改善对患有多发病的老年人的护理。在音乐会上 博伊德博士与她的赞助商一起绘制了一条研究道路，这是她之前工作的直接延伸，并将 在结构化的职业发展计划内进行，该计划包括课程作业、指导和 多学科研究咨询委员会。 相关性(请参阅说明)： 许多老年人有多种并存的疾病，但不知道如何最好地处理这些疾病 各种条件同时发生。博伊德博士的目标是改善老年人的临床决策和结果 患有多发性疾病。

The increasing prevalence of chronic disease in the aging U.S. population presents substantial challenges to delivering medical care that is both patient-centered and consistent with evidence-based guidelines. Dr. Boyd's prior work demonstrated that the application of disease-specific guidelines to older patients with multimorbidity is limited by the complexity, expense, and burden ofthe recommended therapeutic regimens and monitoring requirements. Optimal care for our aging society entails the development of practical evidence-based treatment models for medically-complex older patients that permit flexible goal-setting according to patient preferences and perceived treatment burden. The overall goal of this project is therefore to develop a practical tool for assessing treatment burden among older patients with multimorbidity, to assist in medical decision making. Toward this end, Dr. Boyd proposes to study older individuals with an index diagnosis of diabetes in combination with other comorbid conditions as a model for examining treatment burden in multimorbidity. We propose to characterize the domains and moderators of treatment burden in this population via a secondary analysis of data from the Guided Care project, a study of older adults with multi-morbidity (Aim 1), as well as through a series of focus groups (aim 2). We will synthesize these data and data from the literature to develop a clinically practical measure of treatment burden (Aim 3), and, finally, we will pilot test this instrument in a clinical setting (Aim 4), as preparation for an ROl study to evaluate the clinical utility of the instrument for improving patient adherence and outcomes for a broader population of patients with multi-morbidity. This work will provide the foundation for a clinical research career focused on improving decision making and outcomes for older people with multimorbidity. Dr. Boyd aims to become an independent clinical investigator dedicated to improving care for older people with multimorbidity. In concert with her sponsors, Dr. Boyd has charted a research path that is a direct extension of her prior work, and will be conducted within a structured career development plan that includes coursework, mentoring, and a multidisciplinary research advisory committee. RELEVANCE (See instructions): Many older adults have multiple co-existing conditions, but it is not known how to best manage these conditions simultaneously. Dr. Boyd aims to improve clinical decision-making and outcomes for older people with multimorbidity.