Midcareer Development Award in Neuroaging and Geriatric Pharmacoepidemiology Research

威利斯博士是一名神经学家、神经流行病学家和卫生服务研究员，他建立了一个国内和国际公认的、独立资助的研究计划，致力于以患者为导向的研究，重点是药物效果、护理过程和结果差异，以及患有神经疾病的老年人的卫生服务使用。她在指导来自不同教育背景的学员方面取得了成功。建议的目的是：(1)进行分析流行病学研究，研究处方做法、药物暴露、药物与药物和药物与疾病的相互作用对老年人，特别是帕金森病+痴呆者、路易体痴呆症(包括路易体痴呆症，阿尔茨海默病相关痴呆症/ADRD)、阿尔茨海默病(AD)、轻度认知障碍和慢性神经系统疾病的临床、患者报告和医疗保健利用结果的影响；(2)对患有神经疾病的老年人，特别是患有上述ADRDS和AD的老年人进行健康差异和卫生服务研究，以获得对平等护理的系统性障碍的可行见解；(3a)在老龄化、神经学和药物流行病学的交叉点上开展新的研究，重点关注停药和安全引导的中枢神经系统药物处方对患有上述ADRDS、AD和MCI的个人的认知功能和认知功能下降的生物学、临床和质量影响；(3b)在老龄化、差异和卫生服务研究的交叉点开展新的研究，重点描述和分解个人、邻居和社会因素对指南遵循治疗开始、升级和监测方面的差异的相对贡献；老年神经系统疾病(包括ADRDS和AD)的治疗依从性和结果；(4)利用威利斯博士的研究计划来培训和指导新的研究人员的研究方法，这些方法将通过神经保护性处方、更有效和更公平的护理提供来改善患有ADRDS、AD和慢性神经疾病的老年人的卫生保健结果。K24奖项将为威利斯博士提供必要的保护时间，以开发专注于神经保护性处方和健康差异的新研究，产生关于神经疾病的医疗保健和药物疗法的驱动因素和影响的知识。K24还将使威利斯博士能够增加她的指导专业知识，并制定一个正式的指导计划，以吸引来自神经学、流行病学、老年病学、精神病学、药理学、信息学和生物统计学的年轻研究人员。威利斯博士的指导计划将(1)为受训者提供直接接触主要数据收集和次要数据分析的机会(2)创造一个跨学科的环境，让来自不同专业的受训者直接相互学习(3)向受训者提供她的个性化研究和职业指导。杰出的机构环境和威利斯博士召集的K24咨询团队在宾夕法尼亚大学监督和指导她的进步，支持这项提议的成功。

Dr. Willis is a neurologist, neuroepidemiologist, and health services researcher who has established a nationally- and internationally- recognized, independently funded research program committed to patient-oriented research focused on drug effects, care process and outcome disparities, and health service use in older adults with neurological disease. She has a successful record in mentoring trainees who approach POR from multiple educational backgrounds. Proposal aims: (1) to conduct analytical epidemiology research examining the impact of prescribing practices, drug exposures, drug-drug and drug-disease interactions on clinical, patient-reported and health care utilization outcomes in older adults, particularly those with Parkinson Disease + Dementia; Dementia with Lewy Bodies (which together comprise Lewy Body Dementia, an Alzheimer’s Disease Related Dementia/ADRD), Alzheimer’s disease (AD), Mild cognitive impairment and chronic neurological disease; (2) to conduct health disparities and health services research in older adults with neurological disease, particularly those with the above ADRDs and AD, to gain actionable insights into systematic barriers to equal care; (3a) to develop new studies at the intersection of aging, neurology, and pharmacoepidemiology focused on the biological, clinical, and qualitative effects of deprescribing and safety-guided CNS drug prescribing on cognitive function and cognitive decline in individuals with the above ADRDs, AD, and MCI; (3b) to develop new studies at the intersection of aging, disparities, and health services research, focused on describing and decomposing the relative contributions of individual, neighborhood, and social factors on disparities in guideline adherent treatment initiation, escalation, and monitoring; treatment adherence and outcomes in older adults with neurological disease, including ADRDs and AD; (4) to use Dr. Willis’s research program to train and mentor new investigators in research methods that will improve health care outcomes for older adults with ADRDs, AD and chronic neurological disorders through neuroprotective prescribing, more effective and equitable care delivery. A K24 award will provide Dr. Willis with the protected time needed to develop new research focused on neuroprotective prescribing and health disparities, generate knowledge on the drivers and effects of medical care and drug therapies for neurological disorders. A K24 will also allow Dr. Willis to increase her mentoring expertise and develop a formal mentoring program for engaging young investigators drawn from neurology, epidemiology, geriatrics, psychiatry, pharmacology, informatics, and biostatistics. Dr. Willis’s mentoring program will (1) provide mentees with direct exposure to primary data collection and secondary data analysis (2) create an interdisciplinary environment where trainees from a range of specialties will learn directly from each other (3) provide mentees with individualized research and career mentoring from her. The outstanding institutional environment and the K24 Advisory Team Dr. Willis has assembled to monitor and guide her progress at the University of Pennsylvania support the success of this proposal.