Treatment Phenotypes for Adolescents with Asthma

青少年哮喘的治疗表型

基本信息

批准号：
10551725
负责人：
Heather De Keyser
金额：
$ 16.74万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-02-05 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10551725
关键词：
Adherence Adolescent Adrenal Cortex Hormones Adult Agonist Asthma Award Behavior Behavioral Biological Caring Child Childhood Childhood Asthma Chronic Disease Clinical Clinical Trials Colorado Cost Savings Data Data Collection Disease Electronics Evaluation Expenditure Feeling Funding Future Goals Health Health Services Research Health Status Health behavior change Healthcare Hospitalization Individual Inhalation Institution International Intervention Interview Measurement Measures Medical Mentors Mentorship Methods Monitor Morbidity - disease rate Outcome Outcomes Research Patient Outcomes Assessments Patient-Focused Outcomes Patients Pattern Pediatric Hospitals Pharmaceutical Preparations Phenotype Pilot Projects Population Positioning Attribute Provider Public Health Qualitative Methods Qualitative Research Reach, Effectiveness, Adoption, Implementation, and Maintenance Refractory Research Research Infrastructure Research Methodology Research Personnel Science Self Determination System Techniques Technology Testing Time Training Universities Work adherence rate asthma exacerbation asthmatic behavior change care outcomes career compliance behavior cost health care service utilization high risk improved innovation medical schools medication compliance medication nonadherence monitoring device outreach personalized intervention personalized medicine pilot test pragmatic trial recruit research study sensor technology side effect skills theories therapy design treatment risk

项目摘要

PROJECT ABSTRACT Asthma is the most common chronic disease of childhood, and asthma related morbidity costs the US medical system tens of billions of dollars every year. Adherence to asthma medications (specifically inhaled corticosteroids) has been shown to improve asthma related outcomes. Dr. Hoch will evaluate medication usage patterns in depth over one year and develop an intervention with the input of adolescents and providers to improve asthma adherence and control. Dr. Hoch’s overarching hypothesis is that medication adherence trajectory patterns will exist, and that the qualitative analysis will yield actionable ideas for a personalized intervention, aimed at each child’s specific medication use pattern. The purpose of this application is to assist Dr. Hoch in her transition into an independent, federally funded researcher. To this end, Dr. Hoch will use this award to gain additional training in 1) research study methods, including recruitment and retention of subjects and longitudinal data collection, 2) qualitative research methods and 3) the conduct of pragmatic trials in behavior change. She is uniquely positioned within the University of Colorado Anschutz Medical Campus to conduct this work. She will be supported both by the research infrastructure at the University of Colorado School of Medicine and Children’s Hospital Colorado, as well as the Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) center. Through these two institutions, she will be guided by a group of internationally recognized researchers, including Dr. Stanley Szefler (Primary mentor and asthma clinical trials expert), Dr. Allison Kempe (health services research mentor and pragmatic trials expert), Dr. Jodi Holtrop (qualitative and mixed methods research expert) and Dr. Angela Bryan (health behavior change expert). In order to accomplish Dr. Hoch’s short term research goals, she proposes a project with the following specific aims: 1) To better characterize adherence trajectory phenotypes, and to combine adherence with short acting beta agonist (SABA) use patterns to create defined asthma treatment phenotypes, 2) Use qualitative methods among adolescents and providers to evaluate reasons for adherence/nonadherence and motivating factors for adherence, feelings about device monitoring and suggested strategies for intervention among each of the highest risk treatment phenotypes using a self-determination theory framework, 3) To develop and pilot test an intervention strategy using the RE-AIM framework, with a focus on the highest priority treatment phenotypes (those with poor adherence/poor control, and those with good adherence/poor control). This approach will yield lessons that will be helpful for the future treatment of asthmatic children by personalizing treatment based on medication use patterns, and train Dr. Hoch for her career as an independent researcher.

项目摘要哮喘是儿童最常见的慢性疾病，哮喘相关的发病率使美国医疗成本增加每年花费数百亿美元用于坚持哮喘药物（特别是吸入药物）。皮质类固醇）已被证明可以改善哮喘相关的结果。霍赫博士将评估药物治疗。一年内深入研究使用模式，并根据青少年和提供者的意见制定干预措施提高哮喘的依从性和控制。 Hoch 博士的首要假设是药物依从性。轨迹模式将存在，并且定性分析将为个性化提供可行的想法针对每个孩子的具体用药模式进行干预该应用程序的目的是提供帮助。霍赫博士在转型为一名独立的、联邦资助的研究员时，霍赫博士将利用这一点。奖励以获得1）研究方法的额外培训，包括受试者的招募和保留和纵向数据收集，2) 定性研究方法和 3) 进行实用试验她在科罗拉多大学安舒茨医学校区的独特地位有助于改变行为。她将得到科罗拉多大学研究基础设施的支持。科罗拉多医学院和儿童医院以及成人和儿童健康联盟通过这两个机构，她将成为成果研究和交付科学（ACCORDS）中心。由一组国际公认的研究人员指导，包括 Stanley Szefler 博士（主要导师和哮喘临床试验专家）、Allison Kempe 博士（健康服务研究导师和实用试验专家）、 Jodi Holtrop 博士（定性和混合方法研究专家）和 Angela Bryan 博士（健康行为为了实现 Hoch 博士的短期研究目标，她提出了一个与以下具体目标：1）更好地表征依从轨迹表型，并结合坚持使用短效 β 受体激动剂 (SABA) 使用模式来创建明确的哮喘治疗表型，2) 在青少年和提供者中使用定性方法来评估原因遵守/不遵守以及遵守的激励因素、对设备监控的感受以及建议使用以下方法对每种最高风险的治疗表型进行干预策略：自决理论框架，3）使用以下方法制定并试点测试干预策略： RE-AIM 框架，重点关注最优先的治疗表型（那些较差的治疗表型）依从性/控制力差，以及依从性良好/控制力差的人）这种方法将产生教训。这将有助于未来哮喘儿童的个性化治疗药物使用模式，并培训 Hoch 博士作为一名独立研究员的职业生涯。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Is Once Versus Twice Daily Dosing Better for Adherence in Asthma and Chronic Obstructive Pulmonary Disease?

哮喘和慢性阻塞性肺疾病患者的依从性是每日一次还是两次？

DOI：
发表时间：
2023-07
期刊：
影响因子：
0
作者：
De Keyser, Heather;Vuong, Vy;Kaye, Leanne;Anderson 3rd, William C;Szefler, Stanley;Stempel, David A
通讯作者：
Stempel, David A

Adherence and Self-management Interventions among Systemically Marginalized and Underserved Youth with Asthma.

系统性边缘化和服务不足的哮喘青少年的依从性和自我管理干预措施。

DOI：
发表时间：
2022-12
期刊：
影响因子：
0
作者：
Sweenie, Rachel;Keyser, Heather Hoch De;Gutiérrez;Brammer, Caitlin;Ramsey, Rachelle R
通讯作者：
Ramsey, Rachelle R

Encouraging adherence in adolescents with asthma using financial incentives: An RCT.

使用经济激励措施鼓励哮喘青少年坚持治疗：一项随机对照试验。

DOI：
发表时间：
2023-10
期刊：
影响因子：
3.1
作者：
Keyser, Heather H De;Brinton, John T;Bothwell, Samantha;Camacho, Megan;Kempe, Allison;Szefler, Stanley J
通讯作者：
Szefler, Stanley J

Reply to "Breath-taking compliance: Does lower adherence translate to inferiority?".

回复“令人惊叹的依从性：较低的依从性是否意味着自卑？”。

DOI：
发表时间：
2023-12
期刊：
影响因子：
0
作者：
De Keyser, Heather;Vuong, Vy;Kaye, Leanne;Anderson 3rd, William C;Szefler, Stanley;Stempel, David A
通讯作者：
Stempel, David A