Urban-Rural Sedative & Anxiolytic Use in Long Term Care

城乡镇静

• 批准号: 6637797
• 负责人: SALLY K RIGLER
• 金额: $ 12.06万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6637797
• 关键词: behavioral /social science research tag; belief; benzodiazepines; chemotherapy; clinical research; decision making; extended care; geriatrics; health care service evaluation; health services research tag; human subject; interview; method development; nursing homes; nursing personnel; patient safety /medical error; pharmacists; physicians; population survey; postdoctoral investigator; rural area; sedative /hypnotic; statistics /biometry; tranquilizer; urban area

DESCRIPTION: (Applicant s abstract) Sally K. Rigler, MD, is an academic geriatrician whose clinical experience in long-term care (LTC) led to a strong research interest in prescribing patterns for nursing facility residents. This proposal provides support for formal coursework and implementation of two mentored research projects using quantitative and qualitative methods to address the prescribing of inappropriate benzodiazepine and sedative-hypnotics (Benz/Sed) medications in nursing facilities, with particular focus on potential urban-rural differences. Two interrelated perspectives will ground this work: 1 ) examination of large-scale prescribing trends from 1992-98, using the Kansas Minimum Data Set (MDS), of Benz/Sed drugs; and 2) qualitative evaluation of prescribers beliefs about what factors are influential in LTC when making prescribing decisions regarding these medications. Both approaches will examine urban-rural differences. Career Development Plan: The candidate will undertake coursework in quantitative and qualitative methods, along with research conferences, junior faculty writers? group meetings, and other formal mentoring activities under the primary Sponsorship of Dr. Stephanie Studenski, Director of the Center on Aging, University of Kansas Medical Center. Research Program: a) Quantitative Project (emphasized Years 1 - 2): The applicant?s previous experience with Kansas MDS data is outlined in the proposal; she is aware of its limitations and opportunities. She will investigate use of Benz/Sed medications in Kansas nursing home residents, with special emphasis on those deemed inappropriate for older adults. Urban-rural and time effects will be examined; the 1992-98 data provide information about prescribing patterns prior to recent regulatory changes in the nursing home survey process. Dr. A. Kramer, a senior-level investigator with expertise in secondary data, will serve as Co-sponsor for the quantitative project. b) Qualitative Project (emphasized Years 3 - 5): The candidate will gain new research skills in qualitative methods under the guidance of Dr. D. Stull, Professor of Anthropology, Univ. of Kansas, Lawrence campus. The initial qualitative work will use prescriber focus groups and interviews of consultant pharmacists and directors of nursing, to broadly capture themes about what factors influence prescribing decisions in LTC, emphasizing decisions about Benz/Sed drugs. Potential urban-rural differences will be examined. Further detailed interviews with physician and nurse practitioner prescribers will take place, using insights gained during initial focus groups. Finally, a survey tool will be developed based on these results, followed by modification and validation in preparation for a future broader survey of LTC prescribers. The candidate's goal is to become an independent investigator in the area of prescribing influences in LTC, for the ultimate purpose of developing, implementing, and evaluating targeted interventions to improve prescribing for nursing facility residents.

描述：（申请人摘要）Sally K. Rigler，医学博士，是一位学者 老年病学家，其长期护理 (LTC) 的临床经验带来了强大的 研究兴趣为护理机构居民的处方模式。 该提案为正式课程作业和两个项目的实施提供了支持 使用定量和定性方法指导研究项目 解决不适当的苯二氮卓类药物和镇静催眠药的处方问题 （Benz/Sed）护理机构中的药物，特别关注 潜在的城乡差异。 两个相互关联的观点将奠定基础 这项工作：1）检查 1992-98 年大规模处方趋势， 使用 Benz/Sed 药物的堪萨斯州最低数据集 (MDS)； 2）定性 评估处方者对影响 LTC 的因素的看法 在做出有关这些药物的处方决定时。 两个都 方法将考察​​城乡差异。 职业发展计划：候选人将参加以下课程： 定量和定性方法，以及研究会议，初级 教师作家？小组会议和其他正式指导活动 该中心主任 Stephanie Studenski 博士的主要赞助 老龄化，堪萨斯大学医学中心。 研究计划： a) 定量项目（强调第 1 - 2 年）： 申请人之前使用堪萨斯 MDS 数据的经验在 提议;她意识到它的局限性和机遇。 她会 调查堪萨斯州疗养院居民使用 Benz/Sed 药物的情况 特别强调那些被认为不适合老年人的内容。 城乡 并将检查时间效应； 1992-98 年的数据提供了以下信息： 在疗养院最近的监管变化之前的处方模式 调查过程。 A. Kramer 博士是一位高级研究员，具有以下方面的专业知识： 二手数据将作为定量项目的共同发起人。 b) 定性项目（强调第 3 - 5 年）：候选人将获得新的知识 在 D. Stull 博士的指导下定性方法的研究技能， 大学人类学教授。堪萨斯州劳伦斯校区。 最初的 定性工作将利用处方者焦点小组和顾问访谈 药剂师和护理总监，广泛捕捉有关什么的主题 影响 LTC 处方决策的因素，强调以下决策： 奔驰/Sed 毒品。将审查潜在的城乡差异。 更远 与医生和执业护士开处方者的详细访谈将 利用在最初的焦点小组中获得的见解来进行。 最后，一个 将根据这些结果开发调查工具，然后进行修改 并进行验证，为未来对长期护理处方者进行更广泛的调查做准备。 候选人的目标是成为该领域的独立调查员 规定 LTC 的影响，最终目的是发展， 实施和评估有针对性的干预措施，以改善处方 护理机构的居民。