Predicting Transitions Among Community-Dwelling Elders

预测社区老年人的转变

• 批准号: 6873628
• 负责人: ILENE HARRIS
• 金额: $ 12.93万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-01 至 2009-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6873628
• 关键词: behavior prediction; behavioral /social science research tag; community; comorbidity; data collection methodology /evaluation; drug adverse effect; extended care facility; functional ability; geriatrics; health care model; health services research tag; health surveys; home for elderly; home health care; human data; human old age (65+); human population dynamics; model design /development; patient care management; patient safety /medical error; residential care facility; self care; socioenvironment; therapy compliance

DESCRIPTION (provided by applicant): This application is a request for a Mentored Research Scientist Development Award (K01) to further Dr. Ilene Zuckerman's research in the area of epidemiology of aging and long-term care, with a focus on medication-related issues. Adverse drug events are risk factors for elders transitioning from independent community living to dependent environments such as nursing homes. Medication-related behaviors that lead to adverse drug events and subsequent transitions are preventable with effective intervention. Screening for transitions can identify high-risk elders for interventions to avoid preventable transitions. Dr. Zuckerman's goal for this application is to build a research agenda that examines factors associated with transitions in the elderly. The central hypothesis is that socio-demographic, clinical, behavioral and medication use factors can discriminate elders who experience transitions from independent to dependent settings from those who do not. The objective of the proposed research will be accomplished by pursuing three specific aims: 1) estimate the association between transitions from independent to dependent living and medication use factors in the elderly; 2) develop a predictive model for transitioning from independent to dependent living; and 3) develop and pilot test a screening instrument, based on the predictive model, to discriminate older adults who will experience a transition from those who will not. To accomplish the first two aims, multivariable analysis of survey and administrative claims data will be performed. Qualitative methods will be used to develop and pilot test the screening instrument in Aim #3. In addition to experience gained from completing the proposed research, Dr. Zuckerman will engage in learning activities to enhance her quantitative and qualitative research skills. The proposed training and research are based on her professional interests and build on current work and previous experience. The project represents her continuing efforts to improve the safety of drug use for older adults by understanding the association between drug use factors and elder transitions from independent to dependent environments. Dr. Zuckerman is particularly well prepared to undertake this proposed research, with clinical experience in geriatric pharmacotherapy and epidemiological training. In addition, the mentor and co-mentors have extensive epidemiology of aging research expertise. This research is significant in that it bridges the disparate literature that has separately examined medication use factors and transitions. It is an incremental and important step to building a research agenda that examines socio-demographic, clinical and behavioral factors that affect medication use and transitions in the elderly. Thus, the findings will allow Dr. Zuckerman to build a research agenda that addresses her long term goal to reduce the incidence and prevalence of preventable adverse drug events in the elderly, and to design and evaluate interventions that are targeted toward preventable risk factors for transitions.

描述（由申请人提供）：本申请是申请指导研究科学家发展奖（K01），以进一步推进艾琳·祖克曼博士在衰老流行病学和长期护理领域的研究，重点是药物相关问题。药物不良事件是老年人从独立社区生活过渡到疗养院等依赖环境的危险因素。通过有效干预，可以预防导致药物不良事件和随后转变的药物相关行为。筛查过渡可以识别高风险老年人进行干预，以避免可预防的过渡。 Zuckerman 博士的此应用程序的目标是建立一个研究议程，检查与老年人转变相关的因素。中心假设是，社会人口、临床、行为和药物使用因素可以将经历过从独立环境转变为依赖环境的老年人与那些没有经历过这种转变的老年人区分开来。拟议研究的目标将通过追求三个具体目标来实现：1）估计从独立生活到依赖生活的转变与 老年人的药物使用因素； 2）开发从独立生活过渡到依赖生活的预测模型； 3）根据预测模型开发并试点测试一种筛查工具，以区分将经历过渡的老年人和不会经历过渡的老年人。为了实现前两个目标，将对调查和行政索赔数据进行多变量分析。定性方法将用于开发和试点测试目标#3 中的筛查仪器。除了完成拟议研究中获得的经验外，祖克曼博士还将参与学习活动，以提高她的定量和定性研究技能。拟议的培训和研究基于她的专业兴趣，并建立在当前的工作和以前的经验的基础上。该项目代表了她通过了解吸毒因素与老年人从独立环境到依赖环境的转变之间的关联，为提高老年人吸毒安全性所做的持续努力。祖克曼博士已做好充分准备来承担 这项提出的研究具有老年药物治疗和流行病学培训的临床经验。此外，导师和共同导师拥有广泛的衰老流行病学研究专业知识。这项研究的意义重大，因为它弥合了分别研究药物使用因素和转变的不同文献。这是建立研究议程的渐进且重要的一步，该议程旨在检查影响老年人药物使用和转变的社会人口、临床和行为因素。因此，这些发现将使 Zuckerman 博士能够制定一个研究议程，以实现她的长期目标，即减少老年人中可预防的药物不良事件的发生率和患病率，并设计和评估针对过渡期可预防风险因素的干预措施。