Medications as Acute Precipitants of Falls in the Nursing Home Setting

疗养院环境中作为跌倒急性诱因的药物

基本信息

批准号：
7989314
负责人：
Sarah Dyer Berry
金额：
$ 12.61万
依托单位：
HEBREW REHABILITATION CENTER FOR AGED
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7989314
关键词：
Acute Address Age Aging Antidepressive Agents Antiepileptic Agents Antihypertensive Agents Antipsychotic Agents Award Benzodiazepines Berry Cessation of life Chronic Cohort Studies Communities Comorbidity Cross-Over Studies Crossover Design Data Dementia Development Diuretics Dose Drug Interactions Educational Curriculum Elderly Epidemiology Equilibrium Event Fall prevention Fracture Frequencies Future Goals Health Hypoglycemic Agents Incidence Individual Injury Institutionalization K-Series Research Career Programs Knowledge Lead Learning Manuscripts Medical Medicine Mentors Methodology Muscle Weakness Nursing Homes Outcome Persons Pharmaceutical Preparations Pharmacoepidemiology Population Prevention program Prevention strategy Rehabilitation Centers Research Research Design Research Personnel Research Project Grants Risk Factors Selection Bias Time Training Work Writing bone strength case control disability fall risk falls high risk improved instructor interest medical schools modifiable risk patient oriented prevent public health relevance sedative skills success

项目摘要

DESCRIPTION (provided by applicant): Dr. Sarah Berry is a Harvard Medical School trained Geriatrician and Instructor in Medicine at Hebrew Rehabilitation Center. Dr. Berry's long term objective is to become an academic geriatrician and independent investigator with expertise in the epidemiology and outcomes of falls and fractures. Her previous work has focused largely on the epidemiology of second fractures in elderly persons. It is important that future efforts to prevent fractures focus not only on bone strength, but on fall prevention as well. Medication use is a common and potentially modifiable risk factor for falls in the nursing home setting. Therefore, the primary objectives of her learning curriculum are to increase her knowledge of fall prevention and pharmacoepidemiology, and to improve her skills in study design methodology. The aims of this research project are to describe the frequency of medication changes in the nursing home population, and to determine the effects of medication changes on the acute risk of falls using a unique and appropriate study design: the case-crossover study. The applicant will also assess whether the effects of a particular medication change on the acute risk of falls is greater among ambulatory residents compared with non-ambulatory residents, and among residents with high baseline medication use compared to residents with low baseline medication use. The estimate of the effect of medication changes on the risk of falls will be determined by comparing the frequency of medication changes during the time period just prior to the fall, and comparing this with the frequency of medication changes during non-fall periods in the same individual. This Mentored Patient-Oriented Career Development Award will provide the necessary additional training to develop into an independent investigator in the field of aging, and the proposed project will produce several manuscripts and preliminary data for the applicant to write and submit an R01 application by the final year of the award. PUBLIC HEALTH RELEVANCE: Falls are one of the most serious health concerns in the elderly, and frequently result in disability, injury, institutionalization, and even death. Medication use may be one of the most common and potentially modifiable risk factors for falls in the nursing home. A better understanding of the association between medication changes and falls is likely to lead to the successful development of fall prevention strategies.

描述（由申请人提供）：莎拉·贝里（Sarah Berry）博士是希伯来康复中心（Hebrew Rehabilitation Center）的哈佛医学院培训的老年医学家和医学讲师。贝瑞博士的长期目标是成为一名学术老年医生和独立研究者，在流行病学和瀑布和骨折结果方面具有专业知识。她以前的工作主要集中在老年人的第二次骨折的流行病学上。未来的努力不仅要专注于骨骼力量，而且还要预防秋天，这一点很重要。使用药物是在疗养院环境中跌倒的常见且可能改变的风险因素。因此，她的学习课程的主要目标是提高她对秋季预防和药物电子学的了解，并提高她在研究设计方法学方面的技能。该研究项目的目的是描述疗养院人口中药物变化的频率，并使用独特且适当的研究设计确定药物变化对跌倒急性风险的影响：案例分解研究。申请人还将评估与非卧式居民相比，卧床居民的特定药物变化对急性跌倒风险的影响是否更大，与使用低基线药物使用的居民相比，使用高基线药物使用的居民在使用较高的基线药物。药物变化对跌倒风险的影响的估计将通过比较跌倒前的药物变化的频率来确定，并将其与同一个体的非下降时期的药物变化频率进行比较。这项受到指导的以患者为导向的职业发展奖将为衰老领域的独立研究者提供必要的额外培训，该项目将在奖励的最后一年之前生成几个手稿和初步数据，以便申请人写和提交R01申请。公共卫生相关性：跌倒是老年人最严重的健康问题之一，经常导致残疾，伤害，制度化甚至死亡。用药可能是疗养院跌倒的最常见和可能修改的危险因素之一。更好地了解药物变化和跌倒之间的关联可能会导致秋季预防策略的成功发展。