Enhancing treatment adherence and health outcomes

提高治疗依从性和健康结果

• 批准号: 8264806
• 负责人: Dennis D Drotar
• 金额: $ 12.03万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8264806
• 关键词: Health; Outcome; treatment adherence

DESCRIPTION (provided by applicant): This proposal requests support for a new postdoctoral training program to train MD and PhD researchers to assume leadership roles in developing innovative, high impact research on adherence to medical treatment and chronic illness management that will enhance the health outcomes of children with pediatric chronic conditions. Modern medical treatments have improved the health outcomes of large numbers of children and adolescents with chronic conditions. However, one of the most critical remaining barriers to improving children's health outcomes over the course of their lifetime management of chronic illness is nonadherence to prescribed medical treatment. Nonadherence is defined as the discrepancy between prescribed treatment (medication or other treatments) and what is actually taken by patients. As noted by the World Health Organization (WHO), treatment nonadherence is not only highly prevalent (rates of 50% or greater in pediatric chronic illness populations) but has an extraordinary negative impact on children's health and health care costs. Innovative and clinically relevant research will be needed to close the gap between the health outcomes that are potentially achievable with more optimal treatment adherence and those achieved in current practice. NIH program priorities and requests for applications, scientific consensus conferences, and scholarly reviews have all identified the critical importance of research on pediatric adherence to treatment. A critical barrier to scientific advances in pediatric adherence and chronic illness management research is the shortage of talented, well-trained researchers who are devoting their careers to developing innovative, high impact treatment adherence and chronic illness management research with pediatric populations. One of the most promising ways to address this need and improve child health is to develop innovative interdisciplinary research training programs to train leaders in the field of treatment adherence and chronic illness management research. This is the goal of the proposed program. Specific training innovations will involve the integration of biomedical, behavioral, biostatistics, and health services/outcomes research and are reflected in a comprehensive training curriculum and research opportunities. Research innovations include novel methods of adherence promotion interventions involving technology (telehealth, internet, cell phone) designed to enhance the power and duration of intervention effects and reach diverse populations who cannot easily access traditional clinic-based approaches. Program innovation will also be enhanced by novel research training opportunities to evaluate the comparative effectiveness of adherence promotion interventions in pediatric chronic illness management, to integrate objective methods of adherence measurement (e.g., behavioral and pharmacological) and conduct advanced statistical analyses to evaluate the impact of adherence promotion interventions on children's health outcomes. PUBLIC HEALTH RELEVANCE: Fellowship program graduates will be national leaders who will have a significant scientific impact on research in pediatric treatment adherence and relevant health outcomes for many years to come. This program will result in effective interventions that will enhance adherence to medical treatment for children and adolescents with a wide range of pediatric conditions. These advances will reduce the extraordinary negative impact of pediatric nonadherence and enhance children's health by reducing symptoms, impairment, health care utilization, a well as reduced costs of pediatric chronic illness treatment

描述（由申请人提供）：该提案要求为新的博士后培训计划提供支持，以培训MD和博士学位研究人员在发展依从性医疗治疗和慢性病管理方面扮演领导角色，从而增强儿童患儿科慢性疾病的健康状况。现代医疗治疗改善了慢性病的大量儿童和青少年的健康结果。但是，在慢性疾病的一生管理过程中，改善儿童的健康成果的最关键障碍之一是处方医疗不遵守。不依从性定义为处方治疗（药物或其他治疗方法）与患者实际采取的措施之间的差异。正如世界卫生组织（WHO）所指出的那样，治疗不遵守不仅很普遍（儿科慢性病人群的比率为50％或更高），而且对儿童的健康和医疗保健费用产生了极大的负面影响。将需要创新和临床相关的研究，以弥合可能通过更具最佳治疗依从性和在当前实践中实现的健康结果之间的差距。 NIH计划的优先事项和要求申请，科学共识会议和学术评论都确定了研究对小儿遵守治疗的重要重要性。小儿依从性和慢性疾病管理研究的科学进步的关键障碍是缺乏才华横溢的训练有素的研究人员，他们致力于将自己的职业与儿科人群一起发展创新，高影响力治疗依从性和慢性病管理研究。满足这一需求并改善儿童健康的最有希望的方法之一是开发创新的跨学科研究培训计划，以培训治疗依从性和慢性病管理研究领域的领导者。这是拟议程序的目标。特定的培训创新将涉及生物医学，行为，生物统计学和健康服务/成果研究的整合，并反映在全面的培训课程和研究机会中。研究创新包括涉及技术（远程医疗，互联网，手机）的依从性促进干预措施的新颖方法，旨在增强干预效果的功能和持续时间，并达到无法轻松访问传统基于诊所的方法的不同人群。计划创新还将通过新的研究培训机会来增强，以评估儿科慢性病管理中依从性促进干预措施的比较有效性，以整合依从性测量的客观方法（例如行为和药理学），并进行先进的统计分析以评估促进儿童健康外观的依从性促进措施的影响。 公共卫生相关性：奖学金计划毕业生将成为国家领导人，他们将在未来的许多年中对小儿治疗依从性和相关健康成果的研究产生重大的科学影响。该计划将导致有效的干预措施，从而增强针对各种儿科疾病的儿童和青少年的医学治疗。这些进步将通过减少症状，障碍，医疗保健利用，降低小儿慢性病治疗的成本，从而减少小儿不遵守的特殊负面影响并改善儿童健康