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：
8489232
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 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8489232
关键词：
Acute Address Age Aging Antidepressive Agents Antiepileptic Agents Antihypertensive Agents Antipsychotic Agents Award Benzodiazepines Berry Case-Control Studies 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 disability fall risk falls high risk improved instructor 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.

描述（由申请人提供）：莎拉·贝里博士是哈佛医学院接受过培训的老年病学家和希伯来康复中心的医学讲师。贝瑞博士的长期目标是成为一名学术老年病学家和独立调查员，在流行病学以及跌倒和骨折的结果方面拥有专业知识。她之前的工作主要集中在老年人第二次骨折的流行病学上。重要的是，未来预防骨折的努力不仅要关注骨强度，还要关注预防跌倒。药物使用是疗养院跌倒的常见且可能可改变的危险因素。因此，她学习课程的主要目标是增加跌倒预防和药物流行病学知识，并提高研究设计方法的技能。该研究项目的目的是描述疗养院人群中药物变化的频率，并使用独特且适当的研究设计：病例交叉研究来确定药物变化对跌倒急性风险的影响。申请人还将评估特定药物变化对急性跌倒风险的影响是否在流动居民中比非流动居民更大，以及在高基线药物使用居民中与低基线药物使用居民相比是否更大。药物变化对跌倒风险影响的估计将通过比较跌倒前一段时间内药物变化的频率，并将其与同一时间段内非跌倒期间的药物变化频率进行比较来确定。个人。这个以患者为导向的职业发展奖将提供必要的额外培训，以发展成为老龄化领域的独立研究者，拟议项目将产生几份手稿和初步数据，供申请人在最终之前撰写和提交 R01 申请获奖年份。