The Cirrhosis Medical Home: A Feasibility Study

肝硬化医疗之家：可行性研究

基本信息

批准号：
9978477
负责人：
Eric Orman
金额：
$ 12.15万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2022-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9978477
关键词：
Acute Address American Ascites Behavioral Caring Chronic Disease Cirrhosis Clinical Cognitive Communities Complex Computer software Custom Data Data Collection Dementia Development Dropout Enrollment Ensure Feasibility Studies Feedback Frail Elderly Future Gastrointestinal Hemorrhage Goals Healthcare Systems Hepatic Encephalopathy Home environment Hospitalization Hospitals Impairment Indiana Individual Infection Inpatients Institute of Medicine (U.S.)Intervention Lead Length of Stay Liver Cirrhosis Measures Medical Mental Depression Modeling Morbidity - disease rate Nature Outcome Outcome Assessment Patient Care Patient-Centered Care Patients Physical Function Population Preparation Process Protocols documentation Quality of life Randomized Clinical Trials Randomized Controlled Trials Research Personnel Resources Social Functioning Societies Symptoms Testing United States Centers for Medicare and Medicaid Services Universities Vulnerable Populations biopsychosocial care coordination chronic liver disease collaborative care cost disability disabling symptom efficacy trial experience health care service health care service utilization hospital readmission improved innovation medical schools mortality novel patient oriented patient population personalized care personalized intervention psychologic randomized trial rehabilitation service screening success tool treatment as usual trial comparing

项目摘要

PROJECT SUMMARY Liver cirrhosis places a significant burden on individuals and society, causing diminished quality of life, increased disability, morbidity, and mortality; and high costs and utilization of health care resources. These outcomes could be improved with existing resources, but the current fragmented nature of the health care system does not allow for the necessary coordination to best care for this population. To address the general lack of care coordination in the health care system, collaborative care models have been developed for a wide range of clinical settings, and have successfully improved care for patients with numerous chronic diseases. Researchers at the Indiana University School of Medicine have over 20 years of experience in developing, testing, and implementing collaborative care for patients with dementia, depression, and other conditions. Building on these successes, investigators have customized the collaborative care model to best meet the unique needs of patients with decompensated cirrhosis: The Cirrhosis Medical Home (CMH). This proposal aims to establish the feasibility of performing a randomized controlled trial comparing the CMH to usual care for patients discharged from the hospital with decompensated cirrhosis. The specific aims are: (1) to test the screening and enrollment processes for a randomized trial of the CMH compared to usual care for patients discharged from the hospital with decompensated cirrhosis; (2) to assess the data collection process, outcome assessment, and the acceptability of the CMH randomized trial; and (3) to estimate the effect size of the CMH intervention on quality of life after six months. Upon completion of the proposed study, the investigators will have demonstrated the feasibility of enrolling and retaining subjects in a randomized trial of the CMH, and they will have established an estimated effect size that will ensure adequate power for a future randomized trial that will evaluate the efficacy of the CMH.

项目摘要肝肝硬化给个人和社会带来巨大负担，导致生活质量降低，残疾，发病率和死亡率增加；高昂的成本和医疗资源的利用。这些现有资源可以改善成果，但是医疗保健当前的分散性质系统不允许进行必要的协调来为该人群提供最佳护理。解决一般在医疗保健系统中缺乏护理协调，为广泛开发了协作护理模型临床环境范围，并成功改善了许多慢性疾病患者的护理。印第安纳大学医学院的研究人员在发展中拥有20多年的经验测试并针对患有痴呆症，抑郁症和其他疾病的患者实施协作护理。在这些成功的基础上，调查人员定制了协作护理模型，以最好地满足肝硬化失代偿患者的独特需求：肝硬化医疗之家（CMH）。这个建议旨在建立进行随机对照试验的可行性，将CMH与通常的护理进行比较对于从医院出院的患者，肝硬化。具体目的是：（1）测试与患者的常规护理相比，CMH随机试验的筛查和入学过程从医院出院，肝硬化是代表性的；（2）评估数据收集过程，结果评估以及CMH随机试验的可接受性；（3）估计CMH的效果大小六个月后生活质量的干预。拟议的研究完成后，研究人员将已经证明了在CMH的随机试验中注册和保留受试者的可行性，并且将建立一个估计的效果大小，以确保将来的随机试验的足够权力将评估CMH的功效。