An Intervention to Reduce Cancer Associated Thrombosis Through Improved Prophylaxis

通过改进预防来减少癌症相关血栓形成的干预措施

基本信息

批准号：
10723791
负责人：
Jordan Schaefer
金额：
$ 17.14万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-15 至 2028-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10723791
关键词：
Academic Medical Centers Active Learning Address Agreement American Society of Clinical Oncology American Society of Hematology Anticoagulants Anticoagulation Assessment tool Award Awareness Caring Cause of Death Cessation of life Clinic Clinical Investigator Clinical Trials Coagulation Process Collaborations Communities Community Practice Complex Data Data Analyses Dedications Dose Educational workshop Eligibility Determination Environment Foundations Goals Guidelines Health Policy Hematologist Hemorrhage Hemostatic function Incidence Institution International Intervention Interview Jordan K-Series Research Career Programs Life Malignant Neoplasms Maps Mentors Mentorship Michigan Multicenter Studies National Comprehensive Cancer Network Oncologist Oncology Oral Outcome Outpatients Participant Patient Care Patients Patterns of Care Pharmacists Physicians Population Prophylactic treatment Qualitative Methods Qualitative Research Quality of Care Recommendation Research Research Methodology Research Personnel Research Project Grants Resource-limited setting Resources Risk Risk Assessment Risk Reduction Sampling Self Efficacy Site Societies Structure Testing Theoretical Domains framework Thrombosis Time Training Training Activity Universities cancer risk cancer therapy chemotherapy clinical efficacy clinical practice community setting cost efficacy evaluation evidence base experience high risk implementation evaluation implementation intervention implementation outcomes implementation process implementation science implementation strategy improved innovation interest meetings member multi-component intervention multidisciplinary novel patient population pharmacologic pilot test preventive intervention skill acquisition skills success thrombotic uptake venous thromboembolism

Academic Medical Centers Active Learning Address Agreement American Society of Clinical Oncology American Society of Hematology Anticoagulants Anticoagulation Assessment tool Award Awareness Caring Cause of Death Cessation of life Clinic Clinical Investigator Clinical Trials Coagulation Process Collaborations Communities Community Practice Complex Data Data Analyses Dedications Dose Educational workshop Eligibility Determination Environment Foundations Goals Guidelines Health Policy Hematologist Hemorrhage Hemostatic function Incidence Institution International Intervention Interview Jordan K-Series Research Career Programs Life Malignant Neoplasms Maps Mentors Mentorship Michigan Multicenter Studies National Comprehensive Cancer Network Oncologist Oncology Oral Outcome Outpatients Participant Patient Care Patients Patterns of Care Pharmacists Physicians Population Prophylactic treatment Qualitative Methods Qualitative Research Quality of Care Recommendation Research Research Methodology Research Personnel Research Project Grants Resource-limited setting Resources Risk Risk Assessment Risk Reduction Sampling Self Efficacy Site Societies Structure Testing Theoretical Domains framework Thrombosis Time Training Training Activity Universities cancer risk cancer therapy chemotherapy clinical efficacy clinical practice community setting cost efficacy evaluation evidence base experience high risk implementation evaluation implementation intervention implementation outcomes implementation process implementation science implementation strategy improved innovation interest meetings member multi-component intervention multidisciplinary novel patient population pharmacologic pilot test preventive intervention skill acquisition skills success thrombotic uptake venous thromboembolism

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项目摘要

Candidate: Jordan Schaefer, MD is a hematologist and early clinical investigator specializing in antithrombotic therapies, with particular interests in implementation science and cancer associated thrombosis (CAT). Training Aims: This K01 career development award will facilitate Dr. Schaefer receiving training in qualitative research methods and analysis. Furthermore, he will develop skills in implementation science, including implementation mapping, and conducting a multicenter pilot implementation intervention. He will acquire these skills through focused mentorship meetings, formal coursework, workshops and seminars, and experiential learning. Long term, he will use this training to optimize and implement multicomponent interventions to promote best antithrombotic therapies. Research Context: CAT is a leading cause of death among patients with cancer. Studies have shown a net benefit to anticoagulant thromboprophylaxis for high-risk patients with cancer receiving systemic cancer therapy. Guidelines have broadly endorsed offering apixaban or rivaroxaban for this patient population, but uptake has been extremely low. An academic medical center was able to increase prophylaxis rates to over 90% of eligible patients. However, this intervention is not generalizable to community settings where most patients receive their care. The short-term goal of this proposal is to identify strategies to improve rates of CAT prophylaxis rates in low resource, community settings with a long-term goal of broadly disseminating this intervention to reduce the incidence of CAT. Specific Aims: AIM 1–To identify determinants of CAT prophylaxis in community-based oncology care settings to develop a strategy for improving CAT prophylaxis. AIM 2–To develop an implementation plan to improve the uptake of pharmacologic prophylaxis for CAT using implementation mapping. AIM 3–To pilot an implementation intervention at community-based oncology practices. Research Plan: To accomplish these aims, Dr. Schaefer will perform semi-structured interviews based on the Theoretical Domains Framework at several oncology practices. He will meet regularly with diverse stakeholders and use implementation mapping to establish a multicomponent implementation plan. Finally, he will conduct a pilot test of the intervention and assess implementation outcomes six oncology clinics. Research Environment: Dr. Schaefer is supported by a dedicated, multidisciplinary team of accomplished mentors and advisors with whom he has previously collaborated. The project will be supported by the Michigan Oncology Quality Consortium, the Michigan Anticoagulation Quality Improvement Initiative, and make use of several resources available at the University of Michigan, including the Institute for Healthcare Policy and Innovation. Summary: Completing this project will establish the foundation for a larger, multicenter study to establish the clinical efficacy and sustainability of this intervention. The training from this award will prepare Dr. Schaefer to submit a successful R01 application and achieve research independence using implementation science principles to address complex anticoagulation problems.

候选人：医学博士Jordan Schaefer是血液学家和早期临床研究者，专门研究抗血栓形成对实施科学和癌症相关血栓形成（CAT）特别兴趣的疗法。培训目标：这个K01职业发展奖将有助于Schaefer博士接受定性的培训研究方法和分析。此外，他将发展实施科学的技能，包括实施映射，并进行多中心飞行员实施干预措施。他将获得这些通过专注的精通会议，正式的课程，讲习班和半段的技能以及经验丰富的技能学习。长期，他将使用此培训来优化和实施多组分干预措施促进最佳的抗血栓疗法。研究环境：猫是患者死亡的主要原因癌症。研究表明，对于高危患者，接受全身性癌症治疗的癌症。准则已广泛认可提供Apixaban或Rivaroxaban 对于这个患者人群，但吸收非常低。一个学术医学中心能够将预防率提高到超过90％的合格患者。但是，这种干预措施不能推广大多数患者获得护理的社区环境。该提议的短期目标是确定提高低资源中猫预防率的速度的策略，具有长期目标的社区环境广泛传播这种干预措施以减少猫的事件。具体目的：目标1-识别在社区肿瘤护理环境中，猫预防的决定因素，以制定一种策略改善猫预防。目标2 - 制定一项实施计划，以改善药物的吸收使用实施映射预防CAT。目标3 - 试行实施干预措施基于社区的肿瘤学实践。研究计划：为了实现这些目标，Schaefer博士将执行基于几种肿瘤习惯的理论领域框架的半结构化访谈。他会的定期与潜水员利益相关者会面，并使用实施映射来建立多组分实施计划。最后，他将对干预和评估实施进行试点测试结果六个肿瘤诊所。研究环境：Schaefer博士得到了专门的，他以前与之合作的有成就的导师和顾问团队的多学科团队。这项目将得到密歇根州肿瘤质量财团的支持，密歇根州的抗凝质量改进倡议，并利用密歇根大学提供的几种资源，包括医疗保健政策与创新研究所。摘要：完成此项目将建立为建立这种干预措施的临床效率和可持续性建立更大的多中心研究的基础。该奖项的培训将使Schaefer博士准备提交成功的R01申请和成就使用实施科学原则研究独立性来解决复杂的抗凝问题。