Understanding alcohol use and alcohol-related care among older adults with heart failure

了解患有心力衰竭的老年人的饮酒情况和酒精相关护理

• 批准号: 10723567
• 负责人: Aryn Phillips
• 金额: $ 40.63万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-03 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723567
• 关键词: Acceleration; Accounting; Address; Aging; Alcohol consumption; Alcohols; Behavior; Biological; Blood Pressure; Cardiovascular system; Caring; Characteristics; Chronic; Clinical; Clinical Management; Cognitive; Consumption; Data; Data Sources; Diet; Disease; Dose; Elderly; Emergency department visit; Family Practice; Fee-for-Service Plans; Frequencies; Future; General Practices; Goals; Guidelines; Health; Health and Retirement Study; Healthcare; Heart; Heart failure; Heavy Drinking; Hospitalization; Intervention; Knowledge; Length; Longevity; Maintenance; Measures; Medicare; Medicare claim; Mental Health Services; Methodology; Methods; Minor; Modeling; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Outcome; Outpatients; Patient Self-Report; Patients; Pharmaceutical Preparations; Physical activity; Play; Policies; Population; Prevalence; Provider; Quality of life; Recommendation; Regimen; Research; Risk Factors; Role; Sampling; Self Management; Sensory; Services; Smoking; Source; Structure; Surveys; Symptoms; Testing; Time; accountable care organization; adverse outcome; age group; alcohol effect; alcohol misuse; alcohol research; behavioral outcome; binge drinking; care burden; care coordination; drinking; evidence base; evidence based guidelines; experience; healthspan; high reward; high risk; hospital readmission; human old age (65+); improved; innovation; interest; machine learning method; medical specialties; medication compliance; mortality; motor impairment; payment; response; screening and brief intervention; secondary analysis; service utilization; sociodemographics

Project Summary Rates of alcohol use and misuse are increasing faster among older adults than among any other age group. Simultaneously, the prevalence of heart failure (HF), a major cause of reduced lifespan and health span among older adults, has also been increasing. It is possible that alcohol use and misuse exacerbate and accelerate HF, both directly via biological mechanisms and indirectly by hindering the ability to engage in the rigorous self-management required to avoid adverse health outcomes. If so, addressing alcohol use and misuse among older adults with HF has the potential to substantially improve morbidity, mortality, and quality of life for this population. Yet, despite these hypotheses, little is known about the effects of alcohol use and misuse among older adults with HF nor about the alcohol-related care received by this population. The specific aims of this application are to use rigorous causal inference and machine learning methods to 1) estimate the relationships of alcohol use and misuse with HF self-management behaviors for the first time and 2) produce less biased and more generalizable estimates of the relationships between alcohol use and misuse and adverse HF outcomes, which are currently poorly understood. In addition, we will 3) characterize the quantity and sources (venue, provider specialty, length of patient-provider relationship, provider participation in Accountable Care Organizations) of documented alcohol-related care currently received by older adults with HF. To accomplish these aims, we will utilize a linkage of two existing data sources: Medicare fee-for-service claims and the Health and Retirement Study (HRS), a nationally representative longitudinal panel of 22,000+ older adults. The research will be accomplished by a strong team of experts in alcohol use and misuse, cardiovascular conditions, aging populations, mental health care coordination, and analyses of Medicare claims and HRS. This research has the potential to inform critically needed evidence-based guidelines for clinical management of HF patients as well as future research developing interventions and policies that will improve the delivery of alcohol-related care and overall health outcomes among this population. As such, it helps advance NIAAA’s strategic goal of identifying and reducing alcohol’s influence on health and disease throughout the lifespan. It also responds directly to NIAAA Notice of Special Interest NOT-AA-20-018 “Secondary Analyses of Existing Alcohol Research Data.”

项目摘要 老年人的饮酒率和小姐的速度比其他任何年龄段的人都要快。 同时，心力衰竭的患病率（HF）是寿命和健康跨度降低的主要原因 在老年人中，也在增加。酒精使用和错过的恶化和 直接通过生物学机制加速HF，并通过阻碍参与的能力而间接地加速HF 需要严格的自我管理才能避免不利的健康结果。如果是这样，请解决酒精使用和 HF老年人的滥用有可能大大提高发病率，死亡率和质量 这个人群的生活。然而，尽管有这些假设，但对饮酒的影响和 患有HF的老年人或该人群接受的酒精相关护理的滥用。具体 该应用的目的是将严格的因果推理和机器学习方法使用1）估计 第一次使用饮酒与HF自我管理行为的关系，2） 对酒精使用和滥用和滥用之间的关系的偏见和更广泛的估计 不利的HF结果，目前对此知之甚少。另外，我们将3）表征数量 和来源（场地，提供者专业，患者提供者的关系长度，提供者参与 负责任的护理组织）由老年人目前接受的与酒精有关的护理 HF。为了实现这些目标，我们将利用两个现有数据源的链接：医疗保险为服务费 索赔与卫生与退休研究（HRS），全国代表性的纵向小组22,000多 老年人。这项研究将由一支强大的酒精使用和滥用专家团队完成， 心血管疾病，人口老龄化，心理保健协调和Medicare的分析 索赔和人力资源。这项研究有可能为迫切需要的基于证据的指南提供信息 HF患者的临床管理以及未来的研究制定干预措施和政策 改善该人群中与酒精有关的护理和整体健康状况的提供。因此，它 帮助促进NIAAA识别和减少酒精对健康和疾病的影响的战略目标 在整个生命周期中。它还直接回应NIAA的特殊利益通知，而不是AA-20-018 “现有酒精研究数据的次要分析。”