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

基本信息

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
项目类别：
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

项目摘要

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.”

项目概要老年人饮酒和滥用酒精的比率比任何其他年龄段的人增长得更快。同时，心力衰竭 (HF) 的流行是导致寿命和健康寿命缩短的主要原因在老年人中，饮酒和滥用酒精的情况也可能有所加剧。加速心力衰竭，既可以直接通过生物机制，也可以间接通过阻碍参与心力衰竭的能力。需要严格的自我管理以避免不良健康后果。如果是这样，请解决饮酒和饮酒问题。患有心力衰竭的老年人中的误用有可能大幅改善发病率、死亡率和质量然而，尽管有这些假设，人们对饮酒和饮酒的影响知之甚少。患有心力衰竭的老年人中的滥用情况以及该人群接受的与酒精相关的护理。此应用程序的目标是使用严格的因果推理和机器学习方法来 1) 估计首次发现酒精使用和滥用与心力衰竭自我管理行为之间的关系，并且 2) 产生对酒精使用和滥用之间关系的估计偏差较小且更普遍心力衰竭的不良后果目前尚不清楚。此外，我们将 3) 描述其数量。和来源（地点、提供者专业、患者与提供者关系的长度、提供者参与负责任的护理组织）记录了目前患有酒精中毒的老年人接受的与酒精相关的护理 HF。为了实现这些目标，我们将利用两个现有数据源的链接：医疗保险按服务收费。索赔和健康与退休研究 (HRS)，这是一个由 22,000 多名全国代表组成的纵向小组这项研究将由酒精使用和滥用方面的强大专家团队完成，心血管疾病、人口老龄化、心理保健协调以及医疗保险分析这项研究有可能为迫切需要的基于证据的指南提供信息。心力衰竭患者的临床管理以及未来研究制定的干预措施和政策将改善该人群与酒精相关的护理和整体健康结果。帮助推进 NIAAA 识别和减少酒精对健康和疾病影响的战略目标它还直接响应 NIAAA 特别关注通知 NOT-AA-20-018。 “现有酒精研究数据的二次分析。”