Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury

使用数字解决方案改善急性肾损伤患者的护理过渡

基本信息

批准号：
10601133
负责人：
Jia Hwei Ng
金额：
$ 19.26万
依托单位：
FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-15 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10601133
关键词：
Acute Renal Failure with Renal Papillary Necrosis Address Agreement Ambulatory Care Automated Abstracting Award Behavior Behavior Therapy Behavioral Sciences Biometry Caring Cessation of life Communication Critical Illness Data Data Analyses Development Diagnosis Diet Documentation Education Effectiveness Electronic Health Record Enrollment Environment Epidemiology Evaluation Fostering Foundations Future Goals Health Health Personnel Hospitalization Hospitals Instruction Intervention Intervention Trial Interview K-Series Research Career Programs Kidney Kidney Failure Knowledge Knowledge Management Libraries Link Managed Care Master of Science Measures Medical Mentors Mentorship Monitor Morbidity - disease rate Motivation Obesity Outcome Outcome Measure Outpatients Pamphlets Patient Care Patient Education Patients Pennsylvania Pharmaceutical Preparations Phase Pilot Projects Positioning Attribute Primary Care Physician Printing Provider Public Health Informatics Qualitative Research Questionnaires Randomized Randomized, Controlled Trials Reading Recovery Recurrence Renal function Research Research Design Research Personnel Risk Self Determination Self Management Signal Transduction Structure Surveys Telephone Testing Text Messaging Time Training Treatment Efficacy Universities Work acute care career career development clinical care clinical epidemiology cost design dietary restriction digital digital health effectiveness evaluation effectiveness testing efficacy outcomes electronic health information epidemiology study experience health application health information technology hospital care hospital readmission improved intervention refinement medical schools multidisciplinary patient oriented pilot trial programs prototype skills support tools theories therapy design therapy development tool trial design usability

项目摘要

Title: Using Digital Solutions to Improve Transition of Care for Patients with Acute Kidney Injury The overarching objective of the proposed mentored patient-oriented career development award (K23) is to develop an acute kidney injury (AKI) research program that utilizes behavioral science principles and digital health solutions, fostering Dr. Ng’s development to an independent researcher. AKI, a sudden decline in kidney function, occurs in 16-25% of hospitalized patients. If AKI is not addressed during the transition of care from the hospital to outpatient setting, patients are at risk for recurrent AKI and rehospitalization. Achieving optimal transition of care for AKI is challenging, because AKI information is poorly communicated both to outpatient providers and patients. Outpatient providers cannot address AKI complications nor monitor kidney function, when they are unaware of patient’s AKI status. Additionally, patients lack the knowledge and self-management skills for AKI (e.g., follow kidney-specific dietary restrictions or avoid medications harmful to the kidneys). To improve AKI information flow to providers and patients, the candidate proposes to adapt and evaluate: 1) an AKI section for discharge summary; and 2) the feasibility of a text messages to support patient education and self-management. The Specific Aims are: 1a) adapt existing discharge summary to include AKI information, and test usability; 1b) design and adapt text messages for an AKI management and education tool (AKI-MET); and 2) evaluate the feasibility, acceptability, and preliminary efficacy of intervention components in a 2 sequential pilot RCTs. Dr Ng has completed a master’s degree in clinical epidemiology at the University of Pennsylvania, through which she gained experience in epidemiology, biostatistics, and study design. Her previous training and experience in AKI epidemiology research and qualitative research have prepared her to engage in the work proposed in the studies. Dr Ng is positioned to use this award to launch an independent research career in the rich research and training environment at the Zucker School of Medicine at Hofstra/Northwell. Through her proposed career development, she seeks to gain skills in: 1) application of health information technology and digital health intervention; 2) behavioral science and behavioral intervention design; 3) RCT design, conduct, and analysis, including longitudinal data analysis from the pilot trial; and 4) professional development. Dr. Ng has assembled a multi-disciplinary mentorship team led by experts in the field. Upon completion of these K23 activities, she will be well-positioned to submit an R01 for a larger RCT to assess the effectiveness of AKI transition-of-care tool in improving health outcomes.

标题：使用数字解决方案改善急性肾损伤患者的护理过渡拟议的以患者为导向的职业发展奖（K23）的总体目标是开发急性肾损伤 (AKI) 研究计划，利用行为科学原理和数字技术健康解决方案，促进吴博士发展成为一名独立研究员。如果未解决 AKI，16-25% 的住院患者会发生 AKI（肾功能突然下降）。在从医院到门诊的护理过渡过程中，患者面临复发 AKI 的风险实现 AKI 护理的最佳过渡具有挑战性，因为 AKI 信息很少。与门诊提供者和患者沟通后，门诊提供者无法解决 AKI。当他们不知道患者的 AKI 状态时，他们不会出现并发症，也不会监测肾功能。缺乏 AKI 的知识和自我管理技能（例如，遵循针对肾脏的饮食限制或避免药物（对肾脏有害）改善 AKI 信息流向提供者和患者、候选者。建议调整和评估：1）出院总结的 AKI 部分；2）文本的可行性；支持患者教育和自我管理的信息具体目标是： 1a) 适应现有的。出院总结，包括 AKI 信息，并测试可用性；1b) 设计和调整文本消息 AKI 管理和教育工具 (AKI-MET)；以及 2) 评估可行性、可接受性和初步效果两项连续试点随机对照试验中干预措施的功效。吴博士在宾夕法尼亚大学完成了临床流行病学硕士学位，通过她在流行病学、生物统计学和研究设计方面获得了经验。 AKI流行病学研究和定性研究的经验为她从事这项工作做好了准备研究中提出，吴博士将利用该奖项在该领域开展独立研究生涯。通过她，霍夫斯特拉/诺斯韦尔祖克医学院拥有丰富的研究和培训环境。在拟议的职业发展中，她寻求获得以下方面的技能：1）应用健康信息技术和数字健康干预；2）行为科学和行为干预设计；3）RCT设计、实施、和分析，包括试点试验的纵向数据分析；以及 4) 吴博士的专业发展。在完成这些 K23 课程后，我们组建了一支由该领域专家领导的多学科指导团队。活动，她将有能力提交 R01 进行更大的 RCT，以评估 AKI 的有效性改善健康结果的护理过渡工具。