Tanslating Research into Action for Diabetes (TRIAD) Legacy Study

将研究转化为糖尿病行动 (TRIAD) 遗产研究

• 批准号: 8029476
• 负责人: CAROL M MANGIONE
• 金额: $ 14.8万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-12 至 2013-07-11
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8029476
• 关键词: Tanslating; Research; into; Action; Diabetes

DESCRIPTION OF THE PROJECT: The goal of the Translating Research into Action for Diabetes (TRIAD) legacy studies is to examine the system- and patient-level factors that are associated with long-term processes of care, morbidity, costs, and mortality of persons with diabetes. To address this goal this Legacy Study application proposes five specific aims. The first aim will generate two reports from the multi-site TRIAD cohort that was recruited in 2001 and the remaining aims will extend our work on the TRIAD Part D Medicare Study with 4 new reports that will analyze recently acquired 2007 claims data from 50 states from one of the largest providers of the Part D benefit in the nation. Our specific aims are: 1) To examine whether there is an association between depression and under-use of medications for depression with medical costs and mortality for persons in the TRIAD cohort; 2) To use 2007 data from Medicare Advantage Part D (MAPD) beneficiaries who reside in 50 states to examine the role of chronic medical conditions such as diabetes, dementia, and depression on out-of-pocket costs, gap entry and adherence to medications; 3) To determine the potential cost savings in the Medicare Part D program from generic and therapeutic substitution using data from a 50-state sample of MAPD beneficiaries collected in 2007; 4) To examine the impact of mail-order use on out-of-pocket costs, total medication costs, and medication adherence for the poorest Medicare beneficiaries with diabetes in the Part D program; 5) To compare the out-of-pocket medication costs, total drug costs, and adherence to chronic medications for beneficiaries in Low Income Qualifier (LIQ) versus commercial plans and for persons with diabetes. Many of the reports that either have UCLA faculty as first or senior author have focused on studying underserved and/or high risk populations with diabetes. During the Legacy Study, the 6 analyses proposed will continue to emphasize how benefit design, cost sharing, and co-morbidities such as depression may disproportionately affect the most vulnerable persons with diabetes. A second objective of the Legacy Study is to continue to develop emerging investigators. To this end, the proposed team will continue our 11-year track record of successful mentorship and advancement of junior investigators with a strong focus on women and minority investigators by continuing to mentor Dr. O. Kenrik Duru, Assistant Professor at UCLA, and Rui Li, Ph.D., an economist at the CDC who has recently joined our team and will continue to work with us during the proposed Legacy where she will be mentored by Dr. Susan Ettner, our senior health economist, and Dr. Carol Mangione, the principal investigator of the UCLA Translational Research Center (TRC). Additionally, we expect to continue our mentoring relationships with a number of investigators from the other TRIAD TRCs. Finally, during the TRIAD Legacy phase we expect to be full participants in the steering and publication committee activities that will be vital to the success of the final stage of this ground-breaking study.

项目描述：糖尿病研究转化为行动 (TRIAD) 遗产研究的目标是检查与长期护理过程、发病率、成本和死亡率相关的系统和患者层面的因素患有糖尿病。为了实现这一目标，该遗产研究应用程序提出了五个具体目标。第一个目标将从 2001 年招募的多站点 TRIAD 队列生成两份报告，其余目标将通过 4 份新报告扩展我们在 TRIAD D 部分医疗保险研究上的工作，这些报告将分析最近从 50 个州获得的 2007 年索赔数据。全国最大的 D 部分福利提供者之一。我们的具体目标是： 1) 研究抑郁症和抑郁症药物使用不足与 TRIAD 队列中患者的医疗费用和死亡率之间是否存在关联； 2) 使用居住在 50 个州的 Medicare Advantage Part D (MAPD)​​ 受益人 2007 年的数据来研究糖尿病、痴呆和抑郁症等慢性疾病对自付费用、缺口进入和药物依从性的影响; 3) 使用 2007 年收集的 50 个州 MAPD 受益人样本数据，确定 Medicare D 部分计划中仿制药和治疗替代品可能节省的成本； 4) 检查邮购使用对 D 部分计划中患有糖尿病的最贫困 Medicare 受益人的自付费用、总药物费用和用药依从性的影响； 5) 比较低收入资格 (LIQ) 受益人与商业计划以及糖尿病患者的自付费用、总药物费用以及对慢性药物的依从性。许多以加州大学洛杉矶分校教师为第一作者或资深作者的报告都重点研究服务不足和/或高风险糖尿病人群。在遗产研究期间，提出的 6 项分析将 继续强调福利设计、成本分摊和抑郁症等共病可能如何对最脆弱的糖尿病患者产生不成比例的影响。 遗产研究的第二个目标是继续培养新兴研究者。为此，拟议团队将继续指导加州大学洛杉矶分校助理教授 O. Kenrik Duru 博士和 Rui，延续我们 11 年成功指导和提升初级研究人员的记录，重点关注女性和少数族裔研究人员Li 博士是 CDC 的经济学家，她最近加入了我们的团队，并将在拟议的遗产期间继续与我们合作，在那里她将受到我们的高级健康经济学家 Susan Ettner 博士和 Carol 博士的指导Mangione，加州大学洛杉矶分校转化研究中心（TRC）首席研究员。此外，我们希望继续与其他 TRIAD TRC 的许多研究人员保持指导关系。最后，在 TRIAD Legacy 阶段，我们希望能够全面参与指导和出版委员会的活动，这对于这项突破性研究的最后阶段的成功至关重要。