Prioritizing Quality Improvement for the Treatment of Psychiatric Disturbances Following Traumatic Brain Injury

优先提高脑外伤后精神障碍的治疗质量

• 批准号: 9086550
• 负责人: Jennifer S. Albrecht
• 金额: $ 14.44万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2021-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9086550
• 关键词: Prioritizing; Quality; Improvement; Treatment; Psychiatric

 DESCRIPTION (provided by applicant): This K01 application is designed to prepare the applicant for a successful, independently-funded research career applying methods of stakeholder engagement to investigate the epidemiology of trauma, specifically psychiatric disturbances following TBI. Psychiatric disturbances such as depression, anxiety, and post- traumatic stress disorder (PTSD) following traumatic brain injury (TBI) are associated with poorer cognitive and functional recovery and efficacious treatment would likely improve outcomes. The long term goal of the proposed research is to advance the conduct of patient-centered outcomes research on treatment for psychiatric disturbances following TBI to improve the quality of care. The primary objective of this application is to prioritize patient-selected strategies to overcome barriers to receipt of treatment for psychiatric disturbances following TBI. The specific aims are: 1) Assess patient-centered barriers and facilitators of treatments across comparator treatments and patient groups; 2) Evaluate current treatment patterns and comparative safety associated with treatment of psychiatric disturbances following TBI; and 3) Prioritize patient-selected strategies to overcome barriers to the receipt of treatment for specifi comparator treatments and populations. Two approaches will be employed to identify barriers and facilitators of the receipt of treatment for the three most common psychiatric disturbances following TBI (depression, anxiety, and PTSD). I will implement training in methods of patient engagement and work with my PCOR advisory committee and mentors to identify and recruit patient partners, including individuals with TBI, their family members, and healthcare providers. We will use focus groups and interviews to assess patient-centered barriers and facilitators of treatments across comparator treatments and patient groups and identify comparator treatments for psychiatric disturbances for comparative safety analyses. Next, I will quantify disparities in treatment patterns associated with the three most common psychiatric disturbances following TBI and perform comparative safety analyses to identify variation of treatment risk among defined subgroups. Finally, I will work with my PCOR advisory committee to prioritize patient-selected strategies to overcome barriers to the receipt of treatment for psychiatric disturbances following TBI. The proposed research employs the best of qualitative and quantitative approaches to assess the treatment of psychiatric disturbances following TBI. Patients with TBI will form part of a research advisory committee that will be actively engaged throughout the research process and will drive research questions. The significance of this research is that it will improve the quality of care for patients with psychiatric disturbances following TBI by prioritizing patient-selected strategies to overcome barriers to the receipt of treatment, and providing needed information on treatment patterns and safety of current pharmacologic treatments.

 描述（由应用程序提供）：该K01应用程序旨在为成功，独立资助的研究职业准备应用程序，采用利益相关者参与方法来调查创伤的流行病学，特别是TBI之后的精神疾病。创伤性脑损伤（TBI）之后的抑郁症，焦虑症和创伤后应激障碍（PTSD）等精神疾病与较差的认知和功能恢复和有效治疗有关，可能会改善结果。拟议的研究的长期目标是提高以患者为中心的结果研究，以提高TBI后精神灾害的治疗方法，以提高护理质量。该应用的主要目的是优先考虑患者选择的策略，以克服TBI后接受精神灾害治疗的障碍。 具体目的是：1）评估跨比较者治疗和患者组的以患者为中心的障碍和促进者； 2）评估与TBI后精神灾害治疗相关的当前治疗模式和比较安全性； 3）优先考虑患者选择的策略，以克服接受特定比较者治疗和人群的治疗障碍。将采用两种方法来确定在TBI（抑郁症，动画和PTSD）之后三种最常见的精神灾害接受治疗的障碍和促进因子。我将实施有关患者参与方法的培训，并与我的PCOR咨询委员会和导师合作，以识别和招募患者伴侣，包括具有TBI，其家人和医疗保健提供者的人。我们将使用焦点小组和访谈来评估以患者为中心的障碍和跨比较器治疗和患者组的治疗障碍，并确定用于比较安全性分析的精神疾病的比较治疗。接下来，我将量化与TBI后三个最常见的精神灾害相关的治疗模式差异，并进行比较安全分析，以确定定义的亚组之间治疗风险的变化。最后，我将与我的PCOR咨询委员会合作，优先考虑患者选择的策略，以克服TBI后接受精神灾害治疗的障碍。拟议的研究员工采用了最佳的定性和定量方法来评估TBI后精神灾害的治疗方法。 TBI患者将成为研究咨询委员会的一部分，该咨询委员会将在整个研究过程中积极参与，并将提出研究问题。这项研究的意义在于，它将通过优先考虑患者选择的策略来克服接受治疗的障碍，并提供有关当前药物治疗的治疗模式和安全性的所需信息，从而提高精神疾病患者的护理质量。