Quality and Equity in Osteoarthritis: Understanding & Improving Treatment Use

骨关节炎的质量和公平：理解

• 批准号: 9040883
• 负责人: Ernest R Vina
• 金额: $ 17.79万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-26 至 2020-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9040883
• 关键词: Address; African American; Anti-Inflammatory Agents; Anti-inflammatory; Area; Arthritis; Attitude; Belief; Caring; Characteristics; Clinical; Clinical Practice Guideline; Clinical Trials; Degenerative polyarthritis; Disease; Elderly; Exercise; Goals; Health; Healthcare; Hip region structure; Intervention; Knee; Knowledge; Lead; Learning; Mediating; Medical; Medicine; Methods; Modality; Musculoskeletal Diseases; Narcotics; Operative Surgical Procedures; Opioid; Outcome; Pain; Pain management; Patient Care; Patients; Pharmaceutical Preparations; Physical therapy; Pilot Projects; Placebos; Process; Publishing; Quality of Care; Race; Recording of previous events; Reporting; Research; Rheumatism; Risk; Self Care; Severity of illness; Source; Statistical Models; Surveys; Testing; Treatment Efficacy; Update; career; disability; disabling disease; disparity reduction; evidence base; experience; group intervention; health belief; health care disparity; improved; improved outcome; instrument; interest; patient oriented; personalized medicine; primary outcome; psychosocial; racial difference; racial disparity; racial health disparity; racial minority; shared decision making; skills training; therapy design; therapy development; tool; treatment disparity

 DESCRIPTION (provided by applicant): Candidate Career Goals: Dr. Ernest R. Vina's long-term career goal is to promote equity for patients with rheumatic and musculoskeletal diseases through the development of interventions to eliminate racial disparities and improve outcomes for patients with these diseases. With his research and clinical experience in addressing the sources of racial disparities in the health and health care of patients with rheumatic diseases, Dr. Vina is well-suited to build a research career in this area. However, he will require additiona training and skills in order to address knowledge gaps by exploring patient characteristics and health beliefs that may contribute to disparities in the medical care of patients with osteoarthrits (OA). Dr. Vina's short-term career goals are 1) to develop the expertise required to study the reasons why race disparities in the use of different types of non-surgical OA treatment exist; and 2) to learn to develop an intervention and implement a clinical trial to reduce racial disparities n the use of various OA treatments. Research Background: OA is a highly prevalent and disabling disease. Racial disparities in the outcomes of OA patients have also been demonstrated, with African-Americans (AAs) carrying a greater burden than whites (WHs). In addition, AAs are also less likely to have history of use of various pharmacologic and non- pharmacologic therapies for OA. Sources of racial healthcare disparities in OA are only partially known. Research Aims: There are two main aims for this K23. The first is to examine the determinants of, and barriers to, the utilization of various OA treatments that contribute to disparities in the care of AAs and WHs. The second is to pilot-test the impact of an intervention designed to improve the utilization of effective, non- surgical OA treatments. Methods: To achieve the goals of the first aim, surveys of patients with knee or hip OA will be conducted. The survey will determine patient demographic information, psychosocial characteristics, disease severity, treatment history and health-related knowledge, beliefs and attitudes. The primary outcomes of interest will include utilization of various treatments, including exercises, topical medications, non-steroidal anti- inflammatory drugs and opioid agents. Hierarchical statistical modeling will be conducted to determine which patient-level variables may mediate racial disparities in the utilization of the various OA treatments. For the second aim, an existing educational tool will be chosen and enhanced with the goal of improving patient understanding of OA treatments and increasing the use of available OA therapies. Thereafter, this instrument will be pilot-tested to a relatively smal group of patients with knee or hip OA. The impact of this educational tool in improving the utilization of various OA therapies will be preliminarily determined.

 描述（由适用提供）：候选职业目标：欧内斯特·R·维纳（Ernest R. Vina）的长期职业目标是通过开发干预措施来消除种族分布并改善这些疾病患者的成果，以促进风湿病和肌肉骨骼疾病的患者的公平性。凭借他的研究和临床经验，可以解决风湿病患者健康和医疗保健中种族分布的来源，维纳博士非常适合在该领域建立研究职业。但是，他将需要额外的培训和技能，以通过探索患者特征和健康信念来解决知识差距，这可能导致骨关节炎患者（OA）的医疗保健差异。维纳博士的短期职业目标是1）发展研究不同类型的非手术OA治疗中种族分布所需的专业知识； 2）学习开发干预措施并实施临床试验以减少种族差异，并使用各种OA治疗。研究背景：OA是一种高度普遍且致残的疾病。也证明了OA患者结果的种族差异，非裔美国人（AAS）的燃烧比白人（WHS）更大。此外，AA也不太可能使用OA的各种药理和非药物疗法使用史。 OA中种族医疗差异的来源仅部分知道。研究目的：此K23有两个主要目标。首先是检查各种OA处理的确定性和障碍，这些处理导致AAS和WHS护理的差异。第二个是试点测试旨在改善有效的非手术OA处理的干预措施的影响。方法：为了实现第一个目标的目标，将对膝盖或髋关节OA患者进行调查。该调查将确定患者人口统计信息，社会心理特征，疾病严重程度，治疗史以及与健康有关的知识，信念和与会者。感兴趣的主要结果将包括使用各种治疗方法，包括锻炼，局部药物，非甾体类抗炎药和阿片类药物。将进行层次统计建模，以确定哪些患者级变量可能会在各种OA处理的利用中进行媒体赛车分布。为了第二个目标，将选择和增强现有的教育工具，目的是提高患者对OA治疗的理解并增加可用OA疗法的使用。此后，该仪器将对具有膝盖或髋关节OA的相对SMAL患者进行试点测试。该教育工具对改善各种OA疗法的利用的影响将被初步确定。