We propose to foster the applicant's transition to aging research by combining the analytic, clinical and mentoring capabilities of our group. The proposed research will explore care delivery for older men and women with overactive bladder, with or without urinary incontinence. The results of the proposed investigation will potentially reduce health care disparities, identify opportunities to improve quality of care, and foster a paradigm shift in care delivery by informing design of coordinated care models. The overall aims of this project are: 1) to describe patient- and provider- level variation in pharmacologic intervention for older adults with overactive bladder symptoms;and, 2) to empirically identify patient and provider factors associated with treatment intensity, controlling for important clinica covariates such as incontinence.

Public Health Relevance

Overactive bladder disproportionately affects older adults, with a prevalence reaching as high as 50% among those aged at least 76 years;at its most severe, the symptom complex includes urge urinary incontinence, characterized by unpredictable, embarrassing, large-volume urine loss. National costs for treating patients with overactive bladder symptoms are projected to exceed $82 billion by 2020. The project's proposed examination of variation in prescribing patterns and treatment intensity for overactive bladder will broadly inform policy makers and health system leaders interested in reducing health care disparities, improving quality of care, and designing coordinated care models for the treatment of older patients with overactive bladder.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Small Research Grants (R03)
Project #
1R03AG048130-01
Application #
8757298
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Salive, Marcel
Project Start
2014-09-01
Project End
2016-05-31
Budget Start
2014-09-01
Budget End
2015-05-31
Support Year
1
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Duke University
Department
Other Clinical Sciences
Type
Schools of Medicine
DUNS #
City
Durham
State
NC
Country
United States
Zip Code
27705
Scales Jr, Charles D; Tasian, Gregory E; Schwaderer, Andrew L et al. (2016) Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health. Clin J Am Soc Nephrol 11:1305-12