The goal of this fellowship is to prepare the applicant, Christopher Kaufmann, for an academic research career in geriatric pharmaco-epidemiology, focusing on issues related to [prescribing trends of psychiatric medication to older adults,] and associated health, economic, and societal outcomes. The proposed fellowship consists of two complementary components: a) a research project examining recent trends in the use of sedative-hypnotic medications among older adults, and associated health outcomes and health service utilization in this population;and b) a training plan comprised of formal coursework and mentorship, and other didactic and professional development activities. In the proposed research project, we will examine recent trends in the prescription of sedative-hypnotic medications to older adults, in the context of recent clinical and policy initiatives tackling inappropriate prescription of these medications in this population. [More specifically, we will explore changes in physician prescribing patterns of these medications and patient outcomes in light of the recent introduction of non-benzodiazepine sleep-aid medications and the implementation of Medicare Part D in 2006. We will use data from the National Ambulatory Medical Care Survey (NAMCS) to study physician prescribing trends, and the Health and Retirement Study (HRS) to study the association between sedative- hypnotic use and both adverse health outcomes and service utilization in older adults. This project is supported by a strong interdisciplinary mentorship team with expertise in gerontology, clinical psychiatry, internal medicine, health policy, and statistical methods. Associate Professor Ramin Mojtabai, a practicing psychiatrist with expertise in the pharmaco-epidemiology of psychiatric medications, Professor Joseph Gallo, an established gerontology researcher with extensive mentorship experience, and Assistant Professor Adam Spira, a clinical psychologist with expertise in functional outcomes of late life sleep-disturbances and in anxiety in older adults, will serve as the sponsors of this application. Their mentorship will be complemented by that of Associate Professor Caleb Alexander, an internist with expertise in pharmaco-epidemiology in the Department of Epidemiology, Professor Karen Bandeen-Roche, a statistician with expertise in gerontology in the Department of Biostatistics, and Assistant Professor Lainie Rutkow, from the Department of Health Policy and Management who has expertise in public health law and policy.] The research project and the complementary training plan will provide the applicant with hands-on experience applying pharmaco-epidemiological research methods to answer health-related questions of great relevance to the growing population of older adults. Further, the proposed fellowship will provide Mr. Kaufmann with the skills that he requires to move on to the next stage of his career as an independent researcher.
This study will examine national trends in prescription of sedative-hypnotic medications to older adults over a period of 15 years (1996-2010). In addition, it will prospectively examine the association between the use of these medications and adverse health outcomes and service utilization in older adults. The research project is complemented by a comprehensive training program that will prepare the principal investigator for an independent research career.
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