This application is a request for a Mentored Research Scientist Development Award (K01) to further Dr. Ilene Zuckerman's research in the area of epidemiology of aging and long-term care, with a focus on medication-related issues. Adverse drug events are risk factors for elders transitioning from independent community living to dependent environments such as nursing homes. Medication-related behaviors that lead to adverse drug events and subsequent transitions are preventable with effective intervention. Screening for transitions can identify high-risk elders for interventions to avoid preventable transitions. Dr. Zuckerman's goal for this application is to build a research agenda that examines factors associated with transitions in the elderly. The central hypothesis is that socio-demographic, clinical, behavioral and medication use factors can discriminate elders who experience transitions from independent to dependent settings from those who do not. The objective of the proposed research will be accomplished by pursuing three specific aims: 1) estimate the association between transitions from independent to dependent living and medication use factors in the elderly; 2) develop a predictive model for transitioning from independent to dependent living; and 3) develop and pilot test a screening instrument, based on the predictive model, to discriminate older adults who will experience a transition from those who will not. To accomplish the first two aims, multivariable analysis of survey and administrative claims data will be performed. Qualitative methods will be used to develop and pilot test the screening instrument in Aim #3. In addition to experience gained from completing the proposed research, Dr. Zuckerman will engage in learning activities to enhance her quantitative and qualitative research skills. The proposed training and research are based on her professional interests and build on current work and previous experience. The project represents her continuing efforts to improve the safety of drug use for older adults by understanding the association between drug use factors and elder transitions from independent to dependent environments. Dr. Zuckerman is particularly well prepared to undertake this proposed research, with clinical experience in geriatric pharmacotherapy and epidemiological training. In addition, the mentor and co-mentors have extensive epidemiology of aging research expertise. This research is significant in that it bridges the disparate literature that has separately examined medication use factors and transitions. It is an incremental and important step to building a research agenda that examines socio-demographic, clinical and behavioral factors that affect medication use and transitions in the elderly. Thus, the findings will allow Dr. Zuckerman to build a research agenda that addresses her long term goal to reduce the incidence and prevalence of preventable adverse drug events in the elderly, and to design and evaluate interventions that are targeted toward preventable risk factors for transitions.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Scientist Development Award - Research & Training (K01)
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Application #
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Stahl, Sidney M
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University of Maryland Baltimore
Schools of Pharmacy
United States
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Sato, Masayo; Shaffer, Thomas; Arbaje, Alicia I et al. (2011) Residential and health care transition patterns among older medicare beneficiaries over time. Gerontologist 51:170-8
Obeidat, Nour A; Pradel, Francoise G; Zuckerman, Irene H et al. (2010) Racial/ethnic and age disparities in chemotherapy selection for colorectal cancer. Am J Manag Care 16:515-22
Simoni-Wastila, Linda; Ryder, Priscilla T; Qian, Jingjing et al. (2009) Association of antipsychotic use with hospital events and mortality among medicare beneficiaries residing in long-term care facilities. Am J Geriatr Psychiatry 17:417-27
Ryder, Pricilla T; Joseph, Melanie; Zuckerman, Marni et al. (2009) Administrators' perceptions of medication management in assisted living facilities: results from focus groups. Consult Pharm 24:513-23
Quinn, Charlene C; Gruber-Baldini, Ann L; Port, Cynthia L et al. (2009) The role of nursing home admission and dementia status on care for diabetes mellitus. J Am Geriatr Soc 57:1628-33
Simoni-Wastila, Linda; Zuckerman, Ilene H; Shaffer, Thomas et al. (2008) Drug use patterns in severely mentally ill Medicare beneficiaries: impact of discontinuities in drug coverage. Health Serv Res 43:496-514
Zuckerman, Ilene H; Ryder, Priscilla T; Simoni-Wastila, Linda et al. (2008) Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries. J Gerontol B Psychol Sci Soc Sci 63:S328-33
Yang, Hui-wen Keri; Simoni-Wastila, Linda; Zuckerman, Ilene H et al. (2008) Benzodiazepine use and expenditures for Medicare beneficiaries and the implications of Medicare Part D exclusions. Psychiatr Serv 59:384-91
Zuckerman, Ilene H; Sato, Masayo; Hsu, Van Doren et al. (2007) Validation of a method for identifying nursing home admissions using administrative claims. BMC Health Serv Res 7:202
Max, Ellina K; Hernandez, Jose J; Sturpe, Deborah A et al. (2007) Prophylaxis for opioid-induced constipation in elderly long-term care residents: a cross-sectional study of Medicare beneficiaries. Am J Geriatr Pharmacother 5:129-36

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