Clinically significant drug interactions among nursing home residents with adrd

Active Project Grant Awarded Last action

Award ID
R01AG077620
Recipient
Awarding agency
Obligated
$6,365,914

Award facts

Assistance listing
93.866 Aging Research
Completion date 88% complete
Place of performance
Providence, RI 02903, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
Polypharmacy is common among nursing home (NH) residents and is most prevalent among residents with alzheimer's disease and related dementias (ADRD) due to their high burden of multiple chronic conditions that predispose them to medication use. Polypharmacy is dangerous for NH residents with ADRD because IT substantially increases the risk of drug interactions. Fall-related injuries, including fractures, joint dislocations, and hemorrhages, are one of the most common and impactful adverse outcomes of drug interactions and result in morbidity, disability, and death. Many theoretical interactions between drugs have been identified and healthcare providers believe that drug interactions are common and harmful among older NH residents with ADRD, yet limited data exist about which interactions are most clinically significant. Given that drug interactions resulting from polypharmacy are likely a major, yet modifiable, cause of fall-related injuries among older NH residents with ADRD, identifying drug interactions and their effects is essential for avoiding fall-related injuries. Thus, the overall objective of this proposal is to identify, test, and validate clinically significant drug interactions in NH residents with ADRD through a series of rigorous epidemiological studies that employ novel drug interaction SCREENING and causal inference methods. The central hypothesis is that multiple clinically significant drug interactions will increase the risk of fall-related injuries, and that this risk will be greatest among individuals with the most severe cognitive impairment and on higher medication doses. This hypothesis will be tested through three specific aims: aim 1 (SCREENING), conduct hypothesis-free high-throughput semi-automated SCREENING to identify potential interactions involving drug pairs and triads that increase the risk of fall-related injuries among NH residents with ADRD; aim 2 (TESTING), after prioritizing interaction SCREENING results with the guidance of a multidisciplinary expert stakeholder panel, perform a series of hypothesis-driven studies to quantify the effects of drug interactions on fall-related injuries, including dose, duration, and NH resident subgroup effects; and aim 3 (REPLICATION), conduct a series of validation studies in independent data to determine whether the drug interactions identified during SCREENING and TESTING are consistently associated with fall-related injuries among NH residents with ADRD. To accomplish the three proposed aims, a large novel database of NH electronic health record information be leveraged along with national MDS 3.0 clinical assessment records linked to medicare health insurance and prescription drug claims. The proposed research is highly significant because IT will provide clinically actionable empirical evidence to help guide the prescribing, deprescribing, and management of medications to minimize the risk of important drug interactions and fall-related injuries among NH residents with ADRD. This proposal is directly responsive to PAR-19-070 and advances the national institute on aging's strategic goal C to improve the safe use of medications.

Transactions

Action Obligated Date
Amendment $704,976
Amendment $693,286
Amendment $707,436
Amendment $707,436
Amendment $707,436
Amendment $0
Amendment $0
Amendment $0
Amendment $711,336
Amendment $711,336
Amendment $711,336
Original award $711,336
Show all 12

Subawards

Subrecipient Amount Awarded
University Of Delaware Subrecipient PI will: 1. will attend regular analytic and group meetings and review research materials (e.g., analytic plans, academic manuscripts, and… $28,314
Rhode Island Hospital The Subrecipient PI, a geriatric psychopharmacologist and Senior Research Scientist, is the ADMDC site PI for the proposed research project. She will provide… $38,386
Hebrew Rehabilitation Center Subrecipient PI will be responsible for working with the Brown team to analyze clinically significant drug interactions in nursing home residents with dementia.… $65,921
The Trustees Of The University Of Pennsylvania Subrecipient PI will advise Brown University's Principal Investigator on his scientific leadership of the study by: a) aid in strategic planning; b) lend… $79,949
Rhode Island Hospital Dr. Daiello, a geriatric psychopharmacologist and Senior Research Scientist, is the ADMDC site PI for Dr. Zullo’s proposed research project. She will… $25,000
The Trustees Of The University Of Pennsylvania Charles E. Leonard, PharmD, MSCE, FISPE will serve as Site Principal Investigator and advise Dr. Andrew R. Zullo (Principal Investigator, Brown University) on… $63,738
University Of Delaware 1. Dr Harris will attend regular analytic and group meetings and review research materials (e.g., analytic plans, academic manuscripts, and conference… $55,358
Hebrew Rehabilitation Center Dr. Berry will be responsible for working with the Brown team to analyze clinically significant drug interactions in nursing home residents with dementia. She… $60,439
Rhode Island Hospital Dr. Daiello, a geriatric psychopharmacologist and Senior Research Scientist, is the ADMDC site PI for Dr. Zullo’s proposed research project. She will… $58,953
The Trustees Of The University Of Pennsylvania Charles E. Leonard, PharmD, MSCE, FISPE will serve as Site Principal Investigator and advise Dr. Andrew R. Zullo (Principal Investigator, Brown University) on… $81,130
Hebrew Rehabilitation Center Dr. Berry will be responsible for working with the Brown team to analyze clinically significant drug interactions in nursing home residents with dementia. She… $60,819
Rhode Island Hospital Dr. Daiello, a geriatric psychopharmacologist and Senior Research Scientist, is the ADMDC site PI for Dr. Zullo’s proposed research project. She will… $0
Rhode Island Hospital $0
Show all 13

Quick answers

Who received award R01AG077620?

R01AG077620 was awarded to Brown University by National Institute on Aging (National Institutes of Health) on September 15, 2022.

How much is award R01AG077620 worth?

$6,365,914 has been obligated on R01AG077620.

On GovTribe

See this award's full record

  • Every transaction and subaward
  • The recipient's other awards and teaming partners
  • Similar grant awards
  • Ask GovTribe AI about this award
Try for free Login