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Frailty And Health Care Interventions

  • Effectiveness and safety of drug therapy (PI: Kim): We are evaluating the benefits and harms of medications in older adults using administrative claims data.  This information will be useful to guide drug prescribing in older adults.  Selected ongoing projects include:
    • Antipsychotics and psychoactive drug use in hospitalized older adults
    • Prospective monitoring of newly marketed cardiovascular drugs
    • Effectiveness and safety of commonly used drugs by frailty levels
       
  • Functional recovery after surgical procedures (PI: Kim): We have shown that frailty is useful to predict clinically distinct functional status trajectories after aortic valve replacement.  We are conducting interventional studies to improve functional recovery after a major surgery.  Selected ongoing projects include:
    • Prehabilitation program before major surgery
    • Home-based rehabilitation program after transcatheter aortic valve replacement
       
  • Patient-centered outcomes of post-acute care rehabilitation (PI: Shi): We aim to identify older adults who have a short time at home following post-acute care rehabilitation using the National Health and Aging Trend Study-Medicare database.  Based on this information, we will develop an intervention to improve post-acute care outcomes.
     
  • Antiretroviral therapy adherence in older adults with HIV (PI: Olivieri-Mui): We are examining factors associated with suboptimal adherence to antiretroviral therapy during the community-to-nursing home transition.
     
  • Health care utilization and costs (PI: Kim): We are studying how a claims-based frailty index can be used to predict high-risk and high-needs older adults, and whether Medicare care management services can reduce health care utilization and costs in those with frailty.  Selected ongoing projects include:
    • Frailty, dementia, and health care utilization and costs
    • Medicare care management services