Carolyn T. Thorpe, PhD, MPH was awarded a R01-equivalent grant through the Department of Veterans Affairs (VA). Thorpe will examine patterns and outcomes of intense vs. de-intensified treatment for glycemic, blood pressure, and lipid control in Veterans with limited life expectancy and/or advanced dementia (LLE/AD) who reside in VA nursing homes.
This study will link several large data sources, including Minimum Dataset (MDS) assessments, medication records, VA utilization and clinical data, and Medicare claims to examine variation across VA nursing homes in implementation of recommendations for de-intensified treatment in this population; identify patient, caregiver, provider, and facility factors contributing to this variation; and determine effects on patient outcomes. The study also includes a qualitative component in which the researchers will interview providers and family caregivers at nursing homes with lower vs. higher proportions of intensely treated residents to identify key barriers and facilitators to implementing recommendations for de-intensified treatment.
With input from local and national VA operations and clinical leaders, the researchers will use these data to develop an intervention toolkit that will serve as a basis for quality improvement efforts to ensure safe, effective, and patient-centered prescribing for Veteran nursing home residents near the end of life.
Thorpe is an assistant professor in the pharmacy and therapeutics department at PittPharmacy.
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