Suppr超能文献

为痴呆症护理中的实用临床试验做准备:非药物干预的健康公平性考虑。

Preparing for pragmatic trials in dementia care: Health equity considerations for nonpharmacological interventions.

机构信息

Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, Los Angeles, California, USA.

Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA.

出版信息

J Am Geriatr Soc. 2023 Dec;71(12):3874-3885. doi: 10.1111/jgs.18568. Epub 2023 Sep 1.

Abstract

Inequities with regard to brain health, economic costs, and the evidence base for dementia care continue. Achieving health equity in dementia care requires rigorous efforts that ensure disproportionately affected populations participate fully in-and benefit from-clinical research. Embedding-proven interventions under real-world conditions and within existing healthcare systems have the potential to examine the effectiveness of an intervention, improve dementia care, and leverage the use of existing resources. Developing embedded pragmatic controlled trials (ePCT) research designs for nonpharmacological dementia care interventions involves a plethora of a priori assumptions and decisions. Although frameworks exist to determine whether interventions are "ready" for ePCT, there is no heuristic to assess health equity-readiness. We discuss health equity considerations, case examples, and research strategies across ePCT study domains of evidence, risk, and alignment. Future discussions regarding health equity considerations across other domains are needed.

摘要

在大脑健康、经济成本和痴呆症护理的证据基础方面仍然存在不平等现象。要实现痴呆症护理中的公平,需要做出严格的努力,确保受影响不成比例的人群充分参与并受益于临床研究。在实际条件下和现有医疗保健系统中嵌入经过验证的干预措施,有可能检验干预措施的有效性,改善痴呆症护理,并利用现有资源。为非药物性痴呆症护理干预措施开发嵌入式实用对照试验(ePCT)研究设计涉及大量的事先假设和决策。虽然存在确定干预措施是否“准备好”进行 ePCT 的框架,但没有评估健康公平准备情况的启发式方法。我们讨论了 ePCT 研究领域中的证据、风险和一致性的健康公平考虑因素、案例示例和研究策略。需要就其他领域的健康公平考虑因素进行未来的讨论。

相似文献

1
Preparing for pragmatic trials in dementia care: Health equity considerations for nonpharmacological interventions.
J Am Geriatr Soc. 2023 Dec;71(12):3874-3885. doi: 10.1111/jgs.18568. Epub 2023 Sep 1.
2
Best Practice Recommendations for Integrating Health Equity into Pragmatic Clinical Trials for Dementia Care.
Ethn Dis. 2024 Apr 10;33(2-3):84-90. doi: 10.18865/ed.33.2-3.084. eCollection 2023 Apr.
3
Achieving Health Equity in Embedded Pragmatic Trials for People Living with Dementia and Their Family Caregivers.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S8-S13. doi: 10.1111/jgs.16614.
4
Statistical Considerations for Embedded Pragmatic Clinical Trials in People Living with Dementia.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S68-S73. doi: 10.1111/jgs.16616.
5
6
Dissemination and Implementation of Evidence-Based Dementia Care Using Embedded Pragmatic Trials.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S28-S36. doi: 10.1111/jgs.16622.
7
The Case for Conducting Pragmatic Dementia Care Trials in Medicaid Home and Community-Based Service Settings.
J Am Med Dir Assoc. 2023 Dec;24(12):1918-1923. doi: 10.1016/j.jamda.2023.09.026. Epub 2023 Oct 30.
8
Building a National Program for Pilot Studies of Embedded Pragmatic Clinical Trials in Dementia Care.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S14-S20. doi: 10.1111/jgs.16618.
9
Transforming Dementia Care Through Pragmatic Clinical Trials Embedded in Learning Healthcare Systems.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S43-S48. doi: 10.1111/jgs.16629.
10
Considerations When Designing and Implementing Pragmatic Clinical Trials That Include Older Hispanics.
Ethn Dis. 2024 Apr 10;33(2-3):76-83. doi: 10.18865/ed.33.2-3.076. eCollection 2023 Apr.

引用本文的文献

1
How Do Researchers Identify and Recruit Dementia Caregivers? A Scoping Review.
Gerontologist. 2024 Dec 17;65(2). doi: 10.1093/geront/gnae189.
2
3
Integrating health equity into a national infrastructure to support pragmatic trials in dementia care.
J Am Geriatr Soc. 2024 Oct;72(10):3283-3287. doi: 10.1111/jgs.18975. Epub 2024 May 17.
4
Ready or Not: A Conceptual Model of Organizational Readiness for Embedded Pragmatic Dementia Research.
Res Gerontol Nurs. 2024 May-Jun;17(3):149-160. doi: 10.3928/19404921-20240403-02. Epub 2024 Apr 10.

本文引用的文献

2
Impact of dementia: Health disparities, population trends, care interventions, and economic costs.
J Am Geriatr Soc. 2021 Jul;69(7):1774-1783. doi: 10.1111/jgs.17345.
3
The Urgency of Justice in Research: Beyond COVID-19.
Trends Mol Med. 2021 Feb;27(2):97-100. doi: 10.1016/j.molmed.2020.11.004. Epub 2020 Nov 17.
5
Achieving Health Equity in Embedded Pragmatic Trials for People Living with Dementia and Their Family Caregivers.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S8-S13. doi: 10.1111/jgs.16614.
6
Embedded Pragmatic Trials in Dementia Care: Realizing the Vision of the NIA IMPACT Collaboratory.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S1-S7. doi: 10.1111/jgs.16621.
7
Dissemination and Implementation of Evidence-Based Dementia Care Using Embedded Pragmatic Trials.
J Am Geriatr Soc. 2020 Jul;68 Suppl 2(Suppl 2):S28-S36. doi: 10.1111/jgs.16622.
8
Recruitment and retention of underrepresented populations in Alzheimer's disease research: A systematic review.
Alzheimers Dement (N Y). 2019 Nov 19;5:751-770. doi: 10.1016/j.trci.2019.09.018. eCollection 2019.
10
The National Institute on Minority Health and Health Disparities Research Framework.
Am J Public Health. 2019 Jan;109(S1):S16-S20. doi: 10.2105/AJPH.2018.304883.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验