Issues surrounding the care of older patients, in-hospital falls and adult obesity were the focus of the proposals from four local scientists who are the recipients of the 2015 Blue KC Health Outcomes Research grants recently awarded by Blue Cross and Blue Shield of Kansas City (Blue KC).
“Blue KC has been committed to the Kansas City community for more than 75 years. Our partnership with the Kansas City Area Life Sciences Institute allows us to give grants to local organizations dedicated to improving health and wellness. We’re proud to be a small part of the process to improve the quality of care for our members and community,” said Danette Wilson, Blue KC president and CEO.
This marks the fourth consecutive year that the Kansas City Area Life Sciences Institute (KCALSI) has managed the grants program for Blue KC. “We are very pleased to work with Blue KC to fund the highest quality research that turns their commitment into an over 8x return to the community in future grant dollars and better patient outcomes to our community,” said Dr. Wayne Carter, KCALSI president and CEO. “We work with highly skilled researchers, scientists and physicians to review and assess each application based on scientific merits.”
This year’s grant recipients and a brief description of their research programs follow.
Finding Solutions for Chronic Care Management for Older Patients
Focused on determining how to best deliver Chronic Care Management (CCM) to an aging population, University of Kansas Medical Center researchers will develop a model of care using a health care team that delivers Interprofessional Chronic Care Management with the help of the grant from Blue KC.
“Five percent of Medicare patients, who tend to be older and disabled with multiple chronic conditions, account for almost half of Medicare costs,” explains Dr. Crystal Burkhardt, Clinical Associate Professor, University of Kansas School of Pharmacy. “Our study will focus on how to best deliver CCM services while reducing preventable hospital and emergency room visits, improving patient satisfaction of care and self-assessed health status, and reducing the use of potentially inappropriate medications.”
Improving Medication Adherence in Older Kidney Transplant Patients
Kidney transplant recipients must follow a strict schedule taking immunosuppressive drugs to prevent rejection of the transplanted kidney. Medication non-adherence occurs when medications are not taken as prescribed and is a leading predictor of increasingly poor outcomes among older adults receiving kidney transplants.
“An alarming one-third of older kidney transplant recipients have experienced this preventable problem,” explains Dr. Cynthia Russell, a professor in the School of Nursing and Health Studies at the University of Missouri-Kansas City. “The most common problem for patients adhering to their medication schedule is simply forgetting to take scheduled doses. Missed medication doses, however infrequent, have shown significant negative effects. Finding effective approaches to improving medication adherence are vitally important to improve patient outcomes and reduce post-transplant expenses.”
Dr. Russell will test the effectiveness of an intervention called SystemCHANGE which aims to improve medication adherence by applying concepts of healthy living to change a person’s daily habits and routines. Decreasing transplant complications from noncompliance with medication routines will reduce costs and make additional kidneys available to those waiting for transplants by reducing the number of failed kidney transplant recipients who must rejoin the organ waiting list.
Improving Quality of Care and Patient Safety
through the Study of In-Hospital Falls
Medication interactions and side effects can be a significant cause for in-hospital patient falls. Falls are an important measure of quality of care and patient safety and result in increased health care costs (about $4,200 per hospital visit) for both the patient and the third party payer.
Taking the steps to reconcile a patient’s medication regimen to minimize interactions and side-effects has been shown to prevent in-hospital falls and hospital injuries. A research team will use a unique patient database (HERON) to explore how often patient medication reconciliation was completed between 2007-2014 and identify how many falls were due to factors related to medication use.
“In previous work we discovered less than 50% of patients with in-hospital falls received medication reconciliation,” explains Dr. Rafia Rasu, Associate Professor, Department of Pharmacy Practice at the University of Kansas Medical Center (KUMC). “Understanding why medication reconciliation is not routinely conducted and how many patients were at an increased risk of falling due to medication is imperative to improving the quality of care and eliminating in-hospital falls altogether.”
Findings from the study will help health care providers understand the causes of, and strategies to prevent falls during a hospital stay and improve follow up care.
Decreasing Barriers to Weight Loss among Adults in the U.S.
Weight loss management services are delivered through weekly face-to-face or phone group visits with a health educator. While successful in reducing weight, these approaches can require significant time commitments from both patients and educators, and can be quite costly. With the help of the grant from Blue KC, a team at the University of Kansas Medical Center (KUMC) will use an innovative approach using social media.
“We are addressing the public health issue of obesity using social media and distance learning strategies,” explained Dr. Lisa Vansaghi, Internist at KUMC. “We anticipate patients in the social media group to demonstrate decreases in weight, body mass index and waist circumference similar to over the phone group methods.”
The research team will compare two groups receiving instruction via the University of Kansas Weight Management Program (KWMP) delivery system. One will receive the group phone conference call method and the other will be presented with a version of the KWMP curriculum, modified for delivery remotely through social media. The study aims to demonstrate how social media delivered programs have the potential to be a lower cost approach to reaching large groups of people.
Information about the Blue KC Health Outcomes Research Grants, including eligibility, review criteria and application procedures, can be found on the Kansas City Area Life Sciences Institute’s website at www.kclifesciences.org.
2016 Request for Proposals were released October 12. Letters of Intent are due November 9, 2015.