4.7 Article

Research Priorities in Post-acute and Long-term Care: Results of a Stakeholder Needs Assessment

Journal

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2019.02.018

Keywords

Skilled nursing facility; long-term care; nursing home; community-involved research; community-engaged research; post-acute care; research priorities; community-academic partnership

Funding

  1. National Institutes of Health/National Center for Advancing Translational Sciences (NIH/NCATS) Colorado Clinical and Translational Science Awards (CTSA) [UL1 TR002535]
  2. Colorado Clinical and Translational Sciences Institute (CCTSI) Community Engagement Partnership Development Grant
  3. CCTSI Joint Pilot Grant
  4. Patient-Centered Outcomes Research Institute (PCORI) Pipeline-to-Proposal Grant
  5. VA Geriatric Research Education and Clinical Center

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Objectives: Conduct a needs assessment among post-acute and long-term care (PA-LTC) stakeholder groups to identify (1) research topics of highest priority and (2) perspectives on research, including concerns/barriers to conducting research in the PA-LTC setting. Design: Mixed methods multistakeholder engagement process. Needs assessment conducted with tailored strategies per stakeholder group: interview, survey, and focus group. Setting and Participants: Four stakeholder groups-medical directors/providers (n = 89), administrative leadership (n = 5), frontline staff (n = 17), and family members of residents and residents themselves (n = 11)-were recruited from the Colorado PA-LTC community through an academic-community partnership between the University of Colorado and Colorado Medical Directors Association. Main Outcome(s): Stakeholder perspectives on research and high priority PA-LTC research topics. Results: Research priorities common across stakeholder groups included polypharmacy (overuse of medication generally and overuse of antibiotics specifically), care transitions, mental health (including dementia, Alzheimer's disease, behaviors), chronic pain, urinary tract infection, and quality of life issues. Providers specifically prioritized heart failure, Parkinson's, and other chronic illnesses. Administrators and directors of nurses emphasized hospitalizations. Staff prioritized medication/therapy compliance. Families/residents prioritized neurologic disease. Concerns included staff burden, consenting process, privacy, and family involvement. Conclusions/Implications: PA-LTC patients have a lot to offer as participants and decision makers in research, frontline staff are enthusiastic about participation, family members want to be involved, and providers value research findings in their practice but need a more supportive environment to produce and participate in research. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

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