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Understanding Oral Anticoagulation Use and Success Among Patients with Psychiatric Multimorbidity in Atrial Fibrillation

Award Number: K01HL155236
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 01/01/2021
PERIOD OF PERFORMANCE END DATE: 12/31/2025

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Understanding Oral Anticoagulation Use and Success Among Patients with Psychiatric Multimorbidity in Atrial Fibrillation - Project Summary My long-term career goal is to become an independent pharmacist researcher with expertise in psychiatric multimorbidity research in cardiovascular disease. Through my research program I aim to identify factors that influence the health and medication taking behaviors of older adults with psychiatric multimorbidity using “real world” observational data and direct patient and stakeholder engagement. I have clinical (PharmD) and graduate (PhD) training in pharmacy and I am an assistant professor at Northeastern University in the Department of Pharmacy and Health Systems Sciences. Training facilitated by this K01 award will help me achieve my long- term career goal by building on my clinical and technical skills as a pharmacist and researcher and providing me with the protected time necessary to expand my expertise in longitudinal data analysis, mixed methods and patient-centered research in cardiovascular disease and multimorbidity. I have assembled an outstanding, committed, and interdisciplinary team of nationally renowned experts in fields relevant to the proposed research and my long-term goals. My training plan complements my prior training and experience and incorporates interaction with mentors, formal coursework, hands-on training, workshops, conferences and research activities. Using a mixed methods design, my proposal seeks to build and expand on my preliminary work completed in partnership with the ongoing NHLBI funded study, Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF). I will leverage observational data, currently being collected in SAGE-AF, to evaluate the longitudinal impact of psychiatric multimorbidity (i.e., dyads and the triad of depression, anxiety and cognitive impairment) on oral anticoagulant (OAC) use and outcomes in patients with atrial fibrillation (AF). I will examine relationships between psychiatric multimorbidity and clinical outcomes such as bleeding and medication adherence. I will also examine relationships between psychiatric multimorbidity and patient reported outcomes that are not readily available in the medical record but are increasingly important to patients, their families and clinicians such as patient satisfaction and health-related quality of life. Then, I will conduct focus groups of SAGE- AF participants (92% report willingness to continue in SAGE-AF) and stakeholders to understand protective factors that influence anticoagulation success among patients with psychiatric multimorbidity, including factors that are not evaluated in the SAGE-AF data. The specific aims are to: 1) Examine the relationship between psychiatric multimorbidity and OAC prescribing in AF; 2) Among OAC users, examine longitudinal associations between psychiatric multimorbidity and OAC success indicators and patient reported outcomes over 2 years; and 3) Conduct 6-8 qualitative focus groups including SAGE-AF participants, their caregivers and their clinicians, to identify factors that influence OAC success. This proposal aligns with NHLBI’s overarching objective 3 by investigating factors that account for differences in health among populations and has high potential to identify factors that can be useful targets for patient-centered interventions.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $160,807 )
2025	2025	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	5	1/2/2025	NON-COMPETING CONTINUATION	$160,807
														Subtotal = $160,807

Issue Date FY: 2024 ( Subtotal = $161,681 )
2024	2024	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	4	1/12/2024	NON-COMPETING CONTINUATION	$161,681
														Subtotal = $161,681

Issue Date FY: 2023 ( Subtotal = $162,000 )
2023	2023	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	3	1/20/2023	NON-COMPETING CONTINUATION	$162,000
														Subtotal = $162,000

Issue Date FY: 2022 ( Subtotal = $162,000 )
2022	2022	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	2	12/31/2021	NON-COMPETING CONTINUATION	$162,000
														Subtotal = $162,000

Issue Date FY: 2021 ( Subtotal = $162,000 )
2021	2021	NORTHEASTERN UNIVERSITY	360 HUNTINGTON AVE	BOSTON	MA	02115	SUFFOLK	USA	Cardiovascular Diseases Research	000	1	12/24/2020	NEW	$162,000
														Subtotal = $162,000

Grand Total All Awards = $808,488

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Understanding Oral Anticoagulation Use and Success Among Patients with Psychiatric Multimorbidity in Atrial Fibrillation

Award Number: K01HL155236

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 01/01/2021

PERIOD OF PERFORMANCE END DATE: 12/31/2025

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