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Guideline to Implementation: A Rapid Clinical Care Pathway to Care for Patients Affected by Chronic Constipation

Award Number: K23DK134752
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 05/15/2023
PERIOD OF PERFORMANCE END DATE: 01/31/2028

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Guideline to Implementation: A Rapid Clinical Care Pathway to Care for Patients Affected by Chronic Constipation - PROJECT SUMMARY Technology development is a stated goal of the NIH. Myriad promising technologies have been developed, yet few cross the chasm to adoption. Few NIH-funded researchers are trained to develop and sustain transformative clinical care pathways that harness novel, evidence-based technologies to improve patient health. This training grant proposes to close this gap. Chronic constipation is one of the most frequent medical complaints and leads to 2 million gastroenterology referrals each year in the US. For symptomatic constipation refractory to laxatives, practice guidelines recommend physiological testing to identify anorectal evacuation disorders that preferentially respond to safe and effective pelvic rehabilitation therapy typically delivered by a physical therapist. Unfortunately, 98% of patients never undergo such testing and instead undergo unnecessary and repeated diagnostic procedures and rotating trials of ineffective and costly laxatives. This is largely because high-tech testing is limited to specialty motility centers. We recently developed and prospectively validated the ability of a simple, novel point-of-care device (RED) to predict treatment outcomes with subsequent physical therapy during the initial office consultation. We propose to develop and pilot a rapid clinical care pathway anchored on a provider-facing clinical decision support tool (INTEGRATE) to facilitate adoption of RED and transform care for chronic constipation in general gastroenterology practice. The training plan aims to prepare the applicant for a career vested in transforming healthcare delivery for patients affected by GI motility disorders by developing rapid clinical care pathways that promote targeted therapy harnessing evidence-based diagnostic technology. Targeted advanced coursework will provide training in behavioral economics, user-centered design, and implementation science to facilitate these career goals. In Research Aim 1, we will conduct a needs assessment with patient and provider co-production partners to develop our intervention to nudge providers toward using RED and to facilitate related care. In Aim 2, we will evaluate the usability of our intervention to ensure that it triggers appropriately and fits within clinical workflow. In Aim 3, we will launch our intervention in a regional gastroenterology practice to evaluate its effectiveness and implementation in practice. The project will provide the necessary preliminary data for an R01 supporting a larger, randomized trial. By the conclusion of the K23, the applicant will be positioned for academic success with a niche in creating transformative clinical care pathways harnessing diagnostic technology to pull tertiary care paradigms downstream to general care settings to improve the health of patients affected by the GI motility disorders, the most common GI disorders in practice.


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 = $194,400 )
2025	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	2/18/2025	NON-COMPETING CONTINUATION	$194,400
														Subtotal = $194,400

Issue Date FY: 2024 ( Subtotal = $194,400 )
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	1/30/2024	NON-COMPETING CONTINUATION	$194,400
														Subtotal = $194,400

Issue Date FY: 2023 ( Subtotal = $193,200 )
2023	2023	REGENTS OF THE UNIVERSITY OF MICHIGAN	503 THOMPSON STREET	ANN ARBOR	MI	48109	WASHTENAW	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	5/12/2023	NEW	$193,200
														Subtotal = $193,200

Grand Total All Awards = $582,000

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Guideline to Implementation: A Rapid Clinical Care Pathway to Care for Patients Affected by Chronic Constipation

Award Number: K23DK134752

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 05/15/2023

PERIOD OF PERFORMANCE END DATE: 01/31/2028

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