# Improving Medication Use and Outcomes in Older Adults with Dementia after Hospitalization: Effectiveness of Medicare Programs

> **NIH NIH K08** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2022 · $155,247

## Abstract

PROJECT SUMMARY/ABSTRACT
Hospitalizations and medication problems after discharge are a major risk factor for poor health outcomes in
older adults with Alzheimer's disease and related dementia (ADRD). Increased preventable medication
problems, such as unnecessary continuation of medications with neurocognitive adverse effects, emergency
department visits, readmissions, and costs after hospitalization are a significant burden for older adults with
ADRD. A better understanding of how patient and healthcare factors contribute to use of medications with
neurocognitive effects and poor outcomes after hospitalization will inform policies to improve medication-
related outcomes and care transitions in older adults with ADRD. This K08 Mentored Clinical Scientist
Research Career Development Award application (PA-20-203) is to support Antoinette B. Coe, PharmD, PhD,
a pharmacist-scientist and Assistant Professor in the University of Michigan College of Pharmacy. Dr. Coe's
long-term goal is to become an independent investigator advancing the science of medication use in aging with
a research program demonstrating ways to ensure safe and effective medication use in older adults, especially
those who are vulnerable, cognitively impaired, and have ADRD. To achieve this goal, Dr. Coe will carry out
the scientific aims of this proposal along with a robust career development plan in which she will acquire
content expertise in cognitive impairment, ADRD, and aging, gain advanced epidemiology statistics training
including causal inference methods, and develop an understanding of health and public policy impact on
ADRD outcomes. The overarching scientific goal of this mentored-research proposal is to understand how poor
outcomes related to medications with neurocognitive effects after a hospitalization can be mitigated in older
adults with ADRD. This proposal leverages two existing Medicare care programs and payment policies that
include medication reviews as potential solutions to reduce inappropriate neurocognitive medication use after
care transitions: Medicare Part D Comprehensive Medication Reviews (CMR) and Part B Transitional Care
Management (TCM) visits. Using nationally representative Medicare administrative data, the specific aims are
as follows: 1) Identify predictors of inappropriate neurocognitive medication use in older adults with ADRD after
hospitalization, 2) Examine the use of medication reviews (both CMR and TCM) among older adults who have
been hospitalized and assess factors associated with their use, and 3) Test the effectiveness of
comprehensive medication reviews and transitional care management on outcomes in older adults with ADRD
after hospitalization. Dr. Coe will conduct all work at the rich environment of the University of Michigan, with an
exceptional mentoring and advisory team led by Dr. Julie Bynum. The study's results will inform a large-scale
R01-level application testing strategies to increase medication reviews in older adults w...

## Key facts

- **NIH application ID:** 10381580
- **Project number:** 5K08AG071856-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Antoinette Bartolotta Coe
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $155,247
- **Award type:** 5
- **Project period:** 2021-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10381580

## Citation

> US National Institutes of Health, RePORTER application 10381580, Improving Medication Use and Outcomes in Older Adults with Dementia after Hospitalization: Effectiveness of Medicare Programs (5K08AG071856-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10381580. Licensed CC0.

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