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With the support of collaborators in psychiatry and across the Medical School and university, Dr. Maust has several ongoing projects focused on older adults, which combine “big data” — such as Medicare claims from across the U.S. — with detailed interviews with patients and clinicians. Below you will find details about our most current and ongoing research projects.
The U.S. health care system is poorly equipped to deal with the growing number of persons living with Alzheimer’s disease and related dementias (PLWD) and their complex medical and psychosocial needs, which may help explain the high rate of potentially inappropriate psychotropic and opioid polypharmacy these PLWD experience. We will use national Medicare data to characterize patient characteristics associated with such central nervous system-active polypharmacy, followed by a national survey of their treating clinicians to understand the clinical decision-making that underlies such potentially inappropriate prescribing. Finally, with input from a multidisciplinary Expert Panel, we will identify possible intervention targets and critical remaining knowledge gaps to reduce psychotropic and opioid polypharmacy.
Nursing homes are the most important institutional setting of care in the U.S. for older adults with serious mental illness such as schizophrenia and bipolar disorder, who comprise a growing proportion of nursing home residents. At the same time, these older adults have far greater risk for Alzheimer’s disease and related dementias (ADRD) than the general population. Using national data including the Minimum Data Set and Medicare claims, we will examine the care that nursing home residents with serious mental illness receive and how the presence of ADRD further impacts care quality, followed by semi-structured interviews with nursing home leadership and clinicians to help interpret our quantitative findings and identify barriers and facilitators to providing high quality care to residents with SMI impacted by ADRD.
The National Dementia Workforce Study (NDWS) will be launched by a national team of experts in clinical care of persons living with dementia, survey research, and health workforce research. The core of NDWS will be four surveys that reflect key elements of the professional dementia care workforce in the U.S.: Community Clinicians, Nursing Home Staff, Assisted Living Staff, and Home Care Staff. By pairing the surveys with additional linked data sources, the NDWS data infrastructure will allow researchers and policymakers to ask critical questions related to the care provided to the growing population of persons living with dementia in the U.S.
In addition to the currently funded research projects listed above, Dr. Maust is as affilicated with several research centers at both the
University of Michigan and U.S. Department of Veterans Affairs, including:
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