Improving Older Adults' Decision Making For Obstructive Sleep Apnea Treatment
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DESCRIPTION (provided by applicant): Constance H. Fung, MD, MSHS is committed to becoming an independently-funded investigator who develops and implements patient-centered strategies for helping older adults make informed health care decisions that incorporate their preferences and needs. She has a particular interest in applying these strategies to care of older adults who have obstructive sleep apnea (OSA). Her unique background makes her an ideal candidate for this field of research. She has fellowship training and board certification in both Geriatrics and Sleep Medicine, fellowship training in Health Services Research, and leadership and research experience in improving patient care. Currently, Dr. Fung is supported by seed funding from the American Sleep Medicine Foundation and the UCLA/Hartford Center of Excellence. She is completing a qualitative study on barriers to OSA equipment use among older adults. Career development and training plan: This plan features an outstanding research and education environment at the David Geffen School of Medicine at UCLA, as well as interdisciplinary mentoring by researchers experienced in conducting sleep-related clinical trials in older adults, developing tools to improve shared decision making, and improving patient-centered care. Additional key resources include the UCLA/Hartford Center of Excellence, UCLA Clinical and Translational Science Institute, and the VA Greater Los Angeles Healthcare System Geriatrics, Research, Education and Clinical Center. This plan also features carefully selected formal coursework as well as hands-on training. Research plan: The overall goal of the proposed research is to develop and test a strategy for incorporating individual older adults' preferences and needs into treatment decisions about OSA. This project will develop and test a decision aid for older adults who are newly diagnosed with OSA and face various treatment options. In phase 1, she will explore the factors that impact OSA treatment decisions among older adults, using qualitative methods and a patient survey. In phase 2, she will use these findings to develop a decision aid tailored to older adults with OSA. In phase 3, she will collect feasibility data for a future randomized controlled trial that will compare the decision aid to an attention control. Information on process variables (e.g., recruitment rates) and effect size for primary (acceptance/adherence, decision-related outcomes) and secondary outcomes (sleep, other health-related, and health system outcomes) will inform the design of a future large-scale R01- or PCORI-funded trial. Skills developed from executing this training and research plan will enable Dr. Fung to become an independent researcher and leader in strategies for helping older adults incorporate their preferences and needs into medical decisions.
