Document text
Principal Investigator: Niteesh K Choudhry
Organization: BRIGHAM AND WOMEN'S HOSPITAL
Fiscal Year: 2024
Award: $1,131,543
Funding agency: National Institute on Aging
The evidence-based use of prescription medications has led to substantial improvement in healthy aging.
Despite this, the use of medications by patients and providers remains suboptimal. Many patients are not
prescribed guideline-recommended therapies from which they would benefit; among those for whom
appropriate treatment is initiated, almost half do not adhere over the long-term; and others receive potentially-
hazardous medications with an unfavorable balance of risks and benefits. The result: preventable adverse
health outcomes and health spending for middle-aged and older adults.
While many factors influence the suboptimal use of prescription medications, individual, interpersonal and
institutional behaviors are central. As a result, existing intervention to address these issues have attempted to
remind, reward, motivate, simplify or otherwise change behavior. Unfortunately, these approaches have only
been modestly effective and even among those do work, behavior change is rarely sustained over the long-
term. The results can be explained by the lack of integrating behavioral principles when designing
interventions, a limited focus on evaluating how to deliver them over the long term, and the inherent challenges
in delivering precise and personalized behavior change at population scale.
Thus, the Brigham and Women’s Hospital Roybal Center for Therapeutic Optimization using Behavioral
Science will continue to focus on the thematic area of promoting adherence and maintenance of long-term
behavior change. The structure and activities of the proposed Center will be based upon 4 key principles: (1) a
multi-disciplinary approach; (2) the testing of principle-driven interventions in real-world settings; (3) the explicit
testing of mechanisms of action, and (4) the use of novel analytic methods and technological approaches to
gain a deeper understanding of behavioral mechanisms and to personalize interventions. Based on these
principles, our Center will have the following Specific Aims:(1) to oversee a translational research program for
the testing of principle-driven, potent, practical, scalable and sustainable behavioral interventions to enhance
the appropriate prescribing and use of evidence-based medications.; (2) to strategically direct and to provide
scientific oversight, fiscal and operational support to ensure the successful completion of behavioral
interventions funded by the Center.; and (3) to conduct trials evaluating principle-drive interventions that aim to
sustain behavior change for the use of evidence-based medications. The proposed Year 1 studies conducted
in partnership with large delivery systems and testing novel approaches to promote the deprescribing of high-
risk medications and to support adherence to evidence-based preventive therapies.
The expected impact of the Roybal Center for Therapeutic Optimization using Behavioral Science is that it
will develop principle-driven interventions that will readily translate to improvements in healthy aging and will
also advance our fundamental understanding of how health behaviors can be effectively sustained.
Terms: <Address><Adherence><Area><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral><Behavioral Conditioning Therapy><Behavioral Mechanisms><Behavioral Model><Behavioral Modification><Behavioral Sciences><Behavioral Therapy><Behavioral Treatment><Benefits and Risks><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Clinical><Cognitive Disturbance><Cognitive Impairment><Cognitive decline><Cognitive function abnormal><Communities><Conditioning Therapy><Data><Data Science><Development><Discipline><Disturbance in cognition><Drug Prescribing><Drug Prescriptions><Drugs><Ensure><Equilibrium><Evolution><Funding><Geriatrics><Goals><Guidelines><Health><Health behavior><Healthcare Delivery><Heart Vascular><Hospitals><Impaired cognition><Individual><Infrastructure><Institution><Intervention><Intervention Strategies><Investigators><Knowledge><Learning><Maintenance><Mechanisms of Behavior and Behavior Change><Medication><Medicine><Monitor><Morbidity><Morbidity - disease rate><Motivation><NIH><National Institutes of Health><Non-adherent patient><Nonadherent patient><Outcome><Patient Compliance><Patient Non Compliance><Patient Non-Adherence><Patient Nonadherence><Patient Noncompliance><Patients><Peer Review><Pharmaceutical Preparations><Population><Preventative therapy><Preventive therapy><Provider><Psychology><Publications><Recommendation><Research><Research Personnel><Researchers><Rewards><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Scientific Publication><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Structure><System><Technology><Testing><Therapeutic><Translating><Translational Research Enterprise><United States National Institutes of Health><Woman><Work><age associated><age correlated><age dependent><age linked><age related><age specific><analytical method><balance><balance function><behavior change><behavior intervention><behavior mechanism><behavioral intervention><circulatory system><clinical practice><cognitive dysfunction><cognitive loss><collaboratory><computer science><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><develop therapy><developmental><drug/agent><evidence base><geriatric medicine><health and care delivery><health care delivery><health delivery systems><health related behavior><health services delivery><healthy aging><healthy human aging><high risk><implementation research><improved><interdisciplinary approach><intervention design><intervention development><interventional strategy><medical college><medical schools><medication prescription><mid life><mid-life><middle age><middle aged><midlife><mortality><multidisciplinary><multidisciplinary approach><multimorbidity><multiple chronic conditions><new approaches><novel><novel approaches><novel strategies><novel strategy><older adult><older adulthood><patient adherence><patient cooperation><personalized health intervention><personalized intervention><population health><precision interventions><prescribed medication><programs><response><school of medicine><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><success><theories><therapy design><therapy development><translation research enterprise><translational research program><treatment design><treatment development>