PhD fellowship in General Practice
The Section of General Practice, Department of Public Health at the University of Copenhagen is offering a three-year PhD fellowship in Family Medicine. The PhD fellowship is financed by the Velux foundation.
The fellowship is available from 1 September 2019 or as soon as possible thereafter.
Institutionalized older persons with neuropsychiatric symptoms are at high risk of confusion, dizziness and falls, and this risk is further increased by the inappropriate use of medication. This study aims to achieve a more appropriate prescription of medication in treating neuropsychiatric symptoms and thereby reduce the risk of falls, hip fractures and hospitalizations.
Neuropsychiatric symptoms in frail older persons are common, with up to 90% of older persons with dementia experiencing at least one symptom during the course of the disease. Examples of neuropsychiatric symptoms in dementia include anxiety, agitation, hallucinations, depression, and apathy. Especially psychotic and behavioral symptoms can be distressing for the patient, his or her relatives and other caretakers, but affective symptoms are also common and burdensome. Psychotropic drugs, such as antipsychotics, antidepressants, anxiolytics, hypnotics, anticonvulsants and anti-dementia drugs, as well as analgesics, are often used to treat neuropsychiatric symptoms in frail older persons. However, best practice guidelines primarily recommend non-pharmacological instead of pharmacological treatment of neuropsychiatric symptoms, since pharmacological treatment has proven to be ineffective and even harmful in these persons.
The aim of this project is to reduce the use of antipsychotics, antidepressants, anxiolytics, hypnotics, anticonvulsants and anti-dementia drugs, as well as analgesics, where benefits do not outweigh harms, in long-term institutionalized older persons aged (72 years or above) with and without dementia through a multifaceted intervention based in general practice. We hypothesize that the number of medications will be reduced in the intervention arm as compared to the control arm, while the change in severity of neuropsychiatric symptoms will be similar in the intervention group compared to the control group.
The project is planned to have three phases:
Phase 1: Development and tailoring of a multifaceted intervention using a literature study and qualitative methods.
Phase 2: A cluster-randomized controlled trial based in general practice
Phase 3: Phase 3: Process evaluation of organizational consequences using qualitative methods
The phD-student will be responsible for phase 1 and 2 and involved in phase 3.
Principal supervisor is Maarten Rozing, Associate Professor in General Medicine, the Section of General Practice, Department of Public Health at the University of Copenhagen. E-mail: firstname.lastname@example.org.
Primary co-supervisors are Anne Holm, Post doc, Ph.D., and Gritt Overbeck, Post doc, Ph.D., the Research Unit for General Practice and the Section of General Practice, Department of Public Health at the University of Copenhagen.
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