Lori Daiello, PharmD, ScM

Edit My Page

Title: Assistant Professor of Neurology (Research) and Assistant Professor of Health Services, Policy & Practice (Research)
Department: Neurology

Lori_Daiello@brown.edu
+1 401 444 3337

Download Lori Daiello's Curriculum Vitae in PDF Format

 
Overview | Research | Grants/Awards | Publications

Comprehensive knowledge of the comparative risks and benefits associated with the use or discontinuation of psychopharmacologic medications in patients with dementia and complex medical illness is often not possible due to the knowledge gaps that exist in the field of geriatric pharmacology. My research explores how medications affect the trajectory of decline in cognitive and functional abilities and the development of neuropsychiatric symptoms in progressive degenerative dementias.

Biography

Lori Daiello is an Assistant Professor of Neurology (Research) at The Warren Alpert Medical School of Brown University. She is a PharmD whose research focuses on psychopharmacology, pharmacoepidemiology, and geriatric cognitive disorders. She completed her training at The Ohio State University College of Pharmacy and went on to develop clinical psychopharmacology practices in Ohio and Florida. In 2006, she came to Brown to complete a T32 Dementia Research Fellowship. After completing her research fellowship, she joined the Department of Neurology and the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital. Her current research includes studies funded by the Agency for Healthcare Research and Quality that aim to enhance understanding of how the use or discontinuation of psychoactive medications impacts cognitive, functional, and behavioral symptom domains in dementia and the effects of inhaled anesthetics on the trajectory of cognitive decline in persons with pre-existing cognitive disorders

Research Description

Dementia is a chronic illness. Individuals with AD may live years beyond diagnosis with increasing levels of cognitive and functional dependence. Interventions such as medication therapy and surgical procedures may achieve therapeutic or palliative goals of care or may be associated with increased disability in cognitively impaired, medically and pharmacologically complex patients. For most medications and other interventions, geriatric data are sparse in short-term randomized controlled trials (RCT); even less information is available for longitudinal treatment outcomes. Well-designed observational studies can elucidate how well a given intervention works when used by a typical clinician under usual treatment conditions and can help bridge the evidence gaps for populations for which RCT are not feasible. Comparative effectiveness studies that compare short or longer-term alternate treatment strategies can provide important information to inform patient care and health care policy for groups underrepresented or excluded from RCT such as frail, cognitively impaired elderly patients who reside in nursing homes.

My research aims are 1) To explore the longitudinal neurobehavioral, cognitive, and functional effects of discontinuing CHEIs compared to continuous long term CHEI therapy in nursing facility residents with dementia, and 2) To determine if cognitively impaired patients receiving certain isoflurane general anesthesia during surgery experience greater post-operative cognitive and functional decline in the year after surgery compared to patients receiving other types of general anesthesia. A focus of my career development award is conducting observational comparative effectiveness studies that utilize state-of-the-art analytic methods and automated cross-linked Medicare and Medicaid claims datasets.

Awards

The Ohio State University College of Pharmacy Award for Excellence and Contributions to Pharmacy Practice - 1996

University of Florida Working Professional PharmD Program - Outstanding Faculty Award - 1997 & 2000

The Alzheimer's Resource Center Professional Impact Award - 2004

Best Pharmacists in America - 2004

Lifespan Young Investigators Award, Clinical Science Category - 2007

American Society Of Consultant Pharmacists Senior Care Pharmacist Award - 2008

Affiliations

American Society of Consultant Pharmacists - 1986-present

College of Psychiatric and Neurologic Pharmacists - 2000-present

Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment - 2008-present

International Society for Pharmacoepidemiology - 2009-present

Funded Research

Title: Neglected by the evidence: the intersection between medical complexity and dementia
Role in Project: Principal Investigator
Type of Grant: K08
Funding Source: NIH/AHRQ
Years Funded: 2009-2014
Direct Costs: $706,018

Title: Tailored DVD to improve medication management for low literate elderly patients
Role in Project:Sub-Investigator
Type of Grant: R18
Funding Source: NIH/AHRQ
Years Funded: 2007-2010
Direct Costs: $1,199,549

Title: Naturalistic assessment of driving in cognitively impaired elders.
Role in Project: Sub-Investigator
Type of Grant: R01
Funding Source: NIH/NIA
Years Funded: 2007-2011
Direct Costs: $1,783,538

Title: A longitudinal study of drivers with dementia.
Role in Project: Sub-Investigator
Type of Grant: R01
Funding Source: NIH/NIA
Years Funded: 2001-2007
Direct Costs: $1,439,916

Title: Impact of psychopharmacology consultation to high risk community elderly
Role in Project: Principal Investigator
Funding Source: Administration on Aging
Years Funded: 2001-2002
Direct Costs: $20,000

Selected Publications

  • Daiello LA, Ott BR, Lapane KL, Reinert SE, Machan JT, Dore D. Does Discontinuation of Cholinesterase Inhibitors Exacerbate Behavioral Symptoms in Nursing Home Patients with Dementia? Am J Geriatric Pharmacotherapy 2009;7:74-83.(2009)
  • Ott BR, Heindel WC, Papandonatos GD, Festa EK, Davis JD, Daiello LA, Morris A. Longitudinal Study of Drivers With Dementia. Neurology 2008;70(14):1171-8.(2008)
  • Jalbert JJ, Daiello LA, Lapane KL. The Epidemiology of Dementia of the Alzheimer's Type: A Review. Epidemiologic Rev 2008;30:15-34.(2008)
  • Daiello LA. Atypical antipsychotics for the treatment of dementia-related behaviors: an update. Med Health R I. 2007;90(6):191-4.(2007)
  • Daiello LA. Current Issues in Dementia Pharmacotherapy. Am J Manag Care 2007;Suppl 8:S198-202.(2007)
  • Daiello LA. Atypical Antipsychotics for Dementia-Related Behaviors. Applied Neurology 2007;3(10):16-22.(2007)
  • Golden AG, Daiello LA, Silverman MA, Llorente M, Preston RA. University of Miami Division of Clinical Pharmacology Therapeutic Rounds: Medications used to treat anorexia in the frail elderly. Am J Ther 2003;10(4):292-8.(2003)
  • Daiello LA, Beier MT, Hoffman VP, Kennedy JS. Pharmacotherapy of Behavioral and Psychological Symptoms of Dementia: A Review of Atypical Antipsychotics. Consult Pharm 2003;18:138-57.(2003)
  • Ryan JM, Kidder SW, Daiello LA, Tariot PN. Psychopharmacologic interventions in nursing homes: what do we know and where should we go? Psychiatr Serv 2002 Nov;53(11):1407-13(2002)
  • Daiello LA. Cholinesterase Inhibitors for the Treatment of Alzheimer's Disease: A Review for the Consultant Pharmacist. Consult Pharm 2001;16:1137-50.(2001)
  • Daiello LA. "Psychopharmacy in the Long Term Care Setting: A New Frontier for Pharmacy Practice." Journal of Pharmacy Practice 1995; 5:228-231.(1995)

For more search options, visit the Directory of Research and Researchers at Brown.