Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR)

资助早期医学/外科专家转向老龄化研究 (GEMSSTAR)

• 批准号: 9156042
• 负责人: Ryan D. Nipp
• 金额: $ 12.83万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-15 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9156042
• 关键词: Accounting; Address; Age; Aging; Awareness; Behavioral Medicine; Cancer Center; Cancer Etiology; Cancer Patient; Caring; Cessation of life; Clinical Research; Cognition; Collaborations; Comorbidity; Complex; Consultations; Data; Data Analyses; Development; Diagnosis; Doctor of Philosophy; Elderly; Enrollment; Ensure; Future; General Hospitals; Geriatrics; Goals; Grant; Health; Impairment; Individual; Intervention; Intervention Studies; Interview; Investigation; Malignant Neoplasms; Malignant neoplasm of lung; Massachusetts; Medical; Mentors; Mentorship; Moods; Newly Diagnosed; Oncologist; Operative Surgical Procedures; Outcome; Outpatients; Palliative Care; Patient Outcomes Assessments; Patients; Perception; Phase; Physical Function; Physiological; Polypharmacy; Population; Psychiatry; Psychosocial Influences; Qualitative Research; Quality of life; Randomized Controlled Trials; Reporting; Research; Research Methodology; Research Personnel; Services; Social support; Specialist; Staging; Supportive care; Testing; Training; Work; aging population; cancer care; cancer palliative treatment; design; experience; gastrointestinal; improved; instrumental activity of daily living; meetings; novel; older patient; oncology; patient population; physical symptom; premature; prognostic; psychologic; psychological symptom; psychosocial; reduce symptoms; success; symptom management; therapy development; treatment as usual

Project Summary: Over half of newly diagnosed cancer patients are over age 65, and the number of older adults with cancer is expected to grow as the population ages. Older adults with cancer are more likely to be undertreated and experience premature discontinuation of treatment than younger patients, often resulting in worse outcomes. Studies suggest that poor symptom management and inadequate social support may explain this suboptimal treatment of older cancer patients. Thus, efforts to better understand and address the palliative care needs of older adults with cancer are critically important. We propose to develop an outpatient geriatric care intervention focused on the unique palliative care needs of older adults with incurable gastrointestinal (GI) and lung cancers. GI and lung cancers are among the leading causes of cancer death in the geriatric cancer population, and patients with incurable GI and lung cancers experience high rates of both physical and psychological symptoms. We will first conduct qualitative interviews with oncology, geriatric and palliative care clinicians, followed by patients, to explore their perceptions of the necessary components of the intervention. By exploring the views of these key stakeholders, we seek to develop a transdisciplinary intervention tailored to the needs of older patients with incurable cancer. Notably, the intervention will comprehensively address the unique geriatric and palliative care needs of these patients. We will then conduct a pilot (n=50), randomized controlled trial (RCT) to demonstrate the feasibility of the geriatric care intervention versus usual care in patients age ≥70 with newly diagnosed, incurable cancer. We will estimate the effect size of the intervention for quality of life, physical function, physical and psychological symptoms, cognition and geriatric impairments. The study will take place at Massachusetts General Hospital, drawing on the clinical and research expertise of the Cancer Center, Geriatric Medicine Unit, Palliative Care Department and the Department of Psychiatry's Behavioral Medicine Service. Primary mentorship will be provided by Jennifer Temel, MD, a nationally- recognized expert in the development and testing of supportive care interventions for patients with incurable cancers. Additional mentors include Lara Traeger PhD, Ardeshir Hashmi MD, Vicki Jackson MD, MPH, Supriya Mohile, MD, MS and William Dale, MD, PhD. This mentorship team of experts in geriatric oncology, palliative care, qualitative research methods and intervention development are committed to ensuring the success of the proposed research. The proposed study will not only further our understanding of the supportive care needs of older adults with cancer, but also develop a novel intervention to address these concerns and improve the quality of life of this patient population. Notably, the GEMSSTAR will provide vital support as I seek to become a leader in geriatric oncology research. My overarching goal is to become an independent investigator studying interventions to improve the supportive care provided to older adults with cancer. This grant will provide support for the mentorship, training and experience I need to establish a track record in aging research.

项目摘要：超过一半的新诊断癌症患者年龄超过65岁， 随着人口老龄化，预计成年癌症患者将增加。患有癌症的老年人更有可能 与年轻患者相比，治疗不足和过早停止治疗，通常导致 更糟糕的结果。研究表明，不良的症状管理和社会支持不足可能解释 这种对老年癌症患者的次优治疗。因此，努力更好地理解和解决姑息治疗， 老年癌症患者的护理需求至关重要。我们建议发展一个门诊老人科 护理干预侧重于患有不可治愈的胃肠道（GI）的老年人的独特姑息治疗需求 和肺癌。胃肠道癌和肺癌是老年人癌症死亡的主要原因 患有不可治愈的胃肠道和肺癌的患者的身体和 心理症状。我们将首先对肿瘤学、老年医学和姑息治疗进行定性访谈 临床医生，其次是病人，探索他们的看法的必要组成部分的干预。 通过探讨这些主要利益相关者的意见，我们寻求制定一项针对性的跨学科干预措施， 老年癌症患者的需求。值得注意的是，干预措施将全面解决 这些患者独特的老年和姑息治疗需求。然后，我们将进行一项试验（n=50），随机 对照试验（RCT），以证明老年护理干预与常规护理相比的可行性， 年龄≥70岁的新诊断的不可治愈的癌症患者。我们将估计干预的效应量， 生活质量、身体功能、身体和心理症状、认知和老年障碍。的 这项研究将在马萨诸塞州总医院进行，利用该医院的临床和研究专业知识， 癌症中心、老年医学部、姑息治疗部和精神病学部 行为医学服务。初级导师将提供詹妮弗特梅尔，医学博士，一个全国性的- 公认的专家，在发展和测试支持性护理干预措施的患者无法治愈的 癌的其他导师包括Lara Traeger PhD，Ardeshir Hashmi MD，Vicki杰克逊MD，MPH，Supriya Mohile，MD，MS和William Dale，MD，PhD。这个指导团队的专家在老年肿瘤学，姑息治疗， 护理，定性研究方法和干预措施的发展致力于确保成功的 提议的研究。建议的研究不仅将进一步了解 老年癌症患者，但也开发了一种新的干预措施，以解决这些问题，并改善 患者群体的生活质量。值得注意的是，GEMSSTAR将提供重要的支持，因为我寻求成为 老年肿瘤学研究的领导者我的首要目标是成为一名独立的调查员， 干预措施，以改善为老年癌症患者提供的支持性护理。这笔赠款将提供 支持导师，培训和经验，我需要建立一个跟踪记录在老龄化研究。