Advanced-Stage Development of a Geriatric Palliative Care Research Infrastructure

项目总结 社会正面临其历史上最大的公共卫生挑战之一--人口的增长 老年人和由于慢性严重疾病而导致的发病率不断增加。在接下来的几十年里，大多数医生 将照顾有身体和心理症状的重病老年人；进展性的 功能依赖和脆弱；高度的家庭支持需求；以及不断增加的卫生保健资源使用。的确， 患有多种慢性病的老年人数量预计将增加三分之一以上 在2000年至2030年期间，痴呆症患者将增加近一倍。大量证据表明， 对大多数人来说，晚期疾病的特征是没有得到充分的治疗；支离破碎的 护理系统；医生、病人和家人之间沟通不畅；家庭照顾者压力大。 慈善资助的国家姑息治疗研究中心(NPCRC)一直是 自2006年以来，促进跨学科老年姑息治疗研究的合作机制。全国人大常委会 是为了在全美范围内促进和发展姑息治疗研究而成立的。它向全国发表了讲话 医学科学院建议支持一支数量和人才都是 足以：a)为以科学为基础和实用的医学教育提供领导；以及b) 为严重和慢性疾病患者组织和开展临床、行为和健康服务研究 病痛。“NPCRC与NIA合作，确定了姑息治疗研究的优先事项，增强了 它的证据基础，培养了新一代姑息治疗研究人员，并创建了国家 科学家社区。NPCRC从46人中资助了100名跨学科调查人员(54人在老龄化研究中) 机构和21个州，从初级到高级教师，并参与了广泛的 致力于提高严重疾病患者生活质量的研究。 我们的新奇研究平台现在构成了我们当前R33提案的基础，以扩展和增强这一点 研究基础设施。我们将建立一个新的老年姑息治疗研究实习生网络，通过 美国早期阶段以姑息治疗为重点的博士后项目之间的合作 ，我们将领导一个研究技术援助计划，包括关于以下方面的研讨会和网络研讨会 高级统计研究方法，拨款撰写(即，NIH K和R01应用)技能讲习班，以及 授予审查计划。支持痴呆症和人群研究和培训方面的新举措。 对于有经验的研究人员，我们将支持多站点协作老年医学的开发和开展 通过支持网络和导致多点研究的项目启动会议进行姑息治疗研究 专注于NIA在老年姑息治疗方面的研究重点。我们的提议将推进研究基础设施 成功地利用全国人大常委会作为跨学科伙伴关系的合作工具 为美国各地的实习生、初级和有经验的研究人员进行的老年姑息护理研究。

PROJECT SUMMARY Society is facing one of the largest public health challenges in its history - the growth of the population of older adults and increasing morbidity due to chronic serious illness. Over the next decades, most physicians will be caring for seriously ill older adults with physical and psychological symptom distress; progressive functional dependence and frailty; high family support needs; and escalating health care resource use. Indeed, the number of older adults with multiple chronic conditions is expected to increase by more than a third between 2000 and 2030 and those with dementia will nearly double. Abundant evidence suggests that the advanced stages of disease for most are characterized by inadequately treated physical distress; fragmented care systems; poor communication between doctors, patients, and families; and strains on family caregivers. The philanthropically funded National Palliative Care Research Center (NPCRC) has served as a collaborative mechanism for promoting interdisciplinary geriatric palliative care research since 2006. NPCRC was established to promote and develop palliative care research across the U.S. It addressed the National Academy of Medicine's recommendations to support a “cadre of experts whose numbers and talents are sufficient to: a) supply leadership for scientifically-based and practically useful medical education; and b) organize and conduct clinical, behavioral, and health services research for patients with serious and chronic illness.” The NPCRC, in collaboration with NIA, has established priorities for palliative care research, enhanced its evidence base, developed a new generation of researchers in palliative care, and created a national community of scientists. NPCRC has funded 100 interdisciplinary investigators (54 in aging research) from 46 institutions and 21 states along the continuum from junior to senior faculty and engaged in a broad spectrum of research dedicated to improving quality of life for persons living with serious illness. Our novel, research platform now forms the basis of our current R33 proposal to expand and enhance this research infrastructure. We will establish a new network of geriatric palliative care research trainees through collaboration across the palliative care focused post-doctoral programs in the U.S. For early-stage investigators, we will lead a research technical assistance program encompassing workshops and webinars on advanced statistical research methods, a grant writing (i.e., NIH K and R01 applications) skills workshop, and a grant review program. We will support new initiatives in dementia and population-based research and training. For experienced investigators, we will support the development and conduct of multisite collaborative geriatric palliative care research by supporting networking and project start-up meetings leading to multisite studies focusing on NIA research priorities in geriatric palliative care. Our proposal will advance research infrastructure that has successfully leveraged the NPCRC as the collaborative vehicle for interdisciplinary partnerships for geriatric palliative care research for trainees, junior, and experienced investigators across the U.S.