Advanced-Stage Development of a Geriatric Palliative Care Research Infrastructure

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.