This application responds to PAR-13-287 (Network and Infrastructure Support for Development of Interdisciplinary Aging Research). We propose to bridge the HMO Research Network with the Claude D. Pepper Older Americans Independence Centers (OAICs;aka Pepper Centers) to create a national resource to nurture and advance an interdisciplinary research agenda focused on older adults with multiple chronic conditions (MCCs).
Our specific aims under this initiative are: (1) to collaboratively develop a framework and procedures to enhance the existing HMORN data infrastructure to advance interdisciplinary research on older adults with MCCs;(2) to support interdisciplinary pilot projects that optimize HMORN and OAIC resources and foster collaboration between HMORN and OAIC investigators to address questions relevant to data validity, comparative effectiveness, health outcomes, health disparities, and costs of care in older persons with MCCs. These projects will serve to further define the adequacy of available data, identify and prioritize additional data needs, and lay the groundwork for interventions to preserve and recover function in older adults with MCCs;(3) to identify and mentor junior faculty from the HMORN and OAICs with a research focus on older adults with MCCs;and (4) to disseminate interdisciplinary research approaches and findings relating to the science of MCCs in older adults to the larger scientific community. These synergistic aims leverage the accumulated aging research expertise of the OAICs together with the HMORN's large patient populations, electronic health record data, and cadre of embedded healthcare delivery system researchers to create a unique national resource that will: (1) encourage, facilitate, and support research that can address the most important questions relevant to older persons with MCCs;(2) increase knowledge about how best to use data found in electronic health record systems from multiple, diverse healthcare organizations;(3) promote collaboration among researchers from different disciplines, and engage, mentor, and develop junior faculty from across these fields;and (4) disseminate findings from research on older persons with MCCs that will translate into the delivery of higher quality and more cost-effective care.

Public Health Relevance

We propose to bridge the HMO Research Network with the Claude D. Pepper Older Americans Independence Centers to create a national resource to nurture and advance an interdisciplinary research agenda focused on older adults with multiple chronic conditions. Our efforts will lay the foundation to address the knowledge gaps that exist regarding the health and healthcare of these understudied patients.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Resource-Related Research Projects (R24)
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Neuroscience of Aging Review Committee (NIA)
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Salive, Marcel
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University of Massachusetts Medical School Worcester
Internal Medicine/Medicine
Schools of Medicine
United States
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Dillon, Ellis; Chuang, Judith; Gupta, Atul et al. (2017) Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment. Am J Hosp Palliat Care 34:918-924
Tai-Seale, Ming; Yang, Yan; Dillon, Ellis et al. (2017) Community-Based Palliative Care and Advance Care Planning Documentation: Evidence from a Multispecialty Group. J Am Geriatr Soc :
Murphy, Terrence E; McAvay, Gail J; Allore, Heather G et al. (2017) Contributions of COPD, asthma, and ten comorbid conditions to health care utilization and patient-centered outcomes among US adults with obstructive airway disease. Int J Chron Obstruct Pulmon Dis 12:2515-2522
Gurwitz, Jerry H; Magid, David J; Smith, David H et al. (2017) Treatment Effectiveness in Heart Failure with Comorbidity: Lung Disease and Kidney Disease. J Am Geriatr Soc 65:2610-2618
Gurwitz, Jerry H (2017) Warfarin in Complex Older Patients: Have we Reached a Tipping Point? J Am Geriatr Soc 65:236-237
Gurwitz, Jerry H; Bonner, Alice; Berwick, Donald M (2017) Reducing Excessive Use of Antipsychotic Agents in Nursing Homes. JAMA 318:118-119
Tran, Hoang V; Lessard, Darleen; Tisminetzky, Mayra S et al. (2017) Trends in Length of Hospital Stay and the Impact on Prognosis of Early Discharge After a First Uncomplicated Acute Myocardial Infarction. Am J Cardiol :
Tisminetzky, Mayra; Bayliss, Elizabeth A; Magaziner, Jay S et al. (2017) Research Priorities to Advance the Health and Health Care of Older Adults with Multiple Chronic Conditions. J Am Geriatr Soc 65:1549-1553
Gray, Shelly L; Hart, Laura A; Perera, Subashan et al. (2017) Meta-analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults. J Am Geriatr Soc :
Tisminetzky, Mayra; Goldberg, Robert; Gurwitz, Jerry H (2016) Magnitude and Impact of Multimorbidity on Clinical Outcomes in Older Adults with Cardiovascular Disease: A Literature Review. Clin Geriatr Med 32:227-46

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