(Applicant s abstract) The overall purpose of this award application is to support the patient-oriented research and mentoring program of an academic geriatrician in order to further develop his research and mentoring skills, generate new knowledge in clinical geriatrics and develop other clinical investigators in geriatrics. The candidate is a mid-career clinician and investigator at Duke University and Durham VA Medical Centers with a strong commitment, funding and publication record in patient-oriented research in herpes zoster and medications in the elderly and a history of mentoring house staff and junior faculty in clinical research. The research plan is structured along two complementary areas of investigation involving zoster and medications in the elderly. The objectives of his zoster research program are the optimal management of zoster and postherpetic neuralgia in the elderly. A series of studies is proposed that is centered around his work in the Shingles Prevention Study, a large multicenter clinical trial to determine whether immunization with live attenuated varicella-zoster vaccine can reduce the incidence and/or severity of zoster and PHN in the elderly. Additional research opportunities are available in treatment trials of zoster and studies of genetics and zoster. The objectives of his drug-related research program is to optimize pharmacotherapy in the elderly by reducing polypharmacy, inappropriate prescribing and adverse drug reactions. The basis for a program of drug-related studies is the GEM Drug Study, a multicenter trial to determine if Geriatric Evaluation and Management (GEM) care reduces adverse drug reactions and inappropriate prescribing in the elderly compared to usual care. The candidate will recruit and select advisees from a rich pool of beginning clinical investigators at Duke University Medical Center and mentor them in the context of the above research projects using one-one teaching, the Duke Clinical Research Training Program (CRTP) and other research educational experiences at Duke. The Duke CRTP and Faculty Development Programs will provide opportunities for the candidate s research, mentoring and leadership career development. The award will allow the candidate to devote additional time to patient-oriented research and mentoring by relieving the candidate of clinical and administrative responsibilities in the Division of Geriatrics, the Duke Geriatric Evaluation and Treatment Clinic and Durham VAMC. The award fits into past and future career development by providing a bridge from earlier academic activities to the expansion of mentoring and research skills and to program leadership in geriatrics.
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