There’s a lot of attention to new innovations in biomedical research, and we are proud to be a part of it. While the headlines may tout the latest in whole genome sequencing or the promise of “big data,” there are other areas of important new research, and one of these is the revolution in the study of palliative care.
What’s palliative care? The Center to Advance Palliative Care says:
Palliative care is specialized medical care for people with serious illnesses. It is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family… It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.
The idea behind palliative care is not new. In fact, palliative care was probably the first form of personalized medicine. But today, palliative care is reemerging as a critical component of a complicated and fragmented system of healthcare. Palliative care recognizes that at the center of our vast medical machinery are people—people with complex health conditions, people with individual care preferences, people with varying social support, financial well-being, and healthcare access.
How is the NIA playing a role in palliative care?
We support research in a variety of specific areas to advance the health and quality of life of older adults with serious illnesses. These include:
- treating physical symptoms like fatigue, breathlessness, and nausea
- addressing psychological or emotional suffering
- shared decision-making approaches that allow older adults and their families to incorporate their goals of care into their treatment plans
- attention to the special needs of caregivers
The “typical” geriatric patient—an older individual with multiple chronic conditions, taking multiple medications, with limited mobility and other physical or cognitive impairments, and with variable access to care delivered in multiple settings—is the kind of patient who might benefit tremendously from palliative care approaches. While we know something about delivering this care, there is much yet to learn to increase its effectiveness. NIA wants to support the research that will help us maximize the palliative care approach.
Recently, NIA released a set of program announcements (PAs) called “Advancing the Science of Geriatric Palliative Care,” seeking applications using R01, R03, or R21 mechanisms. These PAs highlight to the scientific community our interest in promoting research at the intersection of two disciplines—geriatrics and palliative care—that share many of the same approaches to clinical care. The National Center for Complementary and Alternative Medicine and the National Institute of Nursing Research are also sponsors.
What kinds of applications does the NIA want to receive?
We’re interested in studies that will move the science forward on a variety of fronts. For example:
- observational studies that help an older patient with one or more chronic conditions predict her prognosis in terms of the likelihood of death or functional impairment so she can make informed decisions about the type of care she wants to receive
- intervention studies that demonstrate whether discontinuing certain therapies leads to the quality of life that an older patient desires
- finding out whether using social media or other technologies can help patients, providers, and caregivers communicate with one another in a way that leads to improved outcomes for everyone involved
- palliative care research in a variety of different settings--for example, home, hospital, short- and long-term care facilities—as well as transitions across these settings.
These are, of course, just a sampling of the kinds of studies we’d like to see. The only part of palliative care that we’re not highlighting specifically in these PAs is end-of-life and hospice care. That’s not because these areas are not important—hardly. The NIA continues to support research in these areas. But for these PAs, we want to focus on how palliative care approaches benefit older individuals at earlier points in the course of their illnesses. That’s an area that hasn’t received much research attention at all. The PAs describe what we’re after in more detail. Here are the links again: R01, R03, R21.
Please feel free to comment below. If you’re thinking about a specific study in response to these PAs, but you’re unsure if it will fit with the NIA, send me an email. I may be able to tell you which of our divisions would be the best home for your proposal.