Post on 15-Jul-2020
Setting: Western New York (WNY).
Engaging Older Adults: In order to partner with older adults and their caregivers we developed an approach based on current literature and in consultation with the Patient Voices Network (PVN).2 Using this approach, shaped by our own experiences, the Elder Voices Network (EVN) was established. One of our preliminary results after year 1 are a list of best practices that can be used to help other groups partner with older adults.
Elder Voices Network: a group of older adults and their caregivers invited to partner with Team Alice* to reduce medication related harm. The majority of older adults are from three local senior centers that offer Aging Mastery Program (AMP) classes3. All participants in the program were invited to attend the Elder Voice Network meetings. These meetings were held at similar times and locations as AMP classes.
Patient Driven DeRx: As part of our strategic plan (right) the 1st
EVN project was designed to promote elder and caregiver alertness to drug complications and how to drive discussions with providers about deprescribing.
Initial project: Pilot study to create patient-driven educational videos for older adults and their caregivers. We asked the 2 caregivers for Alice to develop scripts based on the question, “what do you wish you would have known, that would have saved your loved one?”
Video Production: Video scripts and prototypes were discussed and reviewed by EVN members. Suggested changes and improvements were incorporated into the videos. Before the final production, EVN members will discuss and review the latest round of videos.
Funding: Research Retirement Foundation 2019060 07/2019-06/2021
To develop sustainable partnerships with older adults and their caregivers to not only inform research on DeRx but to drive it.
Elder Voices Network: Partnering With Older People and Their Caregivers
to Avoid Medical Harm
Richbart M, Ranahan M, Brady L, Brennan-Taylor M, Clark CM, Gadzo R, Singh R, Wahler RG
Background- Inappropriate polypharmacy in older adults calls for urgent cross-system action to prevent avoidable harm.-Deprescribing (DeRx) is an important approach to reduce risk but evidence for effective strategies to drive and sustain deprescribing is underdeveloped. -Older adults are an undervalued resource for guiding geriatric research at all stages.-Recent literature suggests the need to distinguish between research that involves older adults and research that is led by older adults and sustains over time.1
Methods
Preliminary Results
Discussion
The majority of literature on research involving older adults
addresses the question, “what does participation mean?” Common
questions that arise for researchers are:
• How to recruit?
• What stage/level of involvement?
• Who determines the research question?
• How to evaluate the involvement?
• Who gets the final say?
Recent literature has identified older adults as “co-researchers” and
as equal members of the research team.4,5,6 In this study we have
chosen to call older adults partners to emphasize the shared goal of
reducing medication related harm motivated by Alice’s Story* and
others like it. It is anticipated that this partnership will continue
after the grant’s completion.
Objective
ConclusionThe last phase of the study involves a pilot clinical trial in two primary care offices measuring the effect the videos have on outcomes such as medication count, hospitalizations, and Patient Attitudes Towards Deprescribing (PATD).7 The results of this study will be shared and interpreted in partnership with the Elder Voices Network.
PROJECT GOALS PROGRESS TO DATE
Recruit Elder Voices NetworkOver a 6 month period 12 meetings at 3 Senior Centers. Other stakeholders include caregivers, ombudsman, senior center staff, and local agencies focused on aging.
Identify and implement best practices for Engaging Older Adults
• Start with a specific project/grant• Build on existing partnerships and established meetings• Use trained qualitative and community engagement
researchers to advocate for older adult perspectives• Engage older adults to recruit other older adults • Have flexible meeting agendas• Partner with community stakeholders to facilitate
meetings• Provide compensation for older adults• Focus on relationships and not extracting data• Be open to criticism and encourage older adults to
question the study’s validity
Develop animated videos 3 animated videos have been developed to date in partnership with the Elder Voices Network.
*Team Alice: An interdisciplinary research team inspired by the story of Alice Brennan who died as a result of inappropriate polypharmacy.
Alice’s story: Team Alice website
Reference1. Munn-Giddings, C., Mcvicar, A., Boyce, M., & O’Brien, N. (2016). Learning from older citizens’
research groups. Educational Gerontology, 42(1), 58–69. https://doi.org/10.1080/03601277.2015.1065690
2. Reilly, S. M., Crowley, M. W., Harold, P., Hemphill, D., & Berhalter, L. T. (2018). Patient Voices Network: Bringing Breast Cancer Awareness and Action into Underserved Communities. Journal of the National Medical Association, 110(5), 448-454.
3. https://www.ncoa.org/healthy-aging/aging-mastery-program/4. Fudge, N., C. D. A. Wolfe, and C. McKevitt. "Involving older people in health research." Age and
Ageing 36, no. 5 (2007): 492-500.5. Littlechild, R., Tanner, D., & Hall, K. (2015). Co-research with older people: perspectives on
impact. Qualitative Social Work, 14(1), 18-35.6. Buffel, T. (2018). Social research and co-production with older people: Developing age-friendly
communities. Journal of aging studies, 44, 52-60.7. Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. Development and validation of the patients'
attitudes towards deprescribing (PATD) questionnaire. International journal of clinical pharmacy. 2013;35(1):51-56.
Strategic Plan
Team AliceJacobs School of Biomedical Sciences
Primary Care Research Institute
Department of Pharmacy PracticeSchool of Pharmacy and Pharmaceutical Sciences
Patient-Driven DeRxArm patients and caregivers to protect themselves• Identify risky prescribing• Advocate for themselves across
the system