NIA Awards R01 to Dr. Boustani for Pharmacological Management of Delirium Trial
May, 2010

The National Institute on Aging has funded Principal Investigator Malaz Boustani, MD, MPH, for “Pharmacological Management of Delirium,” an R01 that will evaluate the efficacy of a multi-component pharmacological intervention in reducing delirium severity and duration and subsequently decrease ICU and hospital length of stay

Pharmaco-epidemiological studies and scattered randomized clinical trials have demonstrated that the pharmacological management of delirium among older adults is complicated and may need to include a combination of a reduction in the use of benzodiazepines and anticholinergics, along with the use of low dose neuroleptics such as haloperidol. However, there are no randomized controlled trials that have evaluated the efficacy of such a pharmacological management on reducing delirium severity, duration, and its related complications.

Read more about Dr. Boustani's R01 in the IU Geriatrics June-July 2010 e-news. 

Dr. Hendrie Named to HHS National Advisory Council on Aging
March, 2010

Center for Aging Research Scientist Hugh C. Hendrie, MB, ChB, DSc, has been named to the National Advisory Council on Aging. His appointment came from Kathleen Sebelius, secretary of the US Department of Health and Human Services and extends through December 2013.

Dr. Hendrie, an internationally respected geriatric psychiatrist and health services researcher, has spent 40 years studying the psychiatric issues of aging, focusing on Alheimer’s disease and depression in older adults. He served for a quarter of a century as chairman of the IU School of Medicine Department of Psychiatry and is now professor emeritus. 

The National Advisory Council on Aging advises the HHS secretary, assistant secretary for health, the director of the National Institutes of Health, and the director of National Institute on Aging in its mission to lead a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life.

Read more about Dr. Hendrie's appointment in the IU Geriatrics February 2010 e-news. 

GRACE Care Management to be Deployed at Indianapolis VA
March, 2010

When Dr. Steve Counsell was named Geriatrics Section Chief at the Indianapolis VAMC in July of 2009, his responsibilities included developing a strategic plan for innovative geriatrics clinical services, education, and research. Grant funding of $1.3 million over the next two years for “Dissemination of GRACE Care Management to At Risk Older Veterans” is the first step in rolling out this strategic plan.

Dr. Counsell and the Indianapolis VA competed successfully for this grant funded out of the Veterans Health Administration Office of Geriatrics and Extended Care, Washington, DC under a call for proposals “To Develop/Disseminate Innovative Patient Centered Alternatives to Institutional Extended Care.”

As a new service within the Geriatrics and Extended Care Service Line, an implementation team will be assembled representing the core disciplines needed for success of GRACE—geriatrics, primary care, nursing, social work, pharmacy, and mental health.

Read more about the GRACE deployment in the January 2010 enews.  

Dr. Weiner Named Director at IU, VA, Regenstrief Institute
January, 2010

IU Geriatrics congratulates Michael Weiner, MD, MPH, who has been named director of the IU Center for Health Services and Outcomes Research, director of the Regenstrief Institute's Health Services Research Program, and director of the Department of Veterans Affairs Health Services Research and Development Center of Excellence on Implementing Evidence-Based Practice, located at the Richard L. Roudebush VA Medical Center in Indianapolis.

Read about Dr. Weiner in the January 2010 enews.  

Dr. Sachs Publishes Editorial in New England Journal of Medicine
December, 2009

How far does an editorial message by a geriatrician travel?  When Greg A. Sachs, MD, wrote about a career-shaping experience as a teenager and added research data that “moves the field forward in major ways,” the world was ready to listen. 

The editorial, “Dying from Dementia,” was published in the October 15, 2009 issue of the New England Journal of Medicine, and was spotted in English and Spanish, on network television, on dot com, dot org and dot gov websites, in national newspapers and magazines from Alaska to Florida, Hawaii to Vermont, and from Indiana to Guam to India.

Dr. Sachs’ editorial described the results of the Journal’s original article, “The Clinical Course of Advanced Dementia.”  Lead author Susan Mitchell, MD, MPH and colleagues examined mortality among patients with advanced dementia who resided in nursing homes. More than half the patients died in 6 months. Pneumonia, febrile episodes, and eating problems were frequent harbingers of death.

Links to the full editorial, original research article and media hits are available on page 3 of the November issue of the IU Geriatrics e-news.

Will Electronic Medication Reconciliation Improve
the Quality of Transitional Care?
October, 2009

Principal investigator Michael Weiner, MD, MPH will produce outcomes to begin to answer this question with Medication Reconciliation to Improve Quality of Transitional Care, a three-year R18 funded by the Agency for Healthcare Research and Quality.

“Although implementation of formal medication reconciliation systems improves the fraction of cases undergoing MR,” notes Dr. Weiner, “we know relatively little about the extent to which these systems alter clinical outcomes. Research also indicates that medication reconciliation should be integrated with computer-based provider order entry, but this seldom if ever occurs.”

The specific aims of this study are to integrate an electronic MR system with an electronic prescribing system, conduct a randomized controlled trial of MR, and determine whether electronic facilitation of MR alters MR and the incidence of medication errors in ambulatory care. The study will target patients at Wishard Health Services.

Dr. Torke to Advance Research with K23 Surrogate Decision Making Study
September, 2009

The National Institute on Aging has awarded a five-year K23 to Alexia M. Torke, MD, MS for Surrogate Decision Making for Hospitalized Older Adults.
        
“My long term goal is to improve the medical care of hospitalized older adults who are unable to make their own decisions,” notes Dr. Torke. “This award provides the training and research time needed to bring about a crucial step toward my goal—characterizing the decision making process as it occurs for these patients.”

In her K23 research, Dr. Torke will conduct a prospective, observational study of older adults and their surrogate decision makers. The specific aims of this study are to describe the frequency, characteristics, and clinical context of surrogate decisions, and to identify important determinants of successful communication and high quality decision making from the surrogate's perspective. These results will serve as the basis for future interventions to improve the care of older adults who are unable to make their own medical decisions.

How Do Doctors Really Feel About Surrogate Decision Making?
September, 2009

Read about this topic and comments from lead author Alexia M. Torke, MD, MS, in an IU School of Medicine news release.

Torke AM, Siegler M, Abalos A, Moloney RM, Alexander GC. Physicians' Experience with Surrogate Decision Making for Hospitalized Adults. J Gen Intern Med. 2009 Sep;24(9):1023-8.

Aging with GRACE: New Healthcare Delivery Model Improves Outcomes, Saves Money
August, 2009

Read an IUSM news release that describes GRACE, a team approach to preventive healthcare delivery for older adults developed by researchers from IU Geriatrics and the IU Center for Aging Research that improves health and quality of life, decreased emergency department visits and lowered hospital admission rates.

Counsell SR, Callahan CM, Tu W, Stump TE, Arling GW. Cost analysis of the Geriatric Resources for Assessment and Care of Elders care management intervention. J Am Geriatr Soc. 2009 Aug;57(8):1420-6.

Dr. Boustani Discusses Delirium on National Public Radio's Morning Edition
August, 2009

Listen to "Treating Delirium: An Often Missed Diagnosis," a story reported by Joseph Shapiro on August 10, 2009.

Delirium in Hospitalized Adults: Situation Critical, No Relief Available
July, 2009

According to an IU School of Medicine news release, every year as many as seven million adults in the United States experience delirium during hospitalization. What does the scientific literature have to say about delirium prevention and treatment?

Read the IUSM news release and learn what authors Noll Campbell, PharmD, Malaz Boustani, M.D., MPH and Stephanie Munger, MPH discovered in their systematic review published in the July 2009 issue of the Journal of General Internal Medicine.

Dr. Counsell Named 2009-2010 Health and Aging Policy Fellow
July, 2009

Steven R. Counsell, MD has been named a 2009-2010 Health and Aging Policy Fellow. The Program is a unique opportunity for professionals in health and aging to receive the experience and skills necessary to make a positive contribution to the development and implementation of health policies that affect older Americans.

Dr. Counsell's fellowship will focus on the completion of a specific health policy project with a focus on policy related to improving care coordination in frail elders at both the state and national levels. His work will be informed by research and geriatrics programming at Indiana University, past work with the Indiana Medicaid Medical Advisory Cabinet, and his recent Packer Policy Fellowship in Australia.

"In putting together the application and learning more from current fellows over the past few months, I feel this is just the right next step as I explore opportunities to impact health policy toward improving healthcare for older adults," states Dr. Counsell.

SCAN Foundation Selects GRACE Care Management for Dissemination in California
July, 2009

The SCAN Foundation has selected Indiana University and IU Geriatrics as the recipient of funding for "Dissemination of GRACE Care Management to High Risk Seniors of a Managed Care Medical Group." The seniors are Medicare beneficiaries aged 70 or older who receive medical care from Healthcare Partners in California.

The project focuses on supporting promising program models for building a long-term care system to help seniors maintain their quality of life and remain independent, at home and in the community. The dissemination project is led by Principal Investigator Steve Counsell, M.D., and Co-investigator Kathy Frank, RN, DNS.

GRACE is a model of primary care for low-income seniors and their primary care physicians developed to improve the quality of geriatric care to optimize health and functional status, decrease excess healthcare use, and prevent long-term nursing home placement. The model was created by IU Geriatrics and was tested in community-based health centers in Indianapolis.