Research Inclusion Across the Lifespan: A Good Start, but There Is More Work to Be Done.
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2023-06
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Abstract
While older adults account for a disproportionate amount of healthcare spending, they are often underrepresented in clinical research needed to guide clinical care. The purpose of this perspective is to make readers aware of new data on age at enrollment for participants included in National Institutes of Health (NIH)-funded clinical research. We highlight key findings of relevance to general internal medicine and suggest ways readers could support the inclusion of older adults in clinical research. Data from the NIH Research Inclusion Statistics Report show that there were 881,385 participants enrolled in all NIH-funded clinical research in 2021, of whom 170,110 (19%) were 65 years and older. However, on average, studies included a far lower percentage of older adults. Additionally, there were many conditions for which overall enrollment rates for older adults were lower than would be expected. For example, while 10% of participants in studies related to diabetes were ≥ 65 years old, older individuals represent 43% of all prevalent diabetes in the USA. Researchers should work with clinicians to advocate for older adults and ensure their participation in clinical research. Best practices and resources for overcoming common barriers to the inclusion of older adults in research could also be disseminated.
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Bowling, C Barrett, Jennifer Thomas, Jennifer M Gierisch, Hayden B Bosworth and Laura Plantinga (2023). Research Inclusion Across the Lifespan: A Good Start, but There Is More Work to Be Done. Journal of general internal medicine, 38(8). pp. 1966–1969. 10.1007/s11606-023-08182-8 Retrieved from https://hdl.handle.net/10161/29362.
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Christopher Barrett Bowling
I am a geriatrician with research training in population health and chronic disease epidemiology. Through my work, I aim to inform patient-centered care that focuses on optimizing function and quality of life over traditional disease-based approaches. Much of my work has focused on chronic kidney disease, however I have recently broadened the scope of investigation to include other chronic conditions including hypertension and systemic lupus erythematosus. The unifying theme of this work has been applying a geriatric research approach to large studies of chronic disease. As Associate Director of Clinical Programs at the Durham VA Geriatric Research Education and Clinical Center, I have also had the opportunity to partner with nephrologists to develop clinical programs in the VA designed to provide patient-centered, geriatric care for older adults with kidney disease.
Jennifer M. Gierisch
Jennifer Gierisch, PhD, is behavioral scientist and health services researcher. She is an Associate Professor in the Department of Population Heath Sciences and the Department of Medicine at Duke University. She is a core investigator with the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) where she serves as the leader of the Partnered Research Methods Core (PRESTO) and Director of the VA OAA Health Services Research Postdoctoral Fellowship. Dr. Gierisch also is the Co-Director of the Evidence Synthesis Program (VA ESP) at the Durham Veteran Affairs Health Care System. She also served as a faculty director of the Duke Clinical Translational Science Institute's Community Engaged Research Initiative (CeRi) for five years
Dr. Gierisch’s research focuses on three overarching areas: 1) behavioral research on the psychosocial factors that influence appropriate uptake and maintenance of complex health behaviors (eg., weight management, smoking cessation, cancer screening); 2) evidence synthesis on key health and healthcare topics to enhance uptake of evidence-based interventions to improve patient and health system outcomes; and 3) participatory and community engaged research approaches.
Area of expertise: health behavior, community-engaged research, evidence synthesis, intervention development, qualitative research
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