BOX 3.1: Major Conclusions and Future Directions

Research

  • Develop an integrated approach to researching the effects of aging on multiple organ systems

  • Develop more sophisticated pharmacokinetic and pharmacodynamic models of multiple drug regimens and multiple drug interactions

  • Examine the social and psychological aspects of medication use in the elderly

  • Implement longitudinal studies of chronic use of medications by older persons

  • Develop research databases that link health outcomes and prescription medication information, explore the feasibility of a national data resource

  • Develop mechanisms for effectively disseminating drug-related information to health professionals and to elderly patients

Recruitment into Clinical Trials

  • Include the older and frailer segments of the elderly population in clinical trials

  • Expand recruitment of elderly minority populations into clinical trials

Capacity Building

  • Recruit young health professionals into geriatric pharmacology and clinical therapeutics research

  • Provide continuity of funding for young investigators

  • Implement incentives to retain mid-career professionals

  • Develop programs to retrain mid-career professionals in research methodologies and geriatrics

The following list highlights specific areas of research that would add to the body of knowledge and clarify our understanding of the aging process especially with regard to improving pharmacotherapy. This list is by no means comprehensive, as numerous research avenues could yield important information on the impact of pharmacotherapy and drug interactions in the elderly. Areas for future research include the impact of aging, gender, genetics, and ethnicity on physiology and metabolic processes. Specifically,

  • age-related changes in cellular transport mechanisms and extrahepatic metabolism and transport including the activity of different enzyme isoforms;

  • biomarkers of drug exposure;

  • mechanisms that cause variable responses to medications in aging racial and ethnic populations;



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