Pharmacokinetics and Drug Interactions in the Elderly and Special Issues in Elderly African-American Populations Workshop Summary (1997) / Chapter Skim
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3 CONCLUSIONS AND FUTURE RESEARCH DIRECTIONS
3 CONCLUSIONS AND FUTURE RESEARCH DIRECTIONS
Pages 35-42
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From page 35... ...
RESEARCH NEEDS AND OPPORTUNITIES Expanding the Scientific Knowledge Base Although progress has been made in understanding the aging process, there is still a paucity of data at the intracellular, organ, system, and population levels. The impact of aging on cells and organ systems has commonly been studied in isolation; however, a more integrated approach is needed that will examine the effects of aging on the body.
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From page 36... ...
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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From page 37... ...
Such research would be a valuable tool in increasing our understanding of the physiology of aging for all populations and may have implications for pharmacotherapies aimed at various elderly groups. Research on diseases and health conditions that primarily affect minority elderly populations needs to be a priority to alleviate the disease burden experienced by these populations.
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From page 38... ...
Obtaining informed consent in elderly populations involves complex issues that need to be addressed including the extent of dementia or cognitive impairment in some elderly patients and their vulnerability to coercion. Informed consent forms have evolved into highly technical legal documents, and a reevaluation of how to best meet their original purpose is needed.
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From page 39... ...
Increased use of managed care to provide health care for the elderly offers opportunities for databases to be implemented that would link health outcomes (particularly adverse drug reactions) and prescription information, while paying close attention to patient confidentiality issues.
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From page 40... ...
Health sciences centers that focus on training medical, nursing, and pharmacy students should be used to conduct independent, unbiased research and continuing education programs for practicing physicians, pharmacists, nurses, and the interested public (Woosley, 1994~. Capacity Building: Researchers and Clinicians One of the major factors limiting the expansion of research in the area of geriatrics, and particularly geriatric pharmacology and clinical therapeutics, is the small number of health professionals entering this field.
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From page 41... ...
The options available for approaching this issue include · 1- to 2-year postbaccalaureate programs to provide research and clinical experience to young people considering a career in this field; · opportunities for medical, nursing, pharmacy, and other health professional students to have additional exposure to geriatric treatment and research during their education; · collaborative efforts between minority academic institutions and academic health sciences centers to encourage minority students to pursue a research program in this field; · loan-forgiveness programs to assist young researchers with high debt loads from health professional or graduate schools; · new sources of fellowships (e.g., through FDA, pharmaceutical compa · · ~ nles, or insurance companies ; · increased commitment to funding from fellowship training to first awards to independent grant support; · merit awards at the midcareer level and specialized sabbaticals to retrain midcareer professionals; and · retraining in research methodologies during sabbaticals for midcareer level geriatricians. SUMMARY Currently there is only a limited understanding of the impact of aging on pharmacokinetics, pharmacodynamics, and drug interactions.
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From page 42... ...
Increasing the knowledge base will enable more effective therapeutic interventions and improved quality of life for the growing population of elderly persons. REFERENCES Alliance for Aging Research.
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