- Researching impact of potentially inappropriate medications, lifespan estimates on caregiver satisfaction, Drs. Rasheeda Hall & Kah Poh (Melissa) Loh honored with AGS’s Arti Hurria Memorial Award#AGS20 #AGS21 #geriatrics http://ow.ly/L1WO30qE4wi
New York (May 8, 2020)—The American Geriatrics Society (AGS) and the AGS Health in Aging Foundation today conferred one of their newest honors, the Arti Hurria Memorial Award for Emerging Investigators in Internal Medicine Focused on the Care of Older Adults, on two experts:
- Rasheeda Hall, MD, a board-certified nephrologist and assistant professor of medicine at Duke University; and
- Kah Poh (Melissa) Loh, MBBCh, BAO, a board-certified internist, hematologist, and oncologist at the University of Rochester Medical Center.
Following the cancellation of the AGS 2020 Annual Scientific Meeting due to COVID-19, Dr. Hall and Dr. Loh both will be presented with the Arti Hurria Memorial Award for their innovative research at the AGS 2021 Annual Scientific Meeting (#AGS21; May 13-15 in Chicago, Ill.).
“Dr. Arti Hurria, the namesake for this award, built so many important bridges between geriatrics and other specialties,” notes Sunny Linnebur, PharmD, FCCP, FASCP, BCPS, BCGP, AGS board chair. “In forging connections not just to other specialties but also between researchers, clinicians, patients, and caregivers, Dr. Hall and Dr. Loh have built admirably on the legacy Dr. Hurria launched and the AGS continues to celebrate.”
“Potentially Inappropriate Medications (PIMs) and Risk of Adverse Outcomes in Older Adults with Chronic Kidney Disease (CKD)” (Rasheeda Hall, MD)
For her research—now featured in a special supplement for the Journal of the American Geriatrics Society (JAGS), Dr. Hall and colleagues from Duke, the University of Pennsylvania, and the University of Maryland at Baltimore evaluated a concern long central to geriatrics expertise: The risk for adverse outcomes when using potentially inappropriate medications, especially for older adults with chronic kidney disease.
The kidneys play a key role in helping our bodies process medicines, and chronic kidney disease can impede their work and increase the risk for adverse effects (the medical term for serious issues or side effects associated with medication). In their study, Dr. Hall’s team looked at data from more than 3,900 adults enrolled in the Chronic Renal Insufficiency Cohort Study to determine whether potentially inappropriate medications—so named because they may have an improper balance of benefits and harms for certain groups, including older adults—were associated with mortality, falls, hospitalization, or worsening chronic kidney disease.
The use of potentially inappropriate medication increased considerably with age: 58.5 percent of patients under 65 used one or more such medication, with figures rising to 64.2 percent for those between the ages of 65 and 70 and 69.5 percent for those 71-years-old or older. In all age groups, the most common potentially inappropriate medications (identified using the AGS Beers Criteria®) were omeprazole, clonidine, and ibuprofen. In looking at patient data, Dr. Hall and her team also concluded that adults with chronic kidney disease taking multiple potentially inappropriate medications had increased risk for hospitalization, death, and falls irrespective of age.
A physician-scientist with expertise in geriatric nephrology, Dr. Hall has structured much of her career to design, test, and implement new models of care that target dialysis (a standard treatment for those with kidney failure). Dr. Hall has been awarded a Grant for Early Medical/Surgical Specialists’ Transition to Aging Research (GEMSSTAR) award and a Paul B. Beeson Career Development Award, both from the National Institute on Aging (NIA). She also received a 2019 AGS Health in Aging Foundation New Investigator Award for work presented at a past AGS Annual Scientific Meeting.
“Association Between Caregiver-Oncologist Discordance in Length-of-Life Estimates for Patient and Caregiver Satisfaction” (Kah Poh Loh, BMedSci, MBBCh, BAO)
In her work also published in the JAGS supplement, Dr. Loh and colleagues from the University of Rochester in N.Y., Rutgers University in N.J., and Alfred Health in Australia looked at the unique connections between caregiver optimism, health professional pragmatism, and satisfaction with care in geriatric oncology. Links between the three are important: Caregiver confidence often leads to overestimates for a patient’s length of life, which in turn can lead to frustration with the health system and dissatisfaction with the level of perceived support someone receives from a care team.
In their study, Dr. Loh and her team identified more than 380 pairs of caregivers and oncologists and asked them to estimate remaining lifespan for an older friend or family member receiving cancer care. Caregivers also completed a questionnaire regarding their satisfaction with the oncologist’s communication at periodic intervals between four weeks and six months after the study began.
More than 270 pairs of caregivers and oncologists disagreed about a patient’s estimated length of life. Interestingly, patient survival appeared to influence the effect discord had on caregiver satisfaction with an oncologist’s communication. For patients who survived cancer treatment, caregivers still rated oncologist communication favorably, even when both parties disagreed about lifespan. Conversely, for patients who died, caregivers tended to report greater frustration with provider communication when the caregiver’s lifespan estimate differed substantially from an oncologist’s prediction.
As an oncologist, Dr. Loh is no stranger to these conversations—but, as a geriatric oncologist, her training and expertise reflect the nuances of how those conversations can change as we age. With a long-term goal of developing behavioral interventions to improve outcomes for older adults living with cancer affecting the blood, Dr. Loh has received considerable support for her work from noteworthy influencers in the U.S. and abroad, including the U.S. National Cancer Institute (K99/R00 Pathway to Independence Award) and the prestigious Wilmot Cancer Institute (Wilmot Cancer Research Fellowship Award) at the University of Rochester.
Like Dr. Hall and Dr. Loh, Dr. Hurria—namesake of this award—championed AGS programs connecting colleagues outside geriatrics to the rewards of supporting health, safety, and independence for us all as we age. Dr. Hurria, who passed away in 2018, believed in the need to infuse geriatrics principles across all specialties. The Arti Hurria Memorial Award for Emerging Investigators in Internal Medicine Focused on the Care of Older Adults is one of several honors conferred by the AGS at its Annual Scientific Meetings. The award recognizes the accomplishments of junior and mid-career clinician-investigators in general internal medicine and its specialties. Chosen from hundreds of research presentations submitted to the AGS, the Hurria join our other award winners in representing healthcare leaders who champion care for older adults. For more information, visit Meeting.AmericanGeriatrics.org.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has—for more than 75 years—worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.
About the Health in Aging Foundation
The Health in Aging Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit HealthinAgingFoundation.org.
About the Arti Hurria Memorial Award for Emerging Investigators in Internal Medicine Who are Focused on the Care of Older Adults
Arti Hurria, MD, namesake of this award, joined the AGS in 2006 and championed some of our most influential programs connecting colleagues outside geriatrics to our principles, and to the rewards of supporting health, safety, and independence for us all as we age. Dr. Hurria, who sadly passed away in November 2018, believed in the need to infuse geriatrics into all specialties. She not only put that belief into action but also became a model for making it a priority across clinical care, research, and education. The Arti Hurria Memorial Award for Emerging Investigators in Internal Medicine Who are Focused on the Care of Older Adults recognizes the geriatrics-focused accomplishments of junior and mid-career clinician-investigators in general internal medicine and its specialties. Chosen from a review of hundreds of research presentations, the Hurria Awardee presents ground-breaking scholarship on the geriatrics aspects of their specialty in a special plenary session at the AGS Annual Scientific Meeting.
About the AGS Annual Scientific Meeting
The AGS Annual Scientific Meeting is the premier educational event in geriatrics, providing the latest information on clinical care, research on aging, and innovative models of care delivery. Following the cancellation of the 2020 gathering due to the COVID-19 pandemic, nearly 3,000 nurses, pharmacists, physicians, physician assistants, social workers, long-term care and managed care providers, healthcare administrators, and others will convene next year from May 13-15 (pre-conference program on May 12), in Chicago, Ill., to advance geriatrics knowledge and skills through state-of-the-art educational sessions and research presentations. For more information, visit Meeting.AmericanGeriatrics.org.