Healthcare practitioners must be trained to collaborate in a dynamic environment where patients are complex and teams can change from day-to-day, but choosing the right measures to assess the effectiveness of interprofessional teamwork among learners is challenging. This study used measures representing four different perspectives to assess student teams in a practice setting where team composition varied each day. We tested the strength of the relationships between these measures, and we examined the impact of additional variables on each measure.
View Article and Find Full Text PDFNursing students participated in an interprofessional student-led prescription produce program (PPP) serving low-income older adults attending a community-based wellness and care coordination program. Students engaged in an online training module covering nutrition education and health promotion, integral components of a PPP. Ninety-five percent of students self-rated themselves as somewhat confident/very confident to participate in the PPP after completing an online learning module.
View Article and Find Full Text PDFIn many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults.
View Article and Find Full Text PDFHepatic xenobiotic metabolism and transport decline with age, while intact xenobiotic metabolism is associated with longevity. However, few studies have examined the genome-wide impact of epigenetic aging on these processes. We used reduced representation bisulfite sequencing (RRBS) to map DNA methylation changes in liver DNA from mice ages 4 and 24 months.
View Article and Find Full Text PDFBackground: Medication self-management capacity (MMC) is essential to safe and independent living. There is a need to understand the challenges low-income older adults face during the routine use of medications to promote safe medication use and healthy aging in place.
Objective: To assess the cognitive and physical deficiencies in MMC and the impact of using pharmaceutical aids/services on MMC among low-income older adults.
We explore the relationship between epigenetic aging and drug metabolism. We review current evidence for changes in drug metabolism in normal aging, followed by a description of how epigenetic modifications associated with age can regulate the expression and functionality of genes. In particular, we focus on the role of epigenome-wide studies of human and mouse liver in understanding these age-related processes with respect to xenobiotic processing.
View Article and Find Full Text PDFBackground: A growing body of research supports the negative impact of anticholinergic drug burden on physical frailty. However, prior research has been limited to homogeneous white European populations, and few studies have evaluated how anticholinergic burden tools compare in their measurement function and reliability with minority community-dwelling adult populations. This study investigated the association between anticholinergic drug exposure and frailty by conducting a sensitivity analysis using multiple anticholinergic burden tools in a diverse cohort.
View Article and Find Full Text PDFParticipation of Black American older adults in community-engaged research remains challenging in health sciences. The objectives of this study were to describe the specific efforts, successes, and challenges in recruiting Black American older adults in research led by the Health and Wellness in Aging Across the Lifespan core, part of the Virginia Commonwealth University Institute for Inclusion, Inquiry, and Innovation (iCubed). We conducted a cross-case analysis of 6 community-engaged research projects using the community-engaged research continuum model.
View Article and Find Full Text PDFImportance: Older age may be accompanied by changes in the pharmacokinetics or pharmacodynamics or both of medications that can result in altered safety and efficacy profiles.
Objective: To assess representation of older adults in clinical trials of new drug applications (NDAs) and biologics license applications (BLAs).
Design, Setting, And Participants: This cross-sectional study analyzed US Food and Drug Administration (FDA) data for NDAs and BLAs approved from 2010 through 2019.
Int J Environ Res Public Health
April 2022
A successful interprofessional faculty development program was transformed into a more clinically focused professional development opportunity for both faculty and clinicians. Discipline-specific geriatric competencies and the Interprofessional Education Collaborative (IPEC) competencies were aligned to the 4Ms framework. The goal of the resulting program, Creating Interprofessional Readiness for Complex and Aging Adults (CIRCAA), was to advance an age-friendly practice using evidence-based strategies to support wellness and improve health outcomes while also addressing the social determinants of health (SDOH).
View Article and Find Full Text PDFBackground And Purpose: The objective was to evaluate (1) students' knowledge in a variety of geriatrics competencies, (2) students' attitudes toward the value of interprofessional practice, and (3) pharmacy students' experiences after an advanced pharmacy practice experience (APPE) in a practice-based interprofessional education (IPE) model.
Educational Activity And Setting: Nursing, pharmacy, social work, and health sciences programs who participated in the Richmond Health and Wellness Program (RHWP) interprofessional experience received pre- and post-surveys to assess changes in geriatrics knowledge. An adapted Attitude Toward Health Care Teams Scale (ATHCTS) was used to assess changes in students' attitudes toward the value of interprofessional teamwork.
Changes that accompany older age can alter the pharmacokinetics (PK), pharmacodynamics (PD), and likelihood of adverse effects (AEs) of a drug. However, older adults, especially the oldest or those with multiple chronic health conditions, polypharmacy, or frailty, are often under-represented in clinical trials of new drugs. Deficits in the current conduct of clinical evaluation of drugs for older adults and potential steps to fill those knowledge gaps are presented in this communication.
View Article and Find Full Text PDFObjectives: Phase II drug metabolism is poorly studied in advanced age and older adults may exhibit significant variability in their expression of phase II enzymes. We hypothesized that age-related changes to epigenetic regulation of genes involved in phase II drug metabolism may contribute to these effects.
Methods: We examined published epigenome-wide studies of human blood and identified the SULT1A1 and UGT1A6 genes as the top loci showing epigenetic changes with age.
Curr Pharm Teach Learn
August 2021
Introduction: The Certificate in Aging Studies at Virginia Commonwealth University allows students to study gerontology while completing their doctor of pharmacy (PharmD) or graduate pharmaceutical sciences degree concurrently. The objective of the study was to evaluate alumni satisfaction with the Certificate in Aging Studies program, its application, and its perceived usefulness.
Methods: Alumni of the program (n = 49) were emailed an anonymous electronic survey about their perceptions of the program.
Background: Self-medication with over-the-counter (OTC) products is common among older adults. Although OTC self-medication is a convenient way to manage some health issues, older persons may be at higher risk of experiencing medication-related problems. This study examines the prevalence, practices, and preferences associated with OTC medication use in older adult residents of senior living communities.
View Article and Find Full Text PDFObjective: This study aims to determine whether current tobacco and/or alcohol use is associated with setting preferences for seeking support for substance use (SU) and mental health (MH) services to African Americans ages 50 and older.
Methods: Data from 368 African American individuals (aged 50+) who participated in a community-based needs assessment survey were used. Preferences included community-based (e.
As the population of older adults continues to grow, the need for health care professionals trained in the delivery of interprofessional care for older adult patients is critical. The purpose of this paper is to detail the outcomes of an interprofessional, geriatrics training program for healthcare professionals with a faculty appointment. Specifically, we gathered outcomes at four levels: reactions/satisfaction, learning, behavioral, and organizational.
View Article and Find Full Text PDFThere is a growing emphasis to use a transdisciplinary team approach to accelerate innovations in science to solve complex conditions associated with aging. However, the optimal organizational structure and process for how to accomplish transdisciplinary team science is unclear. In this forum, we illustrate our team's experience using transdisciplinary approaches to solve challenging and persistent problems for older adults living in urban communities.
View Article and Find Full Text PDFTo determine if student pharmacists' confidence in their knowledge and skills, and their attitudes toward older adults improved throughout pharmacy school with an integrated geriatrics didactic curriculum (years 1-3) and a final year of clinical training including a required advanced pharmacy practice experience (APPE) in geriatrics (year 4). A two-part voluntary anonymous survey was administered at three different time points to two large cohorts of student pharmacists. The first part of the survey assessed students' confidence in attaining geriatrics competencies.
View Article and Find Full Text PDFThe Richmond Health and Wellness Program (RHWP) is an innovative interprofessional care coordination program that seeks to support the health and wellness of independent-living older adults and educate future practitioners. Since 2012, RHWP has provided community-based interprofessional training to students at Virginia Commonwealth University. The sudden suspension of clinical and community-based training due to the COVID-19 pandemic created the need to transform the traditional ways students received clinical education and support the vulnerable communities served by RHWP.
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