Issues and priorities for research in geriatric pharmaceutical care.

Abstract

Research on aging is clearly a topic that has a high priority for practitioners, educators, scientists, policymakers, and granting agencies. At issue is the question of whether life expectancy (approximately 70 years) can move toward life span (approximately 100 years), while maintaining an adequate quality of life. A related question is whether population segments can or should expect parity in the quantity and quality of life. For example, female life expectancy is nearly six years greater than male life expectancy. Is this an immutable law of nature, or is it an unnecessary sentence of early death for males? A massive commitment to research will be needed to discover the answers. Pharmacists involved in a research agenda for aging must recognize the fact that virtually all problems in aging involve multiple causes and effects. Questions of pharmaceutical care require a consideration of behavioral, biomedical, and health services issues. Even within such a relatively narrow area as pharmacokinetics, the contributions of other disciplines or professions are necessary to conduct effective research. One conclusion to be reached from this is that research in aging is an interdisciplinary activity which requires a team approach. Although some important studies can and should be initiated with pharmaceutical care as a primary focus, most studies will have a medical care focus and possibly a pharmaceutical component. The most accessible route to participation in research seems to exist for the pharmaceutical scientist who can advocate his contribution within the context of total patient care needs. If that can be accomplished, the individual will likely be able to interact with other disciplines having a similar orientation. The dynamics of problem identification, proposal writing, and research activity can then be supported by a group process which aggregates and coordinates individual expertise. Quite obviously, this can best occur within an environment where scientific resources, patient populations, and practice settings are in close proximity. A clear trend is the evolution of “institutes” or “centers” for research on aging at academic health centers and universities. These mission-oriented research units provide a valuable resource for the pharmaceutical scientist who has an interest in research on aging. Persons who have access to such a unit should think of it as a point-of-entry which can maximize their individual contributions. Individuals who do not have access to such a unit should strive to cultivate relationships with their colleagues who can focus on patient care needs of the elderly. Research on aging is sponsored by numerous federal agencies, including the National Institute of Aging, National Center for Health Services Research, Health Care Financing Administration, and Veterans Administration. Various foundations, labor groups, insurance programs, and other nonprofit agencies also contribute substantial support. Research support is likely to increase at a rapid pace in the coming decade. Several important contributions have already been made by pharmaceutical scientists; others are currently underway, and prospects for future contributions are bright. New ideas and scientists continue to be needed to help amass knowledge on the aging process.