Research in the Division of Geriatric Medicine occurs in partnership with multiple Centers, Institutes, Divisions, Departments, and Schools at UNC. Our faculty are Principal Investigators on research grants aimed at bringing critical evidence-based findings into healthcare practice to improve the care of older adults.
Alzheimer’s Disease and Related Dementias
Dementia Friendly Hospital Initiative
Through a 2018 grant from the Duke Endowment, the Division launched a ground-breaking program to transform hospitals into dementia-friendly centers of care. The Duke Endowment-funded Dementia Friendly Hospital Initiative program brings comprehensive dementia-friendly training to four UNC Healthcare Hospitals and serves as a blueprint for program expansion both regionally and nationally. UNC Hospitals Hillsborough Campus is the pilot site for hospital-wide training of all staff and clinicians who interact with patients with dementia.
Deprescribing in Older Nursing Home Residents with Dementia
Joshua Niznik, PharmD, PhD, is developing a research program focused on evaluating quality of prescribing and deprescribing medications that may no longer have value in nursing home residents with severe dementia. Dr. Niznik’s program of research has resulted in a number of publications in interdisciplinary collaborations with other UNC investigators including Dr. Laura Hanson (Geriatrics), Dr. Carolyn Thorpe, and Dr. Joshua Thorpe (Division of Pharmaceutical Outcomes and Policy).
Dr. Niznik is currently pursuing an NIA-funded career development award that will examine qualitative perceptions, clinical outcomes, and cost-effectiveness of deprescribing osteoporosis medications in nursing home residents. This project will bring together investigators from the UNC School of Medicine, The Eshelman School of Pharmacy, and the Gillings School of Public Health to generate additional evidence to optimize medication use in older nursing home residents.
Dr. Niznik was awarded pilot funding from the US Deprescribing Research Network (USDeN) for his proposal on “Deprescribing Bisphosphonates in Nursing Home Residents with Dementia”. The 1-year award will develop operational definitions for identifying deprescribing of bisphosphonates using Medicare administrative data and evaluate patterns and factors associated with bisphosphonates deprescribing in older nursing home residents with dementia. The study team will also engage with a stakeholder group of nursing home providers and residents/caregivers to disseminate findings.
Carolina Geriatric Workforce Enhancement Program
Through our HRSA-funded Carolina Geriatric Workforce Enhancement Program (GWEP) grant, Division faculty along with Center for Aging and Health staff have disseminated Geriatrics research and best practices for the care of older adults to 30,000 healthcare providers and 31 rural and underserved primary care sites across North Carolina. Additionally, UNC’s CGWEP program has been awarded a 2015 supplemental grant for Alzheimer’s Disease and Related Dementias to train health care providers in dementia care.
In 2019 HRSA funded UNC and the Center for Aging and Health as North Carolina’s primary site for the GWEP program. This latest award will continue to integrate geriatrics throughout the health care workforce and implement training to improve dementia care, increase rates of advance care planning, target chronic opioid use, and lower both falls rates and rates of uncontrolled diabetes.
Primary Care Clinicians’ Communication Skills in Dementia Palliative Care
With funding from the Gordon and Betty Moore Foundation, Chrissy Kistler, MD, and Laura C. Hanson, MD, are Co-Principal Investigators for a 2-year project on Improving Primary Care Clinicians’ Communication Skills in Dementia Palliative Care. Advance care planning decisions are particularly challenging in the context of Alzheimer’s disease and related neurodegenerative dementias, diseases that lasts for years, yet affect cognitive and communication abilities early in the disease course.
This project addresses the gap in dementia-specific advance care planning and medical treatment decisions for clinicians who provide primary care through the use of 4 video-based advance care planning scenarios and an accompanying training toolkit. Trained clinicians will be assessed for actual application of these skills in their clinical encounters, and the training modules will be disseminated through collaboration with Vital Talk.
Division Chief Dr. Jan Busby-Whitehead is Co-Investigator and Dissemination Task Force Co-Leader for the NIA’s Network for the Investigation of Delirium: Unifying Scientists (NIDUS). NIDUS gathers data on all delirium research, grants, and studies worldwide, and advocates to advance delirium research and understanding.
Dr. Adrian Austin (MD, MCSR) is a delirium researcher who is dually board certified in Geriatric Medicine and Critical Care / Pulmonary Medicine. He has two pilot projects on delirium: a tablet-based delirium assessment tool for home use and a pharmacogenomic study of dose and response variability among mechanically ventilated ICU patients.
Opioids and Deprescribing
Opioids and Falls Risk | Falls Prevention
Stefanie Ferreri, PharmD, Vice Chair of the Division of Practice Advancement and Clinical Education at the UNC Eshelman School of Pharmacy and Geriatric Medicine Division Chief Jan Busby-Whitehead, MD, are co-Principal Investigators of a CDC-funded grant on screening older adults who use prescription opioids and are at risk for falls. The study will engage patients within the UNC Health Care system who are 65 years and older and taking either an opioid or benzodiazepine, with the objective of implementing a de-prescribing protocol to decrease falls risk.
Dr. Ferreri also led a 2016 CDC-funded grant on implementing an integrative falls prevention program for which Dr. Busby-Whitehead is a Co-Investigator.
CGWEP and Opioids Addiction
Carolina Geriatric Workforce Enhancement Program grant also included 2018 funding to study opioid addiction in older adults.
Collaborative Oncology Palliative Care Model
Palliative Care for Stage IV Cancer: With funding from a Tier 2 Clinical / Translational Award from the UNC Lineberger Comprehensive Cancer Center, Laura Hanson, MD, MPH, and other Geriatrics, Palliative Care and Oncology faculty have developed and begun testing a collaborative palliative care model for patients with Stage IV cancer. The research tests an innovative approach to support continuity of care between inpatient and outpatient providers and facilitate efficient and targeted use of specialty Palliative Care.
T-32 | Cancer and Older Adults
The UNC Geriatric Oncology Training Program (UNC-GO) is a T32 training application specifically focused on training physicians (MDs, DOs) in clinical/translational and/or health services research at the interface of Geriatrics and Oncology. The central component of UNC-GO training is the mentored research experience with trainees choosing between two research tracks that represent the best research areas that UNC has to offer: clinical/translational and health services research. Under the guidance of the mentoring team, trainees design and conduct one or more independent projects.
Dr. Hyman Muss, Vice Chair of Hematoloy/Oncology and Dr. Jan Busby-Whitehead, Geriatric Medicine Division Chief, are Co-Principal Investigators and lead the Geriatric Oncology Program, which trains fellows in Medical Oncology and Geriatric Medicine through several pathways.
T-35 | MSTAR
UNC’s Division of Geriatric Medicine is one of seven national training centers for the Medical Students Training in Aging Research (MSTAR) program. The National Institute on Aging (NIA) sponsors this program to connect medical students with mentored research opportunities and academic experiences to advance their knowledge of aging and expose them to broad possibilities for basic science, clinical, and health services research.