Neuropalliative care research

University Of Washington, Seattle WA

Investigators

Abstract

The goal of this Midcareer Investigator Award in Patient-Oriented Research is to enhance the ability of Dr. Claire Creutzfeldt to train, mentor, and support the career development of clinician-scientists focused on developing and testing interventions to improve the quality of life, quality of care and quality of communication for patients with severe stroke and their families. Three quarters of all strokes occur in persons aged 65 years and older. Recent advances in acute stroke treatment have led to reduced morbidity and mortality, but also to an increased number of survivors, who, along with their family members, are faced with long-term challenges and unique, unmet palliative care needs including steep declines in quality of life, receipt of care that does not reflect patients’ values and preferences, and high rates of caregiver burden. In addition, a variety of social, economic, and regional characteristics appear to predict differences in who is more or less likely to receive life-sustaining treatment and access specialists in stroke or palliative care. Although the scope of the problems is well documented, there are few evidence-based interventions to improve patient outcomes. Solving this problem will require the collaboration of scientists with expertise in prognosis, communication and shared decision-making; aging research; and social determinants of health research. Dr. Creutzfeldt is extremely well positioned to lead these efforts. She is a midcareer investigator with a mature, NIH-funded program of research on neuropalliative care with a focus on stroke. She has an extensive track record of successful mentoring in patient-oriented research. She has assembled a team of senior scientists and collaborators to accomplish the proposed research and mentoring plan. She will increase her skills as a mentor and expand her scientific expertise by participating in targeted career development activities in mentoring, social determinants of health research, and communication and decision science. The scientific goal of this proposal is for Dr. Creutzfeldt and her mentees to use the existing data and infrastructure of her ongoing R01s to develop new lines of research exploring palliative care needs specific to severe stroke (Aim 1), and adapt known palliative care interventions and develop new ones specific to severe stroke to improve quality of life, enhance the receipt of goal-concordant care, and reduce caregiver burden after stroke (Aim 2). Aim 3 focuses on extending the reach of neuropalliative care interventions to ensure generalizability all people facing severe stroke. Together, these scientific aims and career development activities will expand Dr. Creutzfeldt’s ability to train the next generation of patient-oriented researchers in developing interventions to improve the quality of care and quality of life for patients with severe stroke and their family care partners.