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Groups Award $2 Million for Research to Improve Palliative Care of Seriously Ill Patients

The American Cancer Society and the National Palliative Care Research Center (NPCRC) are awarding $2 million in research grants to researchers at 12 institutions for studies aimed at reducing suffering for seriously ill patients and their family caregivers. The studies will be conducted over the next two years. Since 2007, a collaborative effort by the organizations has awarded 64 grants totaling almost $9 million. These grants, which are in addition to other grants in this area funded by the American Cancer Society, have brought much-needed research dollars to a field that has become an increasingly important part of patient care, but for which federal funding has been inadequate.

 
“One of the major barriers to improving the quality of life for people living with a serious illness like cancer has been the lack of research funding directed towards palliative care interventions.” said NPCRC Director R. Sean Morrison, MD, who is also professor of Palliative Care, Geriatrics and Medicine at Mount School of Medicine. “These grants from the NPCRC and American Cancer Society support research scientists who are advancing the field of palliative care.  The research findings from our grantees will help ensure that we eliminate impairments in quality of life that are all too commonly associated with serious illnesses like cancer.”
 
Palliative care focuses on relieving suffering and supporting the best possible quality of life for adults and children living with serious illness. It is a field comprising doctors, nurses, social workers, and other specialists who care for patients with chronic illnesses, functional impairment, and a high burden of family caregiving responsibilities. Palliative care is provided at the same time as all other appropriate medical treatments.
 
The collaborative initiative between the American Cancer Society and the National Palliative Care Research Center is designed to support clinician investigators conducting patient-oriented research in palliative care in hopes of bringing more funding from federal agencies, which have supported some research in palliative care, but for whom it is not a priority area. Pilot data results are typically needed before a federal agency will consider funding a research project. 
 
The 2011 Grantees:
 
NPCRC Pilot Project Support Grant Recipients
 
  • University of Washington - Ruth Engelberg, Ph.D. is a Research Associate Professor in the Division of Pulmonary and Critical Care, School of Medicine, and Co-Director of the End-of-life Care Research Program at the University of Washington. Dr. Engelberg will use a mixed-methods design to examine same-sex partners’ experiences as end-of-life decision-makers for decisionally-impaired patients dying in critical care settings.
  • University of California, San Francisco - Steven Pantilat, M.D. is a Professor of Medicine in the Department of Medicine at the University of California, San Francisco, the Alan M. Kates and John M. Burnard Endowed Chair in Palliative Care, and the founding Director of the UCSF Palliative Care Program. Dr. Pantilat will conduct a pilot randomized clinical trial to assess the impact if a comprehensive, interdisciplinary palliative care intervention provided concurrently with standard cardiology on depression, pain, anxiety fatigue, quality of life, satisfaction with care, and resource utilization among outpatients with Class II-IV heart failure compared to standard cardiology care alone.
  • University of California, San Francisco - Rebecca L. Sudore, M.D. is an Assistant Professor at the University of California, San Francisco. Dr. Sudore uses a new paradigm of advance care planning that shifts the focus from the pre-specification of life-prolonging procedures to preparing patients to communicate with their surrogates and to actively participate with clinicians in making the best possible in-the-moment decisions. Dr. Sudore will refine and test a preparation guide that includes communication-based skills training to improve engagement in advance care planning. 
 
American Cancer Society Pilot Project Support Grant Recipients
 
  • University of Utah - Lee Ellington, Ph.D. is an Associate Professor at the University of Utah. Dr. Ellington and her team will conduct a multi-phase study on home hospice nurse-family caregiver communication. The aims of the project are to identify hospice nurse communication behaviors which facilitate confidence and competence among family caregivers of cancer patients.  They will partner with experts in the field, hospice nurses and former family caregivers to gather foundational information on how to best support and empower caregivers. This project has the potential to open the “black box” of home hospice care, and inform future health care provider interventions which support family caregivers.
  • University of California, Irvine - Michelle A. Fortier, Ph.D. is an Assistant Adjunct Professor, Department of Anesthesiology and Perioperative Care; Licensed Clinical Psychologist at the University of California-Irvine. Dr. Fortier's project will address the significant gap in knowledge of pain management of children's cancer, the aims of this two-phase project involve development and implementation of a novel pain management intervention targeting parental management of children's pain using a mobile, innovative, tailored intervention program to be delivered in the pediatric oncology outpatient treatment area.
  • University of Massachusetts Medical School- Jennifer Tjia, M.D., M.S.C.E is an Assistant Professor of Medicine at the University of Massachusetts Medical School. Dr. Tjia will use a combination of qualitative interviews and quantitative medication assessments to understand how current approaches to patient-physician communication and interdisciplinary care coordination affect medication management of older patients with cancer. The goal of her work is to develop a structured approach to help reduce the burden of unnecessary medication use in older adults with life limiting illness.
  • Massachusetts General Hospital- William Pirl, M.D., M.P.H. is the director of The Center for Psychiatric Oncology and Behavioral Sciences at Massachusetts General Hospital. Dr. Pirl's project focuses on the timely topic of testing tumors for gene mutations (tumor genotyping), which guides the selection of chemotherapies for stage IV non-small cell lung cancer (NSCLC). The goal of this study is to examine relationships among tumor genotypes, levels of serum cytokines and growth factors, sleep disturbance, and depression in a sample of individuals with stage IV NSCLC.
  • University of Iowa - Michelle Weckmann M.D., M.S. is an Assistant Professor at The University of Iowa. Dr. Weckmann project will look at delirium - a distressing syndrome commonly seen in cancer patients. There is some evidence that delirium can be prevented and her study will explore the use of a medication used to treat delirium (haloperidol). In Dr. Weckmann's study, haloperidol will be given prophylactically (before delirium develops) to cancer patients who are admitted to the hospital for a bone marrow transplant to determine if it is well tolerated and if it will prevent delirium from developing.
 
NPCRC Junior Faculty Career Development Award Recipients
 
  • Harvard Medical School/Dana-Farber Cancer Institute - Tracy A. Balboni, M.D., M.P.H. is an Assistant Professor in the Department of Radiation Oncology at Harvard Medical School and an Associate Physician in Radiation Oncology at the Dana-Farber Cancer Institute. Dr. Balboni will examine how specific advanced cancer patient religious/spiritual beliefs and attitudes influence patient quality of life near death and medical care received in the final month of life. This research will inform the development of a spiritual care intervention aiming to improve patient well-being and to assist patients in avoiding futile, aggressive therapies near death.
  • University of Southern California - Susan Enguidanos, M.P.H., Ph.D. is the Hanson Family Assistant Professor of Gerontology at the University of Southern California, Davis School of Gerontology. Dr. Enguidanos will use mixed methods to study 30 day hospital readmissions among palliative care patients.  Characterizing the specific problems encountered by seriously ill patients and families following hospital discharge and palliative care consultation will inform the efforts to improve continuity of care and support the patient’s longitudinal palliative needs.
  • Bronx VA Research Foundation - Melissa M. Garrido, Ph.D. is a Research Health Science Specialist with the James J Peters VA Medical Center and an Assistant Professor in the Brookdale Department of Geriatrics and Palliative Medicine at the Mount Sinai School of Medicine. Dr. Garrido’s current research focuses on mental health care access and quality for individuals receiving palliative care. The research goals of her project are to examine whether depression and anxiety affect likelihood and timing of palliative care consultations for veterans with life-limiting illnesses, and to identify patient and provider characteristics that are barriers to and facilitators of mental health assessment during palliative care consults and to receipt of depression/anxiety treatment following consults.
  • Indiana University - Kathleen Unroe, M.D., M.H.A. completed internal medicine residency and geriatrics fellowship at Duke University Medical Center and the Durham VA GRECC and is joining the faculty at Indiana University as an Assistant Professor (July 2011).  Dr. Unroe will examine the role of hospice in the nursing home setting using secondary data analysis to describe characteristics of nursing home patients who elect hospice, differences between nursing home and home hospice patients, and differences in the experiences of nursing home patients who die without hospice vs. those who do use hospice.
  • Dartmouth Medical School – Anna-leila Williams, Ph.D., P.A., M.P.H. will join the Dartmouth Medical School faculty July 2011 as an Instructor in Anesthesiology (Palliative Medicine). Dr. Williams’ project will evaluate the associations between preparation for a death and what the caregiver witnessed during the illness and dying process with prolonged grief disorder. Dr. Williams intends to use the results from her project to inform the development of an intervention study aimed at decreasing the risk for Prolonged Grief Disorder among family caregivers.  
 
Further details about the NPCRC and ACS 2011 Grantees and their research projects are available at http://www.npcrc.org/grantees/
 
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The American Cancer Society combines an unyielding passion with nearly a century of experience to save lives and end suffering from cancer. As a global grassroots force of more than three million volunteers, we fight for every birthday threatened by every cancer in every community. We save lives by helping people stay well by preventing cancer or detecting it early; helping people get well by being there for them during and after a cancer diagnosis; by finding cures through investment in groundbreaking discovery; and by fighting back by rallying lawmakers to pass laws to defeat cancer and by rallying communities worldwide to join the fight. As the nation’s largest non-governmental investor in cancer research, contributing more about $3.4 billion, we turn what we know about cancer into what we do. As a result, more than 11 million people in America who have had cancer and countless more who have avoided it will be celebrating birthdays this year. To learn more about us or to get help, call us any time, day or night, at 1-800-227-2345 or visit cancer.org.
 
The National Palliative Care Research Center (NPCRC) promotes evidence-based palliative care research in order to improve the care of patients with serious illness, and their families. The NPCRC was established in July 2005 with a grant from the Emily Davie and Joseph S. Kornfeld Foundation and has received subsequent funding from the Olive Branch Foundation, Brookdale Foundation, American Cancer Society, American Academy of Hospice and Palliative Medicine, Betty and Norman F. Levy Foundation, Y.C. Ho/Helen and Michael Chiang Foundation, National Institute on Aging, U.S. Cancer Pain Relief Committee, American Express Foundation, Mill Park Foundation, Hospice and Palliative Nurses Association, LIVESTRONG, Hearst Foundations, Lord Foundation, and the Atlantic Philanthropies and The Open Society Institute—both providing funds through the Partnership for Palliative Care. Located in New York City at Mount Sinai School of Medicine, NPCRC works in partnership with the Center to Advance Palliative Care. For more information call 1.212.242.7447 or visit www.npcrc.org.