Celebrating Donaghue Grantees

We are delighted to celebrate the achievements of several of our grantees. These individuals have demonstrated a commitment to advancing medical research and healthcare, and their recent accomplishments reflect the impact of their work. We want to shine a spotlight on some of their contributions. Join us in congratulating these researchers and their endeavors.

Nadine Jackson McCleary, MD, MPH
Dana-Farber Cancer Institute

Meet our latest R3 grantee, Dr. Nadine McCleary, dedicated to enhancing cancer patient care through her research. Our R3 grant program is designed to assist researchers in readying their health interventions for real-world use by supporting the expansion, dissemination, and implementation of their research. McCleary’s original Donaghue-funded project focused on providing patients with advanced breast or gastrointestinal cancer tools to manage symptoms while on oral cancer-directed therapy (OCDT). The team successfully integrated an electronic patient-reported outcomes (ePRO) tool into the Dana-Farber electronic medical record, showcasing the feasibility and acceptance of the tool among patients utilizing OCDT. However, gaps were identified in proactive management and understanding the impact on adherence.

Building on the success of her previous Donaghue-funded project, the team aims to implement proactive symptom management for patients undergoing oral cancer-directed therapy (OCDT). They will work with clinical nurse navigators to develop a standardized workflow, allowing timely triage and response to moderate-severe symptoms using electronic patient-reported outcomes (ePRO). The project aligns with institutional commitment to symptom management, leverages a partnership with the Nurse Track and React (NURTuRe) project, and utilizes specialty pharmacy data to enhance medication adherence understanding.

With the proposed project, McCleary anticipates an enhanced symptom management workflow, improved patient adherence, and a 25% increase in heuristic usage. The team’s commitment to equity is evident, with efforts to offer SymAE PROMs tools in multiple languages and engage interpreter services — ultimately aiming to provide timely and high-quality symptom management for all patients. We are proud to support this innovative project, which has the potential to revolutionize cancer patient care and enhance their quality of life during treatment. This research has the potential to revolutionize cancer care and improve patients quality of life during treatment.

Mark D. Neuman, MD, MSc
University of Pennsylvania

“Transforming Perioperative Medication Practices: The Power of EMR Alerts and Education for Better Patient Care”

We are excited to feature research facilitated by one of our Greater Value Portfolio grantees in this newsletter. Neuman’s Donaghue-funded research intended to produce definitive and immediately actionable information that will accelerate the de-adoption of a widespread, low-value practice. Neuman’s research, published in the September 2023 edition of The British Journal of Anaesthesia (BJA), addresses the significant concern of administering benzodiazepines to elderly patients during anesthesia. The team implemented a comprehensive intervention, combining clinician education and an automated electronic medical record (EMR) alert, to discourage benzodiazepine use in patients aged 70 years and older.

Analyzing data from over 20,000 cases, the study demonstrated a significant 3.2 percentage point reduction in midazolam administration to older adults after implementing the intervention. Remarkably, the impact extends to patients aged 18 to 69 years of age, indicating the intervention’s wider reach. This study underscores the potential of EMR alerts coupled with education to drive evidence-based decision-making and enhance patient care. By influencing anesthesia practices, this intervention not only promotes patient safety but also paves the way for improved medical decision-making in healthcare settings.

While these findings are promising, further research is needed to assess the intervention’s applicability and its impact on patient outcomes. Nevertheless, this study represents a significant step forward in perioperative medication practices, aligning with the Greater Value Portfolio grant opportunity’s mission to advance innovative approaches for a higher-value healthcare system.

Jeffrey E. Stokes, PhD, and Danielle Waldron, PhD
University of Massachusetts Boston

“New Research Sheds Light on Preventive Healthcare Screening for Adults with IDD”

We are excited to share the latest findings from a study conducted by two of our Another Look grantees, which investigates the completion of preventive healthcare screenings among midlife and older adults with intellectual and developmental disabilities (IDD). Our Another Look grant program provides funding for health-related research that has the near term potential to improve health, well-being, and the quality and equity of care for older adults in long-term care facilities.

Individuals with IDD often encounter barriers to accessing healthcare, leading to lower rates of preventive health screenings than the general population. The study analyzed data from the National Core Indicators In-Person Survey (NCI-IPS) in 2012-2013 and 2018-2019 to examine individual and state-level factors associated with mammogram and colonoscopy screenings for adults with IDD receiving state services. The key findings indicate that living situations, transportation access, and community involvement significantly impact the likelihood of completing preventive screenings. More specifically, adults with IDD living with family are less likely to receive breast and colon cancer screenings in mid- and later life, suggesting the need for targeted interventions for this group. Improving transportation access and encouraging community engagement can help break down barriers to healthcare and promote better health behaviors among adults with IDD.

The study also highlights the role of Medicaid expansion, which was associated with an increased likelihood of completing colonoscopy screenings, particularly among younger individuals (in their 50s). While individual factors appear to have a more significant impact on screening completion than state-level factors, the research emphasizes the importance of considering both to design effective interventions. By addressing transportation access, community involvement, and living situations, we can enhance preventive healthcare usage and improve health outcomes for adults with IDD. These findings have the potential to inform policy changes and shape future research efforts to ensure equitable healthcare access and preventive screening for individuals with IDD.

We are proud to acknowledge their continued commitment to uphold the Another Look grant program’s goal of addressing high priority issues affecting older adults in nursing homes and other long-term residential care facilities.

Donaghue Grantees in the News

David Grabowski, PhD
Harvard University

Source: The New York Times “How Nursing Homes Failed to Protect Residents From Covid”, August 19, 2023

Donaghue Another Look grantee David Grabowski recently spoke with The New York Times about the challenges faced by nursing homes during the COVID-19 pandemic. Grabowski’s Donaghue-funded research provided the first large-scale evaluation of a Medicare Advantage plan’s potential to improve outcomes of nursing home residents by increasing clinical presence through the utilization of nurse practitioners. This research aimed to address the issue of limited primary care access for long-stay nursing home residents. The article revealed the grim reality of nursing homes, receiving a disappointing “D” grade for their pandemic performance. During the pandemic, these facilities witnessed over 167,000 resident deaths and 3,100 staff casualties. Shockingly, less than 20% of nursing home residents with COVID-19 received antiviral treatment between May 2021 and December 2022. Additionally, just a quarter of infected residents were provided antiviral medications, while 40% of nursing homes reported zero antiviral usage. The situation was further aggravated by shortages of protective equipment, testing delays, visitor restrictions, and a staffing crisis. While experts like Grabowski call for vital improvements like enhanced ventilation systems, transitioning to private rooms, and consistent staffing, these changes necessitate increased investment and federal oversight. Congratulations to David for his ongoing dedication to realizing the core mission of our Another Look grant program: improving health, well-being, care quality, and equity in long-term care for residents aged 65 and older.

Becca Levy, PhD
Yale University

Source: The Washington Post “Negative thoughts about aging can be harmful”, August 17, 2023

Donaghue-grantee Becca Levy was recently featured in The Washington Post highlighting age bias, particularly internalized ageism, which affects emotional and physical well-being. As a previous Donaghue Investigator and an R3 grantee, Levy’s work focused on positively impacting older individuals’ views on aging and, subsequently, enhancing their well-being on a larger scale. Over 80% of those aged 50-80 subscribe to ageist stereotypes. Levy’s research offers hope, showing that changing age beliefs has immediate and lasting benefits, such as improved memory, reduced stress, and better physical health. Those with positive age beliefs tend to live longer and have a lower risk of dementia. Internalized ageism leads to reduced motivation for health maintenance, premature retirement, and higher susceptibility to heart disease and stroke. Levy’s three-part strategy to combat this includes recognizing ageism, shifting blame from age to ageism, and challenging anti-aging messages for healthier and more positive aging experiences. Becca Levy’s research efforts continue to align with the mission of the Foundation’s R3 grant program to promote knowledge created from research to improve health.