Research and innovation
Research and innovation are extremely important within geriatric medicine, and take different forms. Despite being the majority users of healthcare services, procedures and medications, older people are often excluded from clinical research. As a specialty, we want to get them more involved. We advocate for trials to have a pragmatic design with a real-world study population, where results can be applied to the frail older people we see regularly in clinical practice. The Silver Paper (opens PDF, 137.78KB) is a position statement agreed by the European Union Geriatric Medicine Society in conjunction with other European bodies interested in ageing. This provides an agenda for priority areas for development in healthcare for older people, emphasises the need for research that is both interdisciplinary and translational, and highlights the need to include older patients in clinical trials.
The Centre for Policy on Ageing review also addresses the need for the inclusion of older people in clinical research. There are a number of well-established academic departments in geriatric medicine that provide leadership in various fields of ageing research. The British Geriatrics Society is joint publisher of the well-respected international journal, Age and Ageing (impact factor 4.201).
Recent innovations include an electronic frailty index that can be applied to health records, expansion of trial evidence for CGA (comprehensive geriatric assessment) into further subspecialty areas, and evidence for effectiveness of new models of integrated care with older orthopaedic patients.
There is a growing enthusiasm for quality improvement work with a focus on systems, flow and service reorganisation to allow us to provide the best quality care while acknowledging differences between care service provision in geographical areas. The Frailsafe collaborative is exploring the use of checklists to ensure quality of care for frail older people admitted to hospital.
Doctors undertaking their higher specialist training in geriatric medicine are encouraged to carry out research in a form appropriate for their professional development. This could take the form of a formal research out-of-programme experience (OOPE), a taught masters or a quality improvement fellowship.