Yale Physician Receives National Award for Geriatric Patient-Oriented Research

Terri R. Fried, M.D., associate professor of medicine/geriatrics will be honored with the “Outstanding Scientific Achievement for Clinical Investigation Award” at the annual meeting of the American Geriatrics Society (AGS) May 17-21, 2004.

The award is designed to recognize particularly meritorious early career accomplishment by an investigator actively involved in geriatric patient care and health care problems of older adults.

Fried’s research is focused on understanding the preferences for care of older persons who are acutely and terminally ill. She has studied preferences for treatment site, the goals of care in terminal illness and physician-patient communication.

Fried will give a talk titled, “A Patient-Centered Approach to Shared Decision-Making in Advanced Illness,” describing her most important research accomplishments at the AGS Annual Meeting.

“Despite the efforts that have been put into the development of advance directives, they are rarely used and, with a few exceptions, they do not influence the care provided to patients,” says Fried. “One criticism of current approaches to advance care planning is that they are insufficiently patient-based.”

Fried’s research considers the perceptions of patients and caregivers about treatment decision-making and about physician communication. These perceptions are used to re-shape the discussion about patient treatment preferences. She said a central component of this effort is shifting discussion away from specific treatment interventions and toward patients’ treatment goals.

According to Mary Tinetti, M.D., Fried’s mentor, “Dr. Fried’s work is forcing physicians to look at clinical decision-making from a new and different perspective. Dr. Fried has found, first, that older patients vary in what goals are most important to them. Some want to live as long as possible while others want to be physically or cognitively functional, regardless how long they live. Second, patients are less interested in the treatments they are offered than in the outcomes that are likely to occur with these treatments.”

Fried’s lecture will highlight how these research efforts can inform clinical efforts to enhance a process of shared decision-making for patients with advanced illness.