Vol IX, Nov `04

The five group topics were:

• Anemia
• Dental and Oral Care
• Diabetes
• Urinary Incontinence/Overactive Bladder
• Unintended Weight Loss

A summary of the group discussions follows:

• The Anemia group discussed the need for a clinical practice guideline addressing anemia that could help avoid the increased use of invasive and expensive treatments without risk-benefit data. Participants addressed the value of an AMDA member survey to determine the scope of the problem and physician attitudes/knowledge. They suggested that a Delphi analysis be conducted to reach consensus on specific research questions.
  
• The Diabetes group considered how to be more specific about the data collected. Participants suggested a physician card survey of Research Network members and their colleagues. In addition to collecting demographic data, the survey will help identify treatments/medications being used, use of sliding scale insulin, finger stick monitoring, comorbidities, and other information regarding patients' diabetes.
  
• The Dental and Oral Care group reviewed a Request for Applications (RFA) already submitted to the National Institutes of Health (NIH). The group suggested tasks including a literature review, compilation of stakeholder input, and a prospective study to assess oral health practices in LTC and oral health status of patients in this setting. Group member Cari Levy, MD, CMD, suggested future activities could include a clinical practice guideline on oral assessment, care, and treatment, as well as a subsequent study to determine if guideline implementation improves oral care practices and outcomes.
  
• The UI group brainstormed how UI can be improved in long term care and discussed quality of life issues relating to the condition. Members agreed that it would be useful to look at physician attitudes about UI and how these impact treatment. They discussed how a survey to examine physician attitudes and knowledge might look and the possibility of an on-line pilot.
  
• The Unintended Weight Loss group functioned differently from the other groups, because these members had a preliminary proposal to review and consider. The group provided guidance on ways to structure the final proposal. Participants suggested that the study move forward and expressed hopes that it will answer questions beyond drug use to address this condition.

"Participating in these workgroups was an important part of the conference for me," said Anemia Co-Chair T.S. Dharmarajan, MD, FACP. "It provided an insider's look at how studies are developed, including the methodologies used and what obstacles might be present and how to overcome them," he explained. He added, "It was a unique opportunity to help determine what research questions we can address that would have the greatest impact on medical practice and patient care."