Owoicho Adogwa, MD

How did you first find out about Clin-STAR and the pilot grant program?

I was recruited to UT Southwestern and arrived in January 2020. I knew for a longtime that I had an interest in aging research, however, I really didn’t know how to get started along this path. I was introduced to Una Makris(terrific mentor) in the spring of 2020 because of my growing interest in decisional aids for older adults and Una challenged me to look further upstream (and not just focus on decisional aids), and introduced me to Aanand Naik who has extensive experience in aging research, mentoring faculty and Patient Priorities Care. Dr. Makris thought felt that the Clin-STAR pilot grant program would be ideal for this research project, and introduced me to the grant mechanism.

What inspired you to pursue aging research and how does your perspective as a non-geriatrician specialist contribute to your research activity?

As a neurosurgeon with a focus on spinal disorders, I care for many older adults who suffer with chronic pain from spinal instability, progressive deformity or compression of neural structures. While some of these patients improve with our interventions(surgery), a subset do not. It became apparent to me that there was often a goal mismatch between the desired outcomes of the patients and surgeons, which was often a source of decisional regret and dissatisfaction with care received, and I wanted to change that.

It is my hope that the results of this study will provide tools that help surgeons improve their understanding of the decision-making process including a taxonomy of common treatment outcome goals and an understanding of what older adult patients are willing and unwilling to do. These findings can be disseminated to directly improve how surgeons approach this care

In your view, what does Clin-STAR mean to the field and what does it mean for you to receive a Clin-STAR pilot grant now?

It is an honor to be one of the recipients of the Clin-STAR pilot grant. Through this grant mechanism, I have been exposed to aging research and incredible mentors. It is wonderful to have a community of researchers from different specialties, all focused on improving outcomes in older adults. As an early stage investigator, the access that the Clin-STAR award/program provides to thought-leaders in aging research is invaluable.

The result of this project and others to follow could really shift on how we(surgeons) approach care of older adults. Over the next 40 years, 30%-40% of all surgeries would be performed on an older adult patient. Older adults often experience polypharmacy, reduced treatment tolerance secondary to frailty, and fragmented social support systems, making them older adults an especially vulnerable population. Furthermore, the increasing prevalence of multimorbidity and cognitive impairment in this patient population make decisions around treatment challenging for the healthcare team, as well as families/caregivers. Moving away from disease-specific guidelines to a more patient-centered model, where patient priorities, desired outcomes goals and health preferences drive the decisions around care can potentially improved treatment adherence, decreases treatment burden, healthcare resource utilization, and likelihood of conflicting recommendations.

What’s exciting about your research’s potential impact to your career, field, and patients?

The result of this project and others to follow could really shift on how we(surgeons) approach care of older adults. Over the next 40 years, 30%-40% of all surgeries would be performed on an older adult patient. Older adults often experience polypharmacy, reduced treatment tolerance secondary to frailty, and fragmented social support systems, making themolder adults an especially vulnerable population. Furthermore, the increasing prevelaenceprevalence of multimorbidity and cognitive impairment in this patient population make decisions around treatmemttreatment challenging for the healthcare team, as well as families/caregivers. Moving away from disease-specific guidelines to a more patient-centered model, where patient priorities, desiderddesired outcomes goals and health preferences drive the decisions around care can potentially improved treatment adherence, decreases treatment burden, healthcare resource utilization, and likelihood of conflicting recommendations.

How have you collaborated with your mentor or co-investigators?

We have weekly meetings to discuss progress on the specific aims of this proposal. We have also worked on other aging related projects, one of which has recently been submitted for publication.