IOA Visiting Scholar Series: Dr. Jerry Avorn & Tom Snedden discuss “Improving Physician Prescribing Practices and Medication Policy”

Last week, Penn’s Institute on Aging welcomed Jerome “Jerry” Avorn, MD, Professor of Medicine, Harvard Medical School, and Chief, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital, and Tom Snedden, Director of the Pennsylvania PACE Program, for their Visiting Scholar lecture series.

Their discussion, titled “Improving Physician Prescribing Practices and Medication Policy”, revolved around the importance of ensuring that seniors are receiving the appropriate care and treatment to better their lives, as well as their ability to do so in an affordable way.

Snedden and Avorn have dedicated, and continue to dedicate, a great deal of their time to collaborate in a way that makes this all possible. Dr. Jerry Avorn is behind the Alosa Foundation, a non-profit organization who works together with the PACE program to make sure that seniors are gaining access to the correct medications in the correct dosages. Throughout his talk, Avorn reveals that the problem is not only that patients are being prescribed medications that may not be the most beneficial for their circumstance, but that we are also dealing with the issues of overprescribing as well as under-prescribing.

Among the many drugs mentioned by Dr. Avorn, he explains that one of the most generally overprescribed drugs, bisphosphonates, commonly used to treat osteoporosis and other similar diseases, are also one of the most under-prescribed in patients who really do need it.

Though there are many reasons that this is happening, Dr. Avorn attributes it in part to the idea that drugs are being used in ways that were never expected in clinical trials, both by patients and doctors alike. One also has to keep in mind that it is nearly impossible to stay entirely up to date with any and all new information regarding prescription medication as soon as it comes out. The truth of the matter is, “a primary care physician would have to spend 12 or more hours/week to stay current on all relevant literature,” said Dr. Avorn.

The Alosa Foundation/PACE collaboration of “academic detailing” is Avorn and Snedden’s hope to find a solution to this problem. Their idea is that by using this “service-oriented outreach education” a model, we can improve the flow of effective communication between the pharmaceutical industry and health care providers.

As stated by the Alosa Foundation, this model “uses specially trained clinical educators who meet one-on-one with physicians, nurse practitioners, and physician assistants (at their practice locations), to discuss the most recent clinical data on a particular primary care topic. This approach provides an effective and convenient way for providers to stay up-to-date on the latest clinical research findings, with the ultimate goal of improving prescribing decisions and patient care.”

For more information on the Alosa Foundation, click here.

For more information on the Pennsylvania PACE program, click here.

Looking Closely at a Drug Aiming to Improve Longevity

The Institute on Aging’s annual Joseph A. Pignolo, Sr. Award in Aging Research was presented recently to Joseph A. Baur, PhD, assistant professor of Physiology and member of Penn’s Institute for Diabetes, Obesity, and Metabolism. Created by geriatrician and gernontologist Robert J, Pignolo, MD, PhD, in honor of his father, the award honors the best scientific research publication on biogerentology in the previous year, and is accompanied by a lecture by the paper’s author.PignolBaur_2013_1 of 11

After careful review, the award was given to a Penn researcher for the first time. Dr. Baur co-authored a paper in Science looking at separate effects caused by the drug rapamycin, and in his talk last week, provided a nuanced perspective on how scientists could consider designing a targeted intervention to help people age successfully.

Rapamycin has been shown to expand the lifespan of mice, but with unwanted side effects: diabetes, high triglycerides and a heightened risk of cardiovascular events. His work has helped deduce how those side effects have happened, shining a light on two separate pathways that are rapamycin inhibits: mTORC1 and mTORC2.

Throughout his talk, Dr. Baur examined how disruption to mTORC2 causes insulin resistance, while inhibiting mTORC1 improved health. He noted that, if mTORC1 could be inhibited while leaving mTORC2 alone, there may be positive benefits on diseases from Alzheimer’s to rare mitochondrial diseases.

To watch his talk in its entirety, it’s now available online (to view the video, a Silverlight plugin is required).

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CNDR Fellow Receives Top Prize at National Udall Meeting

Jing Guo, PhD, a post doctoral fellow in the Center for Neurodegenerative Disease Research, recently received an honor at the National Institute of Neurological Disorders and Stroke (NINDS)’s national meeting of all the Morris K. Udall Centers of Excellence for Parkinson’s Disease Research. She presented recent work from the Penn Udall Center showing how one disease protein can morph into different strains of aggregates and promote misfolding of other disease proteins commonly found in Alzheimer’s, Parkinson’s and other related neurodegenerative diseases, which was published in Cell on July 3rd this year. The poster presentation prompted a lot of questions and conversation among the researchers in attendance, earning her poster 1st prize among other posters from Udall Centers around the country.

The work is being carried on within the lab, where the neuropathology team is looking into the presence of pathological strains in human brains.

Guo is renewing her focus on the tau protein, hoping to establish a sporadic model of tau disease. “My goal is to make [the induction of tau pathology] work in a wild type context, as that would be a better model for sporadic diseases,” said Guo. “Our hypothesis is that maybe we haven’t been using the right strain of pathological tau that is infiltrating human brains.”

Ware Retreat Brings International Transmission Experts to Debate Neurodegenerative Disease Progression

In a stellar meeting of the minds, the annual Marian S. Ware Neurodegenerative Disease Research Retreat took on a timely topic this year – the transmission of neurodegenerative disease pathologies – and brought some of the brightest researchers in the field together to debate commonalities and differences between diseases.CNDR Retreat 3

“It’s an exciting time to get everybody together because there are so many things to discuss and share,” said event chair Virginia Lee, PhD, MBA, director of the Penn Center for Neurodegenerative Disease Research.

Congressman Chaka Fattah (PA-02) was on hand for the symposium, and met with the presenters during the poster session.

CNDR Retreat 1 Throughout the day, world leaders in prions, amyloid-beta, tau and alpha-synuclein transmission spoke about their understanding of how various strains pass from other cells while causing damage along the way.

At the end of the day, the group debated whether the diseases were all “prion-like,” with many arguing that they were not similar enough, even though there were some commonalities between the proteins, to call them all prion-like. The group discussed practical implications, such as issues with stigma associated with infectious prions, causing many in the group to pause and concede that perhaps a new term needed to be developed all together.

Penn Community Comes Together for 2nd Annual 5K for the IOA and Memory Mile Walk

It was a perfect fall morning – sunny and 62 – for the second annual Penn 5K for the IOA and Memory Mile Walk on September 22, 2013. Nearly 300 walkers and runners, ranging from 3 years old to 90 years old, turned out some fast times on the new race course through Penn Park, with skyline views of Center City.

_db17305 _db17330  “Despite cuts in federal research support, we have a responsibility to continue age-related research as baby boomers head towards retirement and seniors are living well into their 90s and 100s,” said race organizer P.J. Brennan, MD, chief medical officer of the University of Pennsylvania Health System and an Institute on Aging advisory board member. “Exercise is important as we age. We could prevent 10,000 cases of Alzheimer’s in Pennsylvania alone if 10 percent of the population reduced hypertension, diabetes, obesity, inactivity, smoking, and depression.”_db17705

This year’s winning times came from runners with a variety of Penn and Penn Medicine connections. The overall top male, Eric Chappelle, who works in the gene therapy lab of Jim Wilson, finished in 18:57. The overall top female, Zandra Walton, is a third year Perelman School of Medicine MD/PhD candidate in her first year of graduate work focusing on cancer biology. Zandra, whose grandmother died of Alzheimer’s disease, won the female category last year, and turned in a time of 20:17 this year.

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Other top finishers in the age groups came from Penn Medicine’s Anesthesia department, the Penn Memory Center, Penn Nursing, the Penn Center for Neurodegenerative Disease Research, the Clinical Effectiveness and Quality Improvement department, the department of Medicine, a Penn Neurosurgery traumatic brain injury survivor, and undergraduates from the University’s  College of Arts and Sciences, Liberal and Professional Studies, and Wharton School. A recent addition to Penn Medicine family, Richard Donze from the Chester County Hospital and Health System, the newest member of the University of Pennsylvania Health System, also placed in his age group.

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5K race results are available online through Pretzel City Sports, and photos are available from Daniel Burke Photography.

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All proceeds from the event help further research at the IOA for the treatment and care of patients with Alzheimer’s, neurodegenerative and other age-related diseases. Last year’s race proceeds went to the Pilot Research Grant Program, to support researchers entering the field and to stimulate multi-disciplinary projects exploring new directions in the field of aging.

The day wouldn’t have been possible without a cadre of volunteers and supporters, who ensured the race went off without a hitch.

Institute on Aging director John Trojanowski, MD, PhD, concluded the morning by thanking participants, volunteers, organizers and supporters for raising important funds to continue research on age-related diseases like Alzheimer’s, Parkinson’s and other neurodegenerative diseases.

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