The 5Ts: Preliminary Development of a Framework to Support Inclusion of Older Adults in Research

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 67; no. 2; pp. 342 - 346
• Main Authors: Bowling, C. Barrett, Whitson, Heather E., Johnson, Theodore M.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2019; Wiley Subscription Services, Inc
• Subjects: 5Ts; Aged; Aged, 80 and over; Aging; Biomedical Research - legislation & jurisprudence; Biomedical Research - methods; communication framework; Female; Geriatrics; Geriatrics - legislation & jurisprudence; geriatrics research; Humans; inclusion of older adults; Life span; Male; National Institutes of Health (U.S.); Older people; Patient Selection; Researchers; United States; United States; inclusion of older adults; communication framework; geriatrics research; 5Ts
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.15785

Background/Objectives To address the underrepresentation of older adults in clinical research, the National Institutes of Health will require investigators to include individuals across the lifespan. As investigators from other fields endeavor to recruit participants who are more representative of the patient population, geriatricians may have the opportunity to influence a broad range of research studies in older adults. Our aims were to elicit challenges to inclusion of older adults in clinical research and to develop a preliminary framework for communicating these challenges to non–geriatrics‐trained researchers. Design Communication framework development. Setting Academic hospital and Veterans Affairs Medical Center. Participants Nongeriatrician researchers and staff, aging research experts. Measurements Interviews were used to elicit challenges nongeriatrician investigators and research staff experience when conducting research that includes older adults and then solicit experienced aging researchers' responses to these challenges. Results Challenges described by nongeriatrician investigators included lack of knowledge, rigid study structures, and a disease‐focused approach. Responses from our geriatrics experts included communicating practical advice for avoiding common pitfalls. Our resulting framework is the 5Ts: Target Population, Team, Tools, Time, and Tips to Accommodate. This tool complements the 5Ms (Mind, Mobility, Medications, Multicomplexity, and Matters Most to Me) model for geriatric care and emphasizes representation of the Target Population, building research Teams that include aging expertise, incorporating appropriate Tools for function and patient‐reported outcomes, anticipating Time for longer study visits, and accommodating common needs with practical Tips. Limitations include convenience sampling and lack of formal qualitative thematic analysis. Conclusion Communicating with nongeriatrician researchers using the 5Ts may offer a practical approach to avoiding barriers to inclusion of older adults in research and complements an existing framework for communicating the value of geriatric medicine. Next steps in developing the 5Ts will be to include additional stakeholders (eg, national samples of nongeriatrician investigators, older adults and their families) and evaluating the impact of its implementation. J Am Geriatr Soc 67:342–346, 2019. See related Editorial by George Kuchel in this issue.