Victoria Yeh: Stepping into the Lab, Patients' Lives BACK

Published by AFAR

I am currently involved in two different projects – I am collecting and organizing data for a study on the cognitive status of patients with heart failure and their adherence to medications, and doing data analysis for a study on injuries and illnesses that occur in patients with cardiovascular problems. Both research projects aim to answer questions about patients’ ability to adhere to their treatment regimens for heart disease. For some patients this can be very difficult, and one of the important questions I’ll be looking at is whether it is even more difficult for patients as they get older.

To start off my research, I spent some time doing a literature search to see what others have found in studies on adherence to treatment and exercise. I learned a lot about the different factors that make it difficult for patients to take their many medications, as well as the factors that influence a patient’s ability to exercise after a cardiovascular event. I’m beginning to gain a deeper appreciation of the challenges experienced by elderly patients with heart problems - remembering the dosage and timing of numerous medications (including ones that are unrelated to their heart problems), difficulty accessing or obtaining their medications, trying to exercise despite aching muscles, arthritis, and symptoms such as shortness of breath, and having to deal with multiple co-morbidities. I think these are all important factors to keep in mind when I treat my elderly patients in the future, and using this knowledge, I will try my best to help them work around these problems to maximize the effectiveness of their treatments.

I also went on data collection visits with the research team to see patients in their homes. During the visits, the patients were given tests to evaluate their cognitive function and knowledge of heart failure. Since I was new to the study, I mostly observed while the tests were being performed, and counted the patients’ different types of pills to track how many they’ve taken. The patients also have high-tech pill boxes that track the number of times they open the box throughout the day, as well as scales that are used to record their weight. I’m beginning to discover that medication adherence is a very difficult subject to research – it’s hard to account for what happens to each of the numerous pills that patients have in their possession!

I’ve also enjoyed seeing patients at the retirement community where I shadowed my faculty sponsor. When we saw patients who lived in the retirement home apartments, I discovered that you can learn quite a lot about the patients just by stepping into their homes. I could see if the patients had difficulty moving around in their homes, whether they kept important objects within their reach, and photos of family and friends. I’ve also learned a little about important issues that come up when working with older patients, such as evaluating the need for guardianship when patients begin to lose their cognitive abilities. The patients in the retirement community have been very friendly and great to talk to, and I enjoy learning from them every time.

In the next few weeks I look forward to looking through more of the patient data to find patterns and different factors to analyze, and when the data is finally organized I can eventually do a statistical analysis. I think there will be many interesting findings from the data!

Victoria Yeh
Case Western Reserve University School of Medicine

 

"Diary of an MSTAR Student" follows scholars in the 2011 Medical Student Training in Aging Research (MSTAR) Program, highlighting their summer experiences. As they continue their path of research, training and clinical practice, read their daily thoughts at www.afar.org/mstarblog. New diary entries are posted every day, so check back soon.