Wayne State University School of Medicine faculty member Areeba Jawed, M.D., was selected by the Michigan Center for Urban African American Aging Research to pursue her pilot study on racial disparities in palliative care utilization after acute stroke.
The project will examine racial disparities in patient, clinical and stroke characteristics, communication characteristics, palliative care consultation and treatment decisions after stroke.
“We will perform a secondary analysis of a dataset from a retrospective observational study in patients with stroke admitted to four acute care hospitals. Ultimately, data from this study will be used in the development of interventions to improve communication and decision making after stroke relevant to Black and other minority patients,” she said.
Dr. Jawed is an assistant professor of Internal Medicine in the Division of Nephrology who joined the faculty in 2016. She received her medical degree from the Aga Khan University in Karachi, Pakistan; and her internal medicine, nephrology, palliative care and clinical ethics training at the Indiana University School of Medicine. She applied for the MCUAAR grant with her mentor at Indiana University for a secondary analysis of her study.
The MCUAAAR is a collaborative research, community outreach and faculty mentoring program based at Wayne State University, Michigan State University and the University of Michigan. Under the leadership of a national coordinating center, it is one of 18 national resource centers for minority aging research and specialized Alzheimer’s focused projects funded by the National Institute on Aging.
Dr. Jawed’s long-term goal is to reduce suffering at the end of life by improving the process and quality of palliative care delivery, especially to minority and underserved patient populations with serious illnesses such as chronic kidney disease.
“I believe the first step in addressing inequities begins with scholarly work in the area, and as a MCUAAR Research Scientist I hope to learn from experts in the field of disparity-related research,” she said. “All patients with serious illnesses should have conversations about advance care planning and goals of care. However, racial disparities continue to exist in the quality of communication received by patients.”
In a national survey of bereaved caregivers, surrogates of Black patients were less satisfied with the quality of end-of-life care received by their loved ones or the communication from providers, she added. Black patients reported concerns with providers’ efforts to listen to patients and the extent of information shared with them, with heightened disparities in racially discordant physician-patient relationships.
“It has been found that outcomes of communication can also vary by race, with end-of-life discussions between physicians and their Black patients less likely to result in care consistent with patient preferences as compared to white patients. It is important to study such racial disparities so targeted interventions can be made to address these inequities,” she said.
As a MCUAAAR Research Scientist, Dr. Jawed will work with her mentor to create an individual development plan; attend program meetings to provide project updates and get feedback from MCUAAAR faculty; participate in activities sponsored by the center; submit brief progress reports; provide annual updates; and submit a final report at the end of her pilot funding.
“I am very excited and honored to have received this opportunity, which not only includes grant support but also mentorship and the ability to network with other researchers in the field,” Dr. Jawed said.