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Our Vision

The Northwestern Pepper Center has been established because we recognize that:

  • The US population is aging rapidly (the 65+ age group is growing 3x faster than -65).
  • With age, many Americans develop multiple chronic conditions (MCC).
  • Many people with MCC are unable to adequately manage their conditions, leading to poor health outcomes and burdensome costs. Having MCC usually means worse clinical outcomes, poorer physical function and mental health, higher healthcare utilization, worse quality of life, and increased mortality risk.
  • There are not enough trained geriatricians to care for the growing number of older adults and address their complex health needs.

90%  of adults 65+ have at least one chronic condition.62-80%  of adults 65+ havemultiple chronic conditions (MCC).71% of US healthcare spending is dedicated to patients with multiple chronic conditions (MCC).

To fill the need for increased geriatric care and knowledge of MCC management, we support infusing core geriatrics principles, focusing on MCC, throughout primary care and medical subspecialties. This Northwestern Pepper Center aims to:

  • Formalize a comprehensive, multidisciplinary, aging research program dedicated to improving healthcare, functional independence, and quality of life for older adults with MCC.
  • Expand Northwestern training and mentoring activities to develop future leaders in geriatrics and aging research who will transform healthcare to meet the needs of older adults with MCC
  • Stimulate applied research on the innovative design of primary care models that align with the priorities of older adults with MCC through aging-specific research resources and expertise

The Challenges of Multiple Chronic Conditions

Listed below are some of the ways in which having MCC complicates or adversely affects a person and their health care provider. These are the types of issues we keep in mind as we design research and collect resources.

Challenges to Patients

  • Polypharmacy
  • Multiple lifestyle behavior changes (e.g. diet, physical activity)
  • Burdensome self-care tasks associated with monitoring conditions and managing symptoms
  • High prevalence of functional limitations affecting self-care ability
  • Requisite illness and treatment knowledge to problem solve around self-management
  • Frequent pharmacy visits to collect typical unsynchronized prescriptions and sometimes multiple involved pharmacies
  • Financial costs
  • Changes in cognition, caused either by age, illness or treatment
  • Co-existing behavioral health issues
  • Unmet health-related social needs (i.e. housing instability, food insecurity, transportation)

Challenges to Primary Care Providers

  • Evidence-based guidelines typically focus on a single chronic condition
  • Potential for treatment interactions for different conditions,. And as a result inappropriate prescribing
  • Knowledge of the effect of certain treatments less understood among patients with MCC
  • Involvement of one or more specialists; poor quality of provider-provider communication
  • For many practices, lack of continuity of care
  • Visit time constraints and length of time between visits
  • Inadequate patient involvement in treatment decision making
  • Familiarity and/or availability of referral source in the community to support patient self-management
  • Incomplete, outdated documentation on patients’ most current psychosocial circumstances that may be interfering with proper self-management of chronic conditions and healthcare utilization

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