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Eliciting Preferences of Multimorbid Elderly Adults in Family Practice Using an Outcome Prioritization Tool
Author(s) -
Summeren Jojanneke J.G.T.,
HaaijerRuskamp Flora M.,
Schuling Jan
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14415
Subject(s) - medicine , context (archaeology) , polypharmacy , prioritization , family medicine , paleontology , management science , economics , biology
Objectives To explore an outcome prioritization tool ( OPT ) in eliciting individuals’ preferred health outcomes (remaining alive, maintaining independence, reducing pain, reducing other symptoms) in the context of medication review in family practice. Design Cross‐sectional pilot study with mixed‐methods design. Setting Family practice. Participants Multimorbid individuals (N = 60; aged ≥69) with polypharmacy (≥5 chronic medications) derived from the practice lists of a purposive sample of 13 family physicians ( FP s). Measurements Participants were asked to prioritize each health outcome according the trade‐off principle, and FP s used this prioritization for medication review. The acceptability and practicality were measured using a questionnaire for FP s and participants and semistructured interviews with FP s. Results Ninety‐two percent of participants found the OPT understandable, and 55% could easily prioritize between health outcomes. Working with the OPT (mean duration 31 minutes) was a new approach for FP s, but they became more adept at using it. For FP s, the OPT provides better understanding of their patients. Participants and FP s thought that there should be a specific reason to discuss preferences, such as (expected) decline in health status. Conclusion The OPT appears to be promising in eliciting patient preferences but is not suitable for routine medication review at present. Further optimization before actual use is needed (e.g., knowledge in which clinical situations the OPT is useful). More information is needed on how individuals and their families perceive the tool.