Rob Dillard

DocwireNews

The findings of a <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2752365">study published</a> in JAMA Internal Medicine suggest that patient priorities care (PPC) may be linked to reduced treatment burden and unwanted health care compared to usual care (UC).In this non-randomized clinical trial, researchers conducted propensity adjustments at one PPC site and one UC site of a multi-site primary care practice in Connecticut that provides care to approximately 15% of the state&rsquo;s residents. They recruited 366 patients (64.2% female, 95.6% white) comprised of 163 adults aged 65 or older who had three or more chronic conditions and were cared for by 10 primary care practitioners (PCPs) who were PPC trained, as well as 203 similar patients who received UC from seven PCPs who were untrained in PPC.All participants were enrolled between February 2017, and March 31, 2018, and follow-up took place until September 30, 2018. The study interventions were PPC and physicians basing their decision making around PPC. The key endpoints were specified as: change in patients&rsquo; Older Patient Assessment of Chronic Illness Care (O-PACIC); CollaboRATE, and Treatment Burden Questionnaire (TBQ) scores; electronic health record documentation of decision-making based on patients&rsquo; health priorities; medications and self-management tasks added or stopped; and diagnostic tests, referrals, and procedures ordered or avoided.According to the results, within the UC group, the PPC group was older (mean age, 74.7 vs 77.6) and had both lower physical and mental health scores. At the researchers&rsquo; time of follow-up, PPC participants reported a 5-point greater decrease in TBQ score than those who received UC when evaluated with a weighted regression model with inverse probability of PCP assignment weights.The researchers observed no differences in O-PACIC or CollaboRATE scores. Moreover, the results showed that noted personal health priorities&ndash;based decisions were mentioned in clinical visit notes for 66.3% PPC vs 0% UC participants. Furthermore, with UC patients, PPC patients were more likely to have medications stopped (weighted comparison, 52.0% vs 33.8%; adjusted odds ratio [AOR]=2.05; 95% CI, 1.43 to 2.95) and less likely to have self-management tasks (57.5% vs 62.1%; AOR=0.59; 95% CI, 0.41 to 0.84) and diagnostic tests (80.8% vs 86.4%; AOR=0.22; 95% CI, 0.12 to 0.40) ordered.<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Thank you to our funders <a href="https://twitter.com/johnahartford?ref_src=twsrc%5Etfw">@johnahartford</a> <a href="https://twitter.com/MooreFound?ref_src=twsrc%5Etfw">@MooreFound</a> <a href="https://twitter.com/RWJF?ref_src=twsrc%5Etfw">@RWJF</a> for your support of <a href="https://twitter.com/PtPriorities?ref_src=twsrc%5Etfw">@PtPriorities</a>. We are thrilled to share the results of the pilot study <a href="https://t.co/fF4cUAtlzL">https://t.co/fF4cUAtlzL</a>
&mdash; Mary Tinetti (@GoalsDriveCare) <a href="https://twitter.com/GoalsDriveCare/status/1181243204357652480?ref_src=twsrc%5Etfw">October 7, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>&ldquo;This study&rsquo;s findings suggest that aligning care with patients&rsquo; priorities may improve outcomes for patients with multiple chronic conditions,&rdquo; the study authors wrote.&ldquo;Care aligned with patients&rsquo; priorities may be feasible and effective for older adults with MCCs.&rdquo;<blockquote class="twitter-tweet" data-width="500" data-dnt="true">
How's this for a novel concept: For patients with multiple conditions, ask patients what matters to them and align care accordingly. Interesting study shows priority aligned care leads to less burdensome care, fewer meds and procedures <a href="https://twitter.com/hashtag/geriatrics?src=hash&amp;ref_src=twsrc%5Etfw">#geriatrics</a> <a href="https://twitter.com/hashtag/hpm?src=hash&amp;ref_src=twsrc%5Etfw">#hpm</a> <a href="https://t.co/fmWgFWtyIb">https://t.co/fmWgFWtyIb</a>
&mdash; Ken Covinsky (@geri_doc) <a href="https://twitter.com/geri_doc/status/1181280785816383489?ref_src=twsrc%5Etfw">October 7, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
Patient Priorities&ndash;Aligned Decision-Making Outcomes Among Older Adults With Multiple Chronic Conditions study findings suggest that aligning care with patients&rsquo; priorities may improve outcomes for patients with multiple chronic conditions. <a href="https://t.co/iNFRrkGNIK">https://t.co/iNFRrkGNIK</a>
&mdash; EMAS (@emas_online) <a href="https://twitter.com/emas_online/status/1181440241774800897?ref_src=twsrc%5Etfw">October 8, 2019</a>
</blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>&nbsp;

Bradley Marder, MD

Joel M. Topf, MD, FACP

Gout Studies: Transplant Waitlisting and Bone Erosion

NKF Spring Clinical Meetings 2025

Jayme Locke, MD, MPH

The Promise of Xenotransplantation

Leah Lawrence

Real-World Data Backs Invasive DFS as Surrogate Endpoint for OS in EBC

HR Breast Cancer

Latest News

Aligning Care With Patients' Priorities Improves Outcomes

Career News

The findings of a study published in JAMA Internal Medicine suggest that patient priorities care (PPC) may be linked to reduced treatment burden and unwanted health care ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe