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J Am Geriatr Soc. 2017 Jul;65(7):1549-1553. doi: 10.1111/jgs.14943. Epub 2017 May 26.

Research Priorities to Advance the Health and Health Care of Older Adults with Multiple Chronic Conditions.

Author information

1
Meyers Primary Care Institute, A Joint Endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, Massachusetts.
2
Division of Geriatric Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
3
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
4
Department of Family Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
5
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland.
6
School of Medicine, Yale University, New Haven, Connecticut.
7
Division of Geriatric Medicine, Johns Hopkins University, Baltimore, Maryland.
8
Division of Research, Kaiser Permanente Northern California, Oakland, California.
9
New Courtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
10
HealthPartners Institute, Minneapolis, Minnesota.
11
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
12
Wake Forest Baptist Medical Center, Winston Salem, North Carolina.
13
Kaiser Washington Health Research Institute, Seattle, Washington.
14
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
15
Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
16
Palo Alto Medical Foundation Research Institute, Palo Alto, California.
17
School of Nursing, University of Washington, Seattle, Washington.
18
Duke University Aging Center, Duke University, Durham, North Carolina.
19
Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina.

Abstract

OBJECTIVES:

To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions (MCCs).

DESIGN:

Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs.

SETTING:

Survey conducted through the Health Care Systems Research Network (HCSRN) and Claude D. Pepper Older Americans Independence Centers (OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and OAICs.

PARTICIPANTS:

Individuals affiliated with the HCSRN or OAICs and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios.

MEASUREMENTS:

A "top box" methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics.

RESULTS:

The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making.

CONCLUSION:

Study findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this "high-need, high-cost" population and the healthcare delivery systems responsible for serving it.

KEYWORDS:

aging; geriatrics; multimorbidity; multiple chronic conditions

PMID:
28555750
PMCID:
PMC5507733
DOI:
10.1111/jgs.14943
[Indexed for MEDLINE]
Free PMC Article

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