Patient Priorities Care (PPC)

NCT03600389 | Completed

• 1 other identifier: 1601017608
• Study Type: interventional
• Target: 414
• Locations: 0 countries
• Sites: N/A

Brief Summary

Patient Priorities Care aligns healthcare decision-making and care by all clinicians with patients' own health priorities. Patient Priorities Care involves not only the health outcome goals that patients want to achieve, but also their preferences for healthcare. This approach is about aligning what outcomes patients want from their healthcare with what they are willing and able to do to achieve these outcomes. The approach begins with a member of the healthcare team helping patients identify their health outcome goals and their care preferences and preparing them to interact with their clinicians around these goals and preferences. The goals and preferences are transmitted to the patient's clinicians who use them in decision-making and communication with the patient and other clinicians.

Conditions

Multiple Chronic Conditions

Keywords

Patient Health Priorities; Health Outcome Goals; Healthcare Preferences

Outcome Measures

Primary Outcomes (4)

• Treatment Burden Questionnaire (TBQ)

  Measure to assess treatment burden among patients with one or more chronic conditions. Summary score is 0-150 with lower numbers indicating less burden. This is an exploratory study and the investigators will compare the intervention to control group to determine if the intervention group scores are lower on the TBQ (i.e. less burden).

  6-12 Months

• Older Patient Assessment of Care for Chronic Conditions (O-PACIC)

  Measure to assess chronically-ill patients' perceptions of the degree to which health care delivery is integrated and coordinated. Summary score is 1-5 with higher score indicated greater integration. This is an exploratory study and the investigators will compare the intervention to control group to determine if the intervention group scores higher on O-PACIC (i.e. greater integration).

  6-12 Months

• CollaboRATE

  Measure of shared decision making in clinical encounters. Summary score is 0-100 with higher score indicated greater shared decision making. This is an exploratory study and the investigator will compare the intervention to control group to determine if the intervention group scores higher on CollaboRATE (i.e. greater shared decision-making).

  6-12 Months

• Health Care Utilization

  Measures of changes in health care utilization drawn from review of patient medical records

  6-12 months

Secondary Outcomes (2)

• Older Patient Assessment of Care for Chronic Conditions (O-PACIC) subscales

  6-12 Months

• Combined items from the Treatment Burden Questionnaire (TBQ) that appear to measure similar constructs.

  6-12 Months

Study Arms (2)

Intervention Arm (Implementing Patient Priorities Care)

EXPERIMENTAL

Aligning healthcare recommendations to achieve patients' specific health outcome goals within the context of what patients are willing and able to do.

Behavioral: Patient Priorities Care

Control Arm (Not Implementing Patient Priorities Care)

NO INTERVENTION

Routine Care

Interventions

Patient Priorities Care BEHAVIORAL

Intervention Arm (Implementing Patient Priorities Care)

Eligibility Criteria

• Age: 66 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Age \>65 years
• Member of Pro-Health Practice for \>=3 years
• Determined to be an appropriate candidate evidenced by ANY of the following:
• Multiple Chronic Conditions (presence of \>3 active health problems)
• \>10 medications
• ≥ 1 hospitalization over the past year
• ≥ 2 emergency department visits over the past year
• Seen by \>2 specialists (excluding GYN and eye) over the past year

You may not qualify if:

• End stage renal disease
• Unable to consent (e.g. dementia)
• In hospice or meeting hospice criteria
• Nursing home resident
• Not English speaking

Sponsors & Collaborators

• Yale University: lead
• The John A. Hartford Foundation: collaborator
• Gordon and Betty Moore Foundation: collaborator
• Robert Wood Johnson Foundation: collaborator
• Patient-Centered Outcomes Research Institute: collaborator

Related Publications (1)

• Tinetti ME, Naik AD, Dindo L, Costello DM, Esterson J, Geda M, Rosen J, Hernandez-Bigos K, Smith CD, Ouellet GM, Kang G, Lee Y, Blaum C. Association of Patient Priorities-Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial. JAMA Intern Med. 2019 Dec 1;179(12):1688-1697. doi: 10.1001/jamainternmed.2019.4235.

  PMID: 31589281 DERIVED

MeSH Terms

Conditions

Multiple Chronic Conditions

Condition Hierarchy (Ancestors)

Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Interviewer and chart abstractor is blinded to the nature of the intervention and to the group assignment.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 1, 2018
• First Posted: July 26, 2018
• Study Start: October 1, 2016
• Primary Completion: August 31, 2018
• Study Completion: August 31, 2018
• Last Updated: July 5, 2019

Record last verified: 2019-07

Data Sharing

• IPD Sharing: Will not share