Implementation and Evaluation of Patient Priorities Care-North Carolina for Older Adults with Multiple Chronic Conditions

项目摘要/摘要 这项研究的长期目标是为患有多发性硬化症的老年人重新设计临床决策。 将慢性病(MCC)列为患者健康优先事项的中心。这项研究的总体目标 项目赠款计划(R01)研究旨在实施和评估患者优先护理(PPC)干预 北卡罗来纳州(北卡罗来纳州)采用混合有效性-实施设计的初级保健实践。指导原则 最小干扰医学模型，我们的中心假设是临床决策由 患者的优先事项将减轻患者及其家人的护理负担，增加患者目标 设置，促进患者-提供者共享决策，提高患者的生活质量和满意度 小心翼翼。随着MCC的患病率、费用和治疗负担持续上升，新的护理方法 在不断增长的人口中是迫切需要的。这项研究的发现将为以下实际方法提供参考 使患有MCC的老年人的临床决策与他们的健康优先事项保持一致。这个项目是高度 与国家老龄研究所(NIA)的优先事项相关，这些优先事项需要研究来开发和评估 符合患者价值、偏好和目标的老年人的医疗保健模式和方法 MCC.

Project Summary/Abstract The long-term goal of this research is to re-engineer clinical decision-making for older adults with multiple chronic conditions (MCC) to center within the health priorities of patients. The overall objective of this Research Project Grant Program (R01) study is to implement and evaluate a Patient priorities care (PPC) intervention in primary care practices in North Carolina (NC) using a hybrid effectiveness-implementation design. Guided by the Minimally Disruptive Medicine model, our central hypothesis is that clinical decision-making guided by patients' priorities will result in less burdensome care for patients and their families, increase patient goal setting, facilitate patient-provider shared decision-making, and improve patient quality of life and satisfaction with care. As the prevalence, costs, and treatment burden of MCC continue to rise, new approaches to care are urgently needed in this growing population. Findings from this study will inform practical approaches for aligning clinical decision-making in older adults with MCC with their health priorities. This project is highly relevant to priorities of the National Institute on Aging (NIA) which call for research to develop and evaluate health care models and approaches aligned with patient values, preferences, and goals in older adults with MCC.