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

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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.