Patient Priority-Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions

Clin Geriatr Med. 2016 May;32(2):261-75. doi: 10.1016/j.cger.2016.01.012. Epub 2016 Feb 28.


Older adults with multiple conditions receive care that is often fragmented, burdensome, and of unclear benefit. An advisory group of patients, caregivers, clinicians, health system engineers, health care system leaders, payers, and others identified three modifiable contributors to this fragmented, burdensome care: decision making and care focused on diseases, not patients; inadequate delineation of roles and responsibilities and accountability among clinicians; and lack of attention to what matters to patients and caregivers (ie, their health outcome goals and care preferences). The advisory group identified patient priority-directed care as a feasible, sustainable approach to addressing these modifiable factors.

Keywords: Current care planning; Fragmented and burdensome care; Multiple chronic conditions; Patient priorities; Patient priority–directed care; Patient’s health outcome goals and care preferences.

Publication types

  • Review

MeSH terms

  • Aged
  • Clinical Decision-Making* / ethics
  • Clinical Decision-Making* / methods
  • Decision Making / ethics
  • Humans
  • Multiple Chronic Conditions* / psychology
  • Multiple Chronic Conditions* / therapy
  • Patient Care Planning
  • Patient Comfort* / methods
  • Patient Comfort* / organization & administration
  • Patient Preference
  • Terminal Care* / ethics
  • Terminal Care* / methods
  • Terminal Care* / psychology