Patient Priorities Care (PPC)

NCT ID: NCT03600389

Last Updated: 2019-07-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 414 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-10-01
• Study Completion Date: 2018-08-31

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.

Detailed Description

Many older adults with Multiple Chronic Conditions receive conflicting recommendations and care that may be fragmented across clinicians. Older adults vary in what's most important when faced with tradeoffs and vary in the health-related activities they are willing and able to complete to achieve their desired outcomes. A potential solution to these problems is to move from decision-making predicated solely on disease-guidelines to decision-making based on achieving each patient's own specific health outcome goals (e.g., relief of symptoms sufficient to allow specific functional activity) within the context of what they are willing and able to do (i.e. care preferences) to achieve these outcomes.

The primary aims of the Patient Priorities Care (PPC) pilot is to assess the feasibility of aligning primary and specialty care to focus on the health priorities (i.e. specific and actionable outcome goals and care preferences) of older adults with multiple chronic conditions (MCC)

Conditions

Multiple Chronic Conditions

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Intervention Arm (Implementing Patient Priorities Care)

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

Group Type: EXPERIMENTAL

Patient Priorities Care

Intervention Type: BEHAVIORAL

Control Arm (Not Implementing Patient Priorities Care)

Routine Care

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Patient Priorities Care

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• 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

Exclusion Criteria

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

• Minimum Eligible Age: 66 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

The John A. Hartford Foundation

OTHER

Sponsor Role: collaborator

Gordon and Betty Moore Foundation

OTHER

Sponsor Role: collaborator

Robert Wood Johnson Foundation

OTHER

Sponsor Role: collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role: collaborator

Yale University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

References

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.

Reference Type: DERIVED

PMID: 31589281 (View on PubMed)

Provided Documents

Document Type: Study Protocol

View Document

Other Identifiers

1601017608

Identifier Type: -

Identifier Source: org_study_id