TREATMENT GOALS FOR PERSONS WITH MULTIFACTORIAL GERIATRIC HEALTH CONDITIONS

Yale University, New Haven CT

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): Because older persons may suffer from various combinations of diseases, impairments, and multifactorial health conditions for which there may be multiple possible management goals or outcomes, goal setting is complex. Since no single universal goal or outcome is appropriate for older persons with multifactorial geriatric health conditions, a strategy for systematically eliciting patient goals is essential to optimal clinical decision making. Previous work has demonstrated the poor agreement between patients and physicians on goals. Thus, the development of a strategy to improve goal setting for older persons is greatly needed, and will be the focus of this project. The specific aims of the research are (1) to develop a strategy for eliciting patient treatment goals when faced with multiple and multifactorial geriatric health conditions, and (2) to perform a pilot test of the strategy. For specific aim 1, the investigators propose to develop a Goal-Setting Strategy (GSS) based on their previous research, using an iterative, consensus-based approach among the investigators and a working group of colleagues. The GSS will then be reviewed by an expert panel and by a patient focus group, and refinements will be made based on critical feedback. For specific aim 2, the investigators will pilot test the GSS strategy with 5 physicians, who will each use the GSS with 10 patients. Because the GSS will be based on the premise that feasible patient goals should guide goal setting, and that patients and physicians should agree on goals, the outcome measure for the assessment of the GSS in this proposal will be agreement on goals between patient and physician. As a part of the pilot test, the investigators will solicit patient and physician evaluations of the GSS, including barriers to use, and further refine the GSS based on the patient and physician evaluations. The ultimate objective is to conduct a definitive controlled trial, using the groundwork laid by the proposed research, to determine if the GSS better meets the diverse health needs and preferences than usual care among person with multifactorial geriatric health conditions.