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Article Title

Research Priorities to Advance the Science of Multiple Chronic Conditions in Older Adults From the AGING Initiative Steering and Advisory Committees

Publication Date

8-10-2017

Keywords

aging, elderly, geriatrics, quality of life, survey research and methods, quality of care, disability, health care organizations, complex disease management, multiple chronic conditions, chronic disease, patient reported outcomes, functional status

Abstract

Background: There is an increasing recognition of the substantial gaps in knowledge that exist surrounding the health and health care of older adults with multiple chronic conditions (MCCs). A survey was developed to rank and prioritize research topics relevant to advancing the science of multimorbidity in the geriatric population.

Methods: A web-based survey was developed containing 37 topics organized into 11 domains. Topics were gathered from white papers, grant announcements or funded research projects relating to older adults that included the terms MCCs, multimorbidity and/or comorbidity. The search included the years 2010–2015 and employed the PubMed database as well as websites of the Agency for Healthcare Research and Quality, Patient-Centered Outcomes Research Institute (PCORI), National Institutes of Health, National Academy of Medicine and Google Scholar.

Results: Of the 366 respondents to the survey, 37% were investigators affiliated with the Health Care Systems Research Network, 25% were affiliated with the Claude D. Pepper Older Americans Independence Centers, 22% were affiliated with academic health centers, 5% were affiliated with the Veterans Affairs system, 5% were affiliated with federal agencies, 1% were affiliated with PCORI, and 4% were affiliated with other organizations. Based on top-two box methodology, the top 10 research topics were: interactions between medications, disease processes and health outcomes in older adults with MCCs; health-related quality of life in older adults with MCCs; assessment tools in older adults with MCCs (to assess symptom burden, quality of life, function, etc); shared decision-making to enhance care planning in older adults with MCCs; disability in older adults with MCCs; symptom burden in older adults with MCCs; tools to improve clinical decision-making in older adults with MCCs; the role of the caregiver in caring for older adults with MCCs; self-management interventions in older adults with MCCs; and management of pain or other symptoms in older adults with MCCs.

Conclusion: Our findings are complementary to prior efforts to create a coherent and comprehensive research agenda to address the complex challenges facing these “high-need, high-cost” populations of older adults and the health care systems struggling to serve them. Future efforts should incorporate the views of patients, caregivers and other stakeholders to validate and broaden this important research agenda in this growing population.

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