Patient Priorities Care (PPC) (PPC)
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|ClinicalTrials.gov Identifier: NCT03600389|
Recruitment Status : Completed
First Posted : July 26, 2018
Last Update Posted : July 5, 2019
|Condition or disease||Intervention/treatment||Phase|
|Multiple Chronic Conditions||Behavioral: Patient Priorities Care||Not Applicable|
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)
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||414 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Masking Description:||Interviewer and chart abstractor is blinded to the nature of the intervention and to the group assignment.|
|Official Title:||Patient Priorities Care for Older Adults With Multiple Chronic Conditions Achieved Through Primary and Specialty Care Alignment: Patient Priorities Care (PPC)|
|Actual Study Start Date :||October 1, 2016|
|Actual Primary Completion Date :||August 31, 2018|
|Actual Study Completion Date :||August 31, 2018|
Experimental: 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.
Behavioral: Patient Priorities Care
No Intervention: Control Arm (Not Implementing Patient Priorities Care)
- Treatment Burden Questionnaire (TBQ) [ Time Frame: 6-12 Months ]Measure to assess treatment burden among patients with one or more chronic conditions. Summary score is 0-150 with lower numbers indicating less burden. This is an exploratory study and the investigators will compare the intervention to control group to determine if the intervention group scores are lower on the TBQ (i.e. less burden).
- Older Patient Assessment of Care for Chronic Conditions (O-PACIC) [ Time Frame: 6-12 Months ]Measure to assess chronically-ill patients' perceptions of the degree to which health care delivery is integrated and coordinated. Summary score is 1-5 with higher score indicated greater integration. This is an exploratory study and the investigators will compare the intervention to control group to determine if the intervention group scores higher on O-PACIC (i.e. greater integration).
- CollaboRATE [ Time Frame: 6-12 Months ]Measure of shared decision making in clinical encounters. Summary score is 0-100 with higher score indicated greater shared decision making. This is an exploratory study and the investigator will compare the intervention to control group to determine if the intervention group scores higher on CollaboRATE (i.e. greater shared decision-making).
- Health Care Utilization [ Time Frame: 6-12 months ]Measures of changes in health care utilization drawn from review of patient medical records
- Older Patient Assessment of Care for Chronic Conditions (O-PACIC) subscales [ Time Frame: 6-12 Months ]Sub-scales within the O-PACIC including patient activation (sub-scores range from 1-5 with higher score indicating greater activation), delivery system design/support (sub-scale score ranges from 1-5 with higher scores indicating greater system design/support), goal setting (sub-scale scores range from 1-5 with higher scores indicating improved goal setting), problem-solving/contextual counseling (sub-scale scores range from 1-5 with higher scores indicating improved problem-solving/contextual counseling), and follow-up/coordination (sub-scale scores range from 1-5 with higher scores indicating greater follow-up/coordination).
- Combined items from the Treatment Burden Questionnaire (TBQ) that appear to measure similar constructs. [ Time Frame: 6-12 Months ]Items that assess self-management tasks (3 items that range from 0-30 with lower scores indicating less self-management burden), medical visits (2 items that range from 0-20 with lower scores indicating less burden from doctor visits), laboratory tests and other examinations (1 item that ranges from 0-10 with lower scores indicating less burden from lab exams), relationships with providers (1 item with scores ranging from 0-10 with lower scores indicating less burden from relationships with providers), medications (4 items with scores ranging from 0-40 with lower scores indicating less burden from medications).