Linking Patients’ Goals and Priorities to Recommendations for Medication Changes in a Polypharmacy-Focused Structured Clinical Pathway
| Autor: | Dee Mangin MBChB, DPH, Larkin Lamarche PhD, Karla Freeman MSc, Abbas Ali MPH, Rebecca Clark MSc, Nikki Shah MD, Amen Awan BSc, Jessica Langevin MPH, Jenna Parascandalo MPH, Naomi Dore Brown PharmD, Jane Jurcic-Vrataric PharmD, Kiska Colwill BScPharm, Steven Dragos MSc, Sayem Borhan PhD, Cathy Risdon MD, DMan, Henry Siu MD, Barbara Farrell PhD, Johanna Trimble |
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| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Journal of Patient Experience, Vol 10 (2023) |
| Druh dokumentu: | article |
| ISSN: | 2374-3743 23743735 45707936 |
| DOI: | 10.1177/23743735231174762 |
| Popis: | Polypharmacy is associated with poorer health outcomes in older adults. It is challenging to minimize the harmful effects of medications while maximizing benefits of single-disease-focused recommendations. Integrating patient input can balance these factors. The objectives are to describe the goals, priorities, and preferences of participants asked about these in a structured process to polypharmacy, and to describe the extent that decision-making within the process mapped onto these, signaling a patient-centered approach. This is a single-group quasi-experimental study, nested within a feasibility randomized controlled trial. Patient goals and priorities were mapped to medication recommendations made during the intervention. Overall, there were 33 participants who reported 55 functional goals and 66 symptom priorities, and 16 participants reported unwanted medications. Overall, 154 recommendations for medication alterations occurred. Of those, 68 (44%) recommendations mapped to the individual's goals and priorities, whereas the rest were based on clinical judgment where no priorities were expressed. Our results signal this process supports a patient-centered approach: allowing conversations around goals and priorities in a structured process to polypharmacy should be integrated into subsequent medication decisions. |
| Databáze: | Directory of Open Access Journals |
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