Older Patients’ Perspectives on Managing Complexity in CKD Self-Management

Bowling, C. Barrett; Vandenberg, Ann E.; Phillips, Lawrence S.; McClellan, William M.; Johnson, Theodore M.; Echt, Katharina V.

doi:10.2215/cjn.06850616

Cited by 48 publications

(76 citation statements)

References 30 publications

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“…Minimizing treatment burden and complexity is an increasingly recognized need for persons with MCCs . These patients and their caregivers spend an average of 2 hours a day on healthcare‐related activities and 2 hours on each of their many healthcare visits .…”

Section: Rationale For the MCC Stepsmentioning

confidence: 99%

“…6,7 Furthermore, the accumulated effect of preventing or treating each disease, risk factor, and health complaint often results in treatment burden. 5,[8][9][10][11][12][13] Decision making for individuals with MCCs should involve explicit consideration of a variety of care options according to the tradeoffs among potential benefits, burden, and harms, with the optimal choice determined by individuals' specific health outcome goals and healthcare preferences. 7,14,[16][17][18]…”

Section: Variable Health Priorities Tradeoffs and Treatment Burdenmentioning

confidence: 99%

“…Minimizing treatment burden and complexity is an increasingly recognized need for persons with MCCs. 5,[8][9][10][11][12][13][14] These patients and their caregivers spend an average of 2 hours a day on healthcare-related activities and 2 hours on each of their many healthcare visits. 8 More than 40% of older adults acknowledge some degree of treatment burden that represents an underappreciated yet modifiable source of nonadherence.…”

Section: Minimize Treatment Burdenmentioning

confidence: 99%

“…includes conflicting recommendations, and is not always focused on what matters most to these individuals. [5][6][7][8][9][10][11][12][13][14] The objective of the current work was to translate the MCC Guiding Principles (Table 1) into a framework for decision making for clinicians who provide both primary and specialty care to older people with MCCs 4,15 (Figure 1).…”

mentioning

confidence: 99%

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Decision Making for Older Adults With Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults With Multimorbidity

Boyd

Smith

Masoudi

et al. 2019

J American Geriatrics Society

185

148

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Caring for older adults with multiple chronic conditions (MCCs) is challenging. The American Geriatrics Society (AGS) previously developed The AGS Guiding Principles for the Care of Older Adults With Multimorbidity using a systematic review of the literature and consensus. The objective of the current work was to translate these principles into a framework of Actions and accompanying Action Steps for decision making for clinicians who provide both primary and specialty care to older people with MCCs. A work group of geriatricians, cardiologists, and generalists: (1) articulated the core MCC Actions and the Action Steps needed to carry out the Actions; (2) provided decisional tips and communication scripts for implementing the Actions and Action Steps, using commonly encountered situations: (3) performed a scoping review to identify evidence‐based, validated tools for carrying out the MCC Actions and Action Steps; and (4) identified potential barriers to, and mitigating factors for, implementing the MCC Actions. The recommended MCC Actions include: (1) identify and communicate patients' health priorities and health trajectory; (2) stop, start, or continue care based on health priorities, potential benefit vs harm and burden, and health trajectory; and (3) align decisions and care among patients, caregivers, and other clinicians with patients' health priorities and health trajectory. The tips and scripts for carrying out these Actions are included in the full MCC Action Framework available in the supplement (http://www.geriatricscareonline.org). J Am Geriatr Soc 67:665–673, 2019.

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Section: Rationale For the MCC Stepsmentioning

confidence: 99%

Section: Variable Health Priorities Tradeoffs and Treatment Burdenmentioning

confidence: 99%

Section: Minimize Treatment Burdenmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Decision Making for Older Adults With Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults With Multimorbidity

Boyd

Smith

Masoudi

et al. 2019

J American Geriatrics Society

185

148

View full text Add to dashboard Cite

show abstract

“…Like other populations with chronic illness, patients with CKD can have a high symptom burden, a high prevalence of other comorbid conditions, and limited life expectancy (1). Several recent studies among members of this population suggest that the concerns of patients can be diametrically opposed to those of their providers, and that patients may experience their illness and care in ways that might be surprising to providers (2)(3)(4)(5)(6)(7)(8). These studies illuminate patients' experiences in ways that provide both impetus and direction for efforts to make care for this population more patient-centered.…”

Section: Introductionmentioning

confidence: 95%