Research Priorities to Advance the Health and Health Care of Older Adults with Multiple Chronic Conditions

Abstract

Objective Substantial gaps in knowledge exist surrounding the health and healthcare of older adults with multiple chronic conditions (MCCs). We sought to prioritize research topics relevant to the care of this growing population. Design Survey of experts in MCC practice, research, and/or policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs. Setting Survey conducted through the HCSRN-OAICs AGING Initiative, a joint endeavor of the Health Care Systems Research Network (HCSRN) and Claude D. Pepper Older Americans Independence Centers (OAICs). Participants Individuals affiliated with the HCSRN or OAICs, and national MCC experts, including individuals affiliated with funding agencies having MCC-related grant portfolios. Measurements We employed “top box” methodology, counting the number of respondents selecting the top response on a five-point Likert scale, then dividing by total number of responses to calculate a top box percentage for each of 37 topics. Results Highest ranked research topics relevant to the health and healthcare of older adults with MCCs included: health related quality of life in older adults with MCCs; development of assessment tools (e.g., to assess symptom burden, quality of life, and function, etc.); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association of clusters of chronic conditions with clinical, financial, and social outcomes; the role of the caregiver; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making. Conclusions Our findings serve to inform the development of a comprehensive research agenda to address the challenges relating to the care of this “high-need, high-cost” population, and the healthcare delivery systems responsible for serving them.

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