Priorities of multimorbid patients in a multi-age multi-ethnic setting
Research type
Research Study
Full title
Using the outcome prioritisation tool to elicit health outcome priorities of multi-morbid patients in a multi-age and multi-ethnic setting
IRAS ID
272739
Contact name
Kamlesh Khunti
Contact email
Sponsor organisation
University of Leicester
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Multi-morbidity refers to the presence of two or more chronic health conditions in a patient, and has been identified as an area of key priority for health research. The National Institute of Clinical Excellence (NICE) has highlighted the inclusion of the patients’ priorities, values and goals as a quality standard in their guidance for the management of patients with multimorbidity. The outcome prioritisation tool was developed in 2009 by Fried et al at Yale University, and is a simple, tool that allows patients to rate from 0 to 100, how important each of four overall outcomes of their healthcare, are for them (maintaining independence, staying alive, reducing pain, reducing other symptoms).
The team who developed this tool have previously tested how feasible the tool was to use to record the priorities of older patients with multiple health conditions. Researchers in the Netherlands have also explored using this tool as part of medication reviews for patients aged over 65 with multi-morbidity. However, the use of this tool in patients under the age of 65 has so far not been tested. Whilst a higher proportion of older adults (aged over 65) suffer from multi-morbidity, the prevalence of multi-morbidity in younger patients (aged under 65) is also high, and increasing. Amongst those aged under 65, multi-morbidity is most prevalent in middle-aged patients, i.e. patients aged 45-64.
The main aim of this study is to investigate the perceptions of multi-morbid patients aged 45 or above on how easy this tool is for them to use, and how useful and relevant this tool would be to their healthcare. The other aims of this study are to understand what the health outcome priorities of patients by clusters of multi-morbidities and by age categories and different ethnic groups. The study population will be multi-morbid patients, defined as suffering two or more chronic conditions and aged 45 or above, in order to allow us to investigate the use of this tool in a wider age group of patients and also look for any differences in the priorities of different age groups of patients.
We will also aim to recruit patients from a range of ethnicities from our local multi-ethnic population, to determine if there are differences by ethnicity in the priorities of multi-morbid patients. The benefits of this study are that its results can be used to determine whether the outcome prioritisation tool can be effectively used to ascertain the priorities of both middle-aged and older multi-morbid patients. The results of this study will also make a new contribution to existing research on the health outcome priorities of multi-morbid patients, from a range of age groups and a range of ethnic backgrounds.
Summary of results:
The results of this study have shown that the majority of patients aged 45 or over and suffering with multiple long-term conditions found the Outcome Prioritisation Tool easy to use, relevant to their healthcare and felt it would be useful in communicating their priorities to their doctor. The findings of this study have also shown that this tool can be used in middle-aged patients with multiple long-term conditions, that is patients aged 45 or above, as well as older patients with multiple long-term conditions (patients aged 65 or above), and also that it can be used in an an area where there is a high level of ethnic diversity within the population.REC name
London - Riverside Research Ethics Committee
REC reference
20/LO/0570
Date of REC Opinion
25 Mar 2020
REC opinion
Favourable Opinion