Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun 10;6(6):e010903.
doi: 10.1136/bmjopen-2015-010903.

Making patient values visible in healthcare: a systematic review of tools to assess patient treatment priorities and preferences in the context of multimorbidity

Dee Mangin  1 , Gaibrie Stephen  2 , Verdah Bismah  3 , Cathy Risdon  4
Affiliations

Making patient values visible in healthcare: a systematic review of tools to assess patient treatment priorities and preferences in the context of multimorbidity

Dee Mangin et al. BMJ Open. .

Abstract

Objectives: To identify studies of existing instruments available for clinicians to record overall patient preferences and priorities for care, suitable for use in routine primary care practice in patients with multimorbidity. To examine the data for all identified tools with respect to validity, acceptability and effect on health outcomes.

Design: Systematic Review.

Data sources: MEDLINE, EMBASE and Cochrane databases, each with a predefined search strategy.

Eligibility criteria: Citations were included if they reported a tool used to record patient priorities or preferences for treatment, and quantitative or qualitative results following administration of the tool.

Results: Our search identified 189 potential studies of which 6 original studies and 2 discussion papers were included after screening for relevance. 5 of 6 studies (83%) were of cross-sectional design and of moderate quality. All studies reported on the usability of a tool in order to elicit patient preferences. No studies reported on changes to patient-specific healthcare outcomes as a consequence of recording preferences and priorities. 1 of 6 studies reported on eliciting patient preference in the context of multimorbidity. No studies incorporated patient preferences into an electronic medical record.

Conclusions: Given the importance of eliciting patient priorities and preferences in providing patient-centred care in the context of multimorbidity and polypharmacy, we found surprisingly few relevant tools. Some aspects of the tools used for single-disease contexts may also be useful in the context of multimorbidity. There is an urgent need to develop ways to make patient priorities explicitly visible in the clinical record and medical decision-making and to test the effect on patient-relevant outcomes.

Keywords: GERIATRIC MEDICINE; PRIMARY CARE; REHABILITATION MEDICINE.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow chart of search, identification and screening of studies for inclusion.
See this image and copyright information in PMC

References

    1. Mangin D, Heath I, Jamoulle M. Beyond diagnosis: responding to the comorbidity challenge. BMJ 2012;344:e3526 10.1136/bmj.e3526 - DOI - PubMed
    1. Organization WH. Micronutrient deficiencies. Battling iron deficiency anaemia. World Health Organisation, 2003. http://www.who.int/nut/ida.htm (updated 9 Apr 2003; cited 25 July 2003).
    1. Vervloet M, Linn AJ, van Weert JCM et al. . The effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature. J Am Med Inform Assoc 2012;19:696–704. 10.1136/amiajnl-2011-000748 - DOI - PMC - PubMed
    1. Starfield B. Primary care: balancing health needs, services, and technology. New York: Oxford University Press, 1998.
    1. Stewart M, Brown JB, Weston WW et al. . Patient-centred medicine: transforming the clinical method. United Kingdom: Radcliffe Medical Press, 2003.

Publication types

LinkOut - more resources