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Research Priorities to Advance the Health and Health Care of Older Adults with Multiple Chronic Conditions.
Tisminetzky, Mayra MD, PhD 1,2; Bayliss, Elizabeth A. MD 3,4; Magaziner, Jay S. PhD 5; Allore, Heather G. PhD 6; Anzuoni, Kathryn BS 1; Boyd, Cynthia M. MD 7; Gill, Thomas M. MD 6; Go, Alan S. MD 8; Greenspan, Susan L. MD 9; Hanson, Leah R. PhD 10; Hornbrook, Mark C. PhD 11; Kitzman, Dalane W. MD 12; Larson, Eric B. MD 13; Naylor, Mary D. PhD 14; Shirley, Benjamin E. BS 15; Tai-Seale, Ming PhD 16; Teri, Linda PhD 17; Tinetti, Mary E. MD 6; Whitson, Heather E. MD 18,19; Gurwitz, Jerry H. MD *,1,2
[Report] Journal of the American Geriatrics Society. 65(7):1549-1553, July 2017.

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OBJECTIVES: To prioritize research topics relevant to the care of the growing population of older adults with multiple chronic conditions (MCCs).

DESIGN: Survey of experts in MCC practice, research, and policy. Topics were derived from white papers, funding announcements, or funded research projects relating to older adults with MCCs.

SETTING: Survey conducted through the Health Care Systems Research Network (HCSRN) and Claude D. Pepper Older Americans Independence Centers (OAICs) Advancing Geriatrics Infrastructure and Network Growth Initiative, a joint endeavor of the HCSRN and 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: A "top box" methodology was used, counting the number of respondents selecting the top response on a 5-point Likert scale and dividing by the total number of responses to calculate a top box percentage for each of 37 topics.

RESULTS: The highest-ranked research topics relevant to the health and healthcare of older adults with MCCs were health-related quality of life in older adults with MCCs; development of assessment tools (to assess, e.g., symptom burden, quality of life, function); interactions between medications, disease processes, and health outcomes; disability; implementation of novel (and scalable) models of care; association between clusters of chronic conditions and clinical, financial, and social outcomes; role of caregivers; symptom burden; shared decision-making to enhance care planning; and tools to improve clinical decision-making.

CONCLUSION: Study 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 it.