Primary Care Clinicians' Experiences With Treatment Decision Making for Older Persons With Multiple Conditions

“Second, the presence of these conditions may also increase the likelihood that the individual will experience adverse effects with any given intervention.(3,4) Finally, the polypharmacy that generally accompanies multimorbidity confers an increased risk of adverse drug events, independent of the chronic conditions.”

“Second, the presence of these conditions may also increase the likelihood that the individual will experience adverse effects with any given intervention.(3,4) Finally, the polypharmacy that generally accompanies multimorbidity confers an increased risk of adverse drug events, independent of the chronic conditions.”

“In addition to the studies demonstrating the risk of adverse outcomes associated with guideline-directed care, evidence also suggests that the patients who are at the highest risk for these adverse outcomes may also be the ones most likely to derive benefit from the intervention.(17) Clinicians’ descriptions of how th…”

“Finally, the polypharmacy that generally accompanies multimorbidity confers an increased risk of adverse drug events, independent of the chronic conditions.(5,6) On the other hand, editorials and clinical studies remind readers that the clinical trials”

“Moreover, other clinicians noted that the reduction in risk for a disease-specific outcome might not be what was most important to the patient, an observation supported by studies indicating that the adverse effects of medications may be as, if not more, important to patients than their primary effects.(20,21) Disagre…”

“Moreover, other clinicians noted that the reduction in risk for a disease-specific outcome might not be what was most important to the patient, an observation supported by studies indicating that the adverse effects of medications may be as, if not more, important to patients than their primary effects.(20,21) Disagre…”

“First, the presence of comorbid conditions may result in persons receiving less benefit from therapy directed at a particular condition.(1,2) Second, the presence of these conditions may also increase the likelihood that the individual will experience adverse effects with any given intervention.”

“Finally, the polypharmacy that generally accompanies multimorbidity confers an increased risk of adverse drug events, independent of the chronic conditions.(5,6) On the other hand, editorials and clinical studies remind readers that the clinical trials”

“First, the presence of comorbid conditions may result in persons receiving less benefit from therapy directed at a particular condition.(1,2) Second, the presence of these conditions may also increase the likelihood that the individual will experience adverse effects with any given intervention.”

“These observations corroborate previous reports of the limitations of currently conducted randomized clinical trials to detect the full range of adverse effects of treatments in older adults with multimorbidity.(12) There is growing evidence from cohort studies to suggest that these adverse effects include ones not tr…”

“Disagreement between patients or caregivers and clinicians regarding the goals for an individual patient’s care has also been demonstrated quantitatively.(22,23) Although the authors of these studies suggest that these findings indicate a lack of clinicians’ awareness of the patient’s priorities, the clinicians in the…”

“Disagreement between patients or caregivers and clinicians regarding the goals for an individual patient’s care has also been demonstrated quantitatively.(22,23) Although the authors of these studies suggest that these findings indicate a lack of clinicians’ awareness of the patient’s priorities, the clinicians in the…”

“Second, the clinicians who discussed the absence of risk calculators for patients with multiple conditions highlight the need for the development of methods to provide individualized assessments of harm vs benefit associated with different treatment strategies in order to determine optimal therapy depending on a patie…”

“benefits and harms associated with guideline-directed care reflects the ongoing uncertainty regarding the clinical strategies that will provide the best outcomes.(16) In addition to the studies demonstrating the risk of adverse outcomes associated with guideline-directed care, evidence also suggests that the patients…”

“However, some studies have demonstrated that, when presented with numerical data regarding risk reduction, many patients would be willing to take medication only if the amount of risk reduction exceeded the actual benefit provided by commonly prescribed therapies.(18,19) Moreover, other clinicians noted that the reduc…”

“However, some studies have demonstrated that, when presented with numerical data regarding risk reduction, many patients would be willing to take medication only if the amount of risk reduction exceeded the actual benefit provided by commonly prescribed therapies.(18,19) Moreover, other clinicians noted that the reduc…”

“Second, the clinicians who discussed the absence of risk calculators for patients with multiple conditions highlight the need for the development of methods to provide individualized assessments of harm vs benefit associated with different treatment strategies in order to determine optimal therapy depending on a patie…”

“Physicians recognize the limitations of focusing on managementof individualdiseases in thecareofpatientswithmultiple chronic conditions.(9) In addition to restructuring how care is deliveredandpaidfor,physiciansneednewtoolsandappropriate datatomaketherightdecisionsforindividualpatientswithmultiple chronic conditions (…”

“The individual treatment options are considered in terms of their effects on each of these outcomes, so that a treatment can be selected according to its likelihood of achieving the patient’s most-desired outcome or avoiding the least-desired outcome.(21,22) There are several additional considerations for clinicians t…”