多病共存ケアにおける健康の優先事項の理解

タイトル: Health outcome priorities of people with multiple long-term conditions before and during the COVID-19 pandemic: Survey data from the UK

概要: BackgroundThe outcome prioritisation tool (OPT) is a simple tool to ascertain the health outcome priorities of people with MLTC. Use of this tool in people aged under 65 years with MLTC has not previously been investigated. This study investigated the feasibility of using the OPT in people with MLTC aged 45 years or above, in a multi-ethnic primary-care setting, to describe the health outcome priorities of people with MLTC by age, clusters of long-term conditions and demographic factors, and to investigate any differences in prioritisation in light of the COVID-19 pandemic. MethodsThis was a multi-centre cross-sectional study using a questionnaire for online self-completion by people aged 45 years or above with MLTC in 19 primary care settings across the East Midlands, UK. Participants were asked to complete the OPT twice, first from their current perspective and second from their recollection of their priorities prior to COVID-19. ResultsThe questionnaire was completed by 2,454 people with MLTC. The majority of participants agreed or strongly agreed that the OPT was easy to complete, relevant to their healthcare and will be useful in communicating priorities to their doctor. Summary scores for the whole cohort of participants showed Keeping Alive and Maintaining Independence receiving the highest scores. Statistically significant differences in prioritisation by age, clusters of long-term conditions and employment status were observed, with respondents aged over 65 most likely to prioritise Maintaining independence, and respondents aged under 65 most likely to prioritise Keeping alive. There were no differences before or after COVID-19, or by ethnicity. ConclusionsThe OPT is feasible and acceptable for use to elicit the health outcome priorities of people with MLTC across both middle-aged and older age groups and in a UK setting. Individual factors could influence the priorities of people with MLTC and must be considered by clinicians during consultations. HIGHLIGHTSO_LISurvey data from 2,454 patients with MLTC showed that keeping alive and maintaining independence were the top first-choice priorities from the health outcome priorities tool (OPT). C_LIO_LIThe health outcomes priorities differed by socio-demographics and clusters of long-term conditions. C_LIO_LIThere were no differences in health outcomes priorities before and during COVID-19. C_LIO_LIOPT is easy and acceptable to implement in a health care setting in a broad patient group. C_LIO_LITranslation of the OPT into different languages is recommended to address any potential language barrier for people with MLTC completing the OPT C_LI