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Assessing What Matters Most in Older Adults With Multicomplexity
Jennifer Moye1,2, Jane A Driver1,3, Montgomery T Owsiany1
1VA Boston Healthcare System, New England Geriatric Research Education and Clinical Center (GRECC), Massachusetts, USA.
The Gerontologist
|May 27, 2021
Summary
Identifying older adults' priorities is possible using the What Matters Most-Structured Tool (WMM-ST). This tool helps clarify values for complex care, though further validation is needed.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Patient-Centered Care
Background:
- Older adults with multiple complex conditions face challenges in achieving valued abilities and activities.
- The Geriatrics 5Ms framework emphasizes prioritizing care based on "what matters most" to patients.
- The What Matters Most-Structured Tool (WMM-ST) was developed to operationalize this principle.
Purpose of the Study:
- To evaluate and refine the WMM-ST for assessing patient priorities.
- To describe the values of older adults with multicomplexity.
- To assess the association between patient characteristics and their stated values.
Main Methods:
- 105 older adults with an average of 4 chronic conditions completed the WMM-ST and the Serious Illness Conversation Guide.
- Participants underwent cognitive and frailty screening.
- Quantitative and qualitative analyses were used to assess tool validity, acceptability, and content accuracy.
Main Results:
- Patient values varied significantly.
- Modest associations were found between values and social support, religiosity, cognition, and frailty.
- The WMM-ST demonstrated good understandability (86%) and applicability (61%), independent of education.
Conclusions:
- The WMM-ST is a viable tool for assessing "what matters most" in older adults with complex conditions.
- Structured tools can aid in clarifying patient priorities for care.
- Further validation in diverse populations is recommended.
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