Linking Patients' Goals and Priorities to Recommendations for Medication Changes in a Polypharmacy-Focused Structured...

Area of Science:

• Gerontology
• Clinical Pharmacy
• Health Services Research

Background:

• Polypharmacy in older adults is linked to adverse health outcomes.
• Balancing medication benefits and harms is complex, especially with single-disease guidelines.
• Patient input is crucial for optimizing medication management.

Purpose of the Study:

• To describe participant goals, priorities, and preferences in a structured polypharmacy process.
• To assess how decision-making aligned with patient input, indicating a patient-centered approach.

Main Methods:

• A single-group, quasi-experimental study nested within a feasibility randomized controlled trial.
• Patient goals and priorities were systematically mapped to medication recommendations.
• Data collected on functional goals, symptom priorities, and unwanted medications.

Main Results:

• 33 participants reported 55 functional goals and 66 symptom priorities.
• 16 participants identified unwanted medications.
• Out of 154 medication alteration recommendations, 68 (44%) aligned with patient goals and priorities.

Conclusions:

• A structured process incorporating patient goals and priorities supports a patient-centered approach to polypharmacy.
• Integrating patient conversations into medication decisions is recommended for older adults.
• This methodology can help minimize medication harms while maximizing benefits.