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Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations

  • 0Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Addenbrookes Biomedical Campus, Robinson Way, Cambridge, CB20SZ, UK. Sde23@medschl.cam.ac.uk.
European Geriatric Medicine +

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May 24, 2025

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May 24, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Co-designed recommendations improve communication of prognostic uncertainty for older adults with advanced multimorbidity. This approach supports parallel planning and enhances the care experience by fostering trust and open discussion.

Area Of Science

  • Gerontology and Palliative Care
  • Health Communication
  • Qualitative Research Methods

Background

  • Older adults with advanced multimorbidity experience unpredictable illness trajectories.
  • Effective communication of prognostic uncertainty is crucial but lacks evidence in multimorbidity.
  • Co-designing recommendations can address this gap by incorporating patient and professional expertise.

Purpose Of The Study

  • To co-design clinical practice recommendations for communicating prognostic uncertainty in advanced multimorbidity.
  • To base recommendations on the lived experiences of patients, carers, and healthcare professionals.
  • To improve the communication of uncertainty for better patient care.

Main Methods

  • A multi-method qualitative co-design study was conducted.
  • Phase one involved interviews and focus groups with older adults, carers, and health professionals.
  • Phase two utilized stakeholder events for feedback and iterative development of recommendations.

Main Results

  • Personalized approaches, trusting relationships, and adequate preparation are key for discussing prognostic uncertainty.
  • Open, honest discussions within negotiated limits are essential.
  • Clinicians should signpost support and engage in parallel planning for future possibilities.

Conclusions

  • Co-designed recommendations offer a framework for communicating prognostic uncertainty in advanced multimorbidity.
  • Implementing these recommendations can mitigate negative impacts of uncertainty.
  • Improved communication can lead to a better overall care experience for older adults.

Keywords:

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