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

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.