Aligning the Visit Priorities of Complex Patients and their Primary Care Providers

The primary care visit is a key opportunity for catalyzing changes in care for complex patients with multiple heath issues. With too many items to address in the time allotted, however, the decision of which items to focus on requires prioritization. Prior studies have shown that: 1) patients and providers often have discordant priorities, 2) this discordance is associated with less effective care (e.g., poor adherence, lack of medication intensification), and, conversely, 3) collaborative interactions with informed, activated patients and prepared providers lead to better clinical outcomes. We hypothesize that a systematic approach that enables patients and providers to align visit priorities will result in more effective, patient-centered care because explicitly negotiated management decisions that address both patient and provider priorities are more likely to be adopted. This project will include focus groups and a pilot clinical trial examining impact on patient-centered outcomes.

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