Complex health care decisions with older patients in general practice: Patient-centeredness and prioritization in consultations following a geriatric assessment

Patient Education and Counseling

Volumn 90, Issue 1, 2013, Pages 54-60

  Wrede, Jennifer ^a,b   Voigt, Isabel ^a   Bleidorn, Jutta ^a   Hummers Pradier, Eva ^a   Dierks, Marie Luise ^a   Junius Walker, Ulrike ^a  

^a HANNOVER MEDICAL SCHOOL   (Germany)

^b UNIVERSITY MEDICAL CENTER HAMBURG EPPENDORF   (Germany)

Author keywords

Aged; Communication; General practice; Germany; Health priorities; Patient centered care

Indexed keywords

ADULT; AGED; ARTICLE; COMMUNICATION SKILL; COMORBIDITY; CONSULTATION; CONTROLLED STUDY; DOCTOR PATIENT RELATION; FEMALE; GENERAL PRACTITIONER; GERIATRIC ASSESSMENT; GERIATRIC PATIENT; HOLISTIC CARE; HUMAN; MALE; MEDICAL DECISION MAKING; OBSERVATIONAL STUDY; PATIENT CARE; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); TREATMENT PLANNING;

AGED; AGED, 80 AND OVER; COMMUNICATION; COMORBIDITY; DECISION MAKING; FEMALE; GENERAL PRACTICE; GENERAL PRACTITIONERS; GERIATRIC ASSESSMENT; GERMANY; HUMANS; MALE; PATIENT CARE PLANNING; PATIENT PARTICIPATION; PATIENT-CENTERED CARE; PHYSICIAN'S PRACTICE PATTERNS; PHYSICIAN-PATIENT RELATIONS; PROCESS ASSESSMENT (HEALTH CARE); REFERRAL AND CONSULTATION;

EID: 84870849075     PISSN: 07383991     EISSN: 18735134     Source Type: Journal    
DOI: 10.1016/j.pec.2012.07.015     Document Type: Article

References (44)

1. Fortin M., Lapointe L., Hudon C., Vanasse A., Ntetu A.L., Maltais D. Multimorbidity and quality of life in primary care: a systematic review. Health Qual Life Outcomes 2004, 2:51. 10.1186/1477-7525-2-51.
2. Tinetti M.E., Fried T. The end of the disease era. Am J Med 2004, 116:179-185.
3. Wiesner G., Bittner E. On the incidence and prevalence of polypathia in Germany. Arbeitsmed Sozialmed Umweltmed 2005, 40:490-498. [in German].
4. Renteln-Kruse W.v. Epidemiological aspects of morbidity in older age. Z Gerontol Geriat 2001, 34:10-15. [in German].
5. Bahrs O. Mein Hausarzt hat Zeit für mich - Wunsch und Wirklichkeit Ergebnisse einer europäischen Gemeinschaftsstudie. GGW 2003, 1:17-23. [in German].
6. Hodek J.M., Ruhe A., Greiner W. Multimorbidity and health-related quality of life among elderly persons. Bundesgesundheitsblatt 2009, 52:1188-1201. [in German].
7. Boyd C.M., Darer J., Boult C., Fried L.P., Boult L., Wu A.W. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases implications for pay for performance. J Amer Med Assoc 2005, 294:716-724. 10.1001/jama.294.6.716.
8. Junius-Walker U., Theile G., Hummers-Pradier E. Prevalence and predictors of polypharmacy among older primary care patients in Germany. Fam Pract 2007, 24:14-19. 10.1093/fampra/cml067.
9. Piccoliori G., Gerolimon E., Abholz H. Geriatric assessment in general practice - a study of the south Tyrolean academy of general practice. ZFA 2005, 81:491-498. [in German]. 10.1055/s-2005-872582.
10. European Academy of Teachers in General Practice - Network within WONCA Europe. The European Definition of General Practice/Family medicine. Short Version 2005, EUROACT, p. 7.
11. Härter M., Loh A., Spies C. Gemeinsam entscheiden - erfolgreich behandeln. Neue Wege für Ärzte und Patienten im Gesundheitswesen 2005, Deutscher Ärzte Verlag, Köln, [in German].
12. Loh A., Simon D., Kriston L., Härter M. Shared decision making in medicine. Dtsch Arztebl 2007, 104:21. [in German].
13. Simon D., Loh A., Härter M. Development and evaluation of interventions to support shared decision making - framework and measuring instruments. Z Med Psychol 2008, 17:149-159. [in German].
14. Matthys J., Elwyn G., Van Nuland M., Deveugele M. Patients' ideas, concerns, and expectations (ICE) in general practice: impact on prescribing. Br J Gen Pract 2009, 58:29-36. 10.3399/bjgp09X394833.
15. Bertrakis K.D., Azari R. Determinants and outcomes of patient-centered care. Patient Educ Couns 2011, 85:46-52.
16. Mead N., Bower P. Patient-centered consultations and outcomes in primary care: a review of the literature. Patient Educ Couns 2002, 48:51-61.
17. Lewin S., Skea Z., Entwistle V.A., Zwarenstein M., Dick J. Interventions for providers to promote a patient-centered approach in clinical consultations. Cochrane Database Syst Rev 2001, 4:CD003267.
18. Voigt I., Wrede J., Diederichs-Egidi H., Dierks M.L., Hummers-Pradier E., Junius-Walker U. PrefCheck: patient-centered treatment planning with older multimorbid patients. Method and design. Z Gerontol Geriat 2010, 43:303-309. [in German].
19. Williams E.I., Fischer G., Junius U., Sandholzer H., Jones D., Vass M. An evidence-based approach to assessing older people in primary care 2002, Royal College of General Practitioners, London.
20. Stange K.C. A science of connectedness. Ann Fam Med 2009, 7:387-395.
21. Epstein R.M., Franks P., Fiscella K., Shields C.G., Meldrum S.C., Kravitz R.L., et al. Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med 2005, 61:1516-1528.
22. Silverman J.D., Kurtz S., Draper J. Skills for communicating with patients 1998, Radcliffe Medical Press, Oxford.
23. Tate P. Ideas, concerns expectations. Medicine (Baltimore) 2005, 33:26-27.
24. Klemperer D, Rosenwirth M., Shared Decision Making: Konzept, Voraussetzungen und politische Implikationen. Chartbook. Gütersloh: Bertelsmann Stiftung; 2005. Online: [accessed 24.08.11].[in German]. http://www.bertelsmann-stiftung.de/cps/rde/xbcr/SID-83453704-580045BA/bst/chartbook_190705_%282._Auflage%29.pdf.
25. Patientenbeteiligung bei medizinischen Entscheidungen. 2. Tagung des Förderschwerpunktes. Der Patient als Partner im medizinischen Entscheidungsprozess 2004, Düsseldorf, Köln, German Medical Science, [in German].
26. Larson E.B., Yao X. Clinical empathy as emotional labor in the patient-physician relationship. J Amer Med Assoc 2005, 293:1100-1106.
27. Rappaport J. Terms of empowerment/examples of prevention: toward a theory for community psychology. Am J Couns Psyhcol 1987, 15:121-149.
28. Spicker P. What is a priority?. J Health Serv Res 2009, 14:117-118.
29. Shulman K.I., Gold D.P., Cohen C.A., Zucchero C.A. Clock drawing and dementia in the community: a longitudinal study. Int J Geriatr Psychiatry 1993, 8:487-496.
30. Bastiaens H., Van Royen P., Pavlic D.R., Raposo V., Baker R. Older people's preferences for involvement in their own care: a qualitative study in primary health care in 11 European countries. Patient Educ Couns 2007, 68:33-42.
31. Towle A., Godolphin W., Grams G., Lamarre A. Putting informed and shared decision making into practice. Health Expect 2006, 9:321-332.
32. Elwyn G, Edwards A, Rhydderch M., Shared Decision Making: das Konzept und seine Anwendung in der klinischen Praxis. In: Härter M, Loh A, Spies C, editors. Gemeinsam entscheiden - erfolgreich behandeln. Cologne: Deutscher Ärzte Verlag, 2005. p. 3-12.[in German].
33. Schneider A., Körner T., Mehring M., Wensing M., Elwyn G., Szecsenyi J. Impact of age, health locus of control and psychological co-morbidity of patients' preferences for shared decision making in general practice. Patient Educ Couns 2006, 61:292-298.
34. Whitney S.N. A new model of medical decisions: exploring the limits of shared decision making. Med Decis Making 2003, 23:275-280.
35. Fossum B., Arborelius E. Patient-centered communication: videotaped consultations. Patient Educ Couns 2004, 54:163-169.
36. Stewart M. Towards a global definition of patient centered care. The patient should be the judge of patient centered care. Brit Med J 2001, 322:444-445.
37. Clayton M.F., Latimer S., Dunn T.W., Haas L. Assessing patient-centered communication in a family practice setting: how do we measure it, and whose opinion matters?. Patient Educ Couns 2011, 84:294-302.
38. Schwenk T.L. Competing priorities and comorbidities. So much to do and so little time. Comment on Arch Fam Med 1997, 6:238-239.
39. Farin E. Patient-Provider communication in chronic illness: current state of research in selected areas. Rehabilitation (Stuttg) 2010, 49:277-291.
40. Roter D.L., Stewart M., Putnam S.M., Lipkin M., Stiles W., Inui T.S. Communication patterns of primary care physicians. J Amer Med Assoc 1997, 277:350-360.
41. Kurtz S.M., Silverman J.D. The Calgary-Cambridge observation guides: an aid to defining the curriculum and organising the teaching in communication training programmes. Med Educ 1996, 30:83-89.
42. Simmenroth-Nayda A., Gagyor I., Ahrens D., Chenot J.F., Fischer T., Scherer M., et al. " Instant Aging" a teaching concept for enhancing the patient perspective in 3 year-medical students. ZFA 2007, 83:252-255. [in German]. 10.1055/s-2007-980198.
43. Junius-Walker U., Voigt I., Wrede J., Hummers-Pradier E., Lazic D., Dierks M.L. Health and treatment priorities in patients with multimorbidity: report on a workshop from the European General Practice Network meeting 'Research on multimorbidity in general practice'. Eur J Gen Pract 2010, 16:51-54.
44. Deutscher Ethikrat. Nutzen und Kosten im Gesundheitswesen - Zur normativen Funktion ihrer Bewertung. Stellungnahme. [Statement of the German Ethics Council: Benefits and costs of health care]. Berlin, 2011. Online: [accessed 09.09.11] [in German]. http://www.ethikrat.org/dateien/pdf/stellungnahme-nutzen-und-kosten-im-gesundheitswesen.pdf.