How to ask: older adults' preferred tools in health outcome prioritization.

OBJECTIVE

To assess older adults' attitudes toward eliciting health outcome priorities.

METHODS

This observational cohort study of 356 community-living adults age ≥65 included three tools: (1) Health Outcomes: ranking four outcomes (survival, function, freedom from pain, and freedom from other symptoms); (2) Now vs. Later: rating importance of current versus future quality of life; (3) Attitude Scale: agreement with statements about health outcomes and current versus future health.

RESULTS

Whereas 41% preferred Health Outcomes, 40% preferred the Attitude Scale. Only 7-12% rated any tool as very hard or hard. In bivariate analysis, participants of non-white race and with lower education, health literacy, and functional status were significantly more likely to rate at least one of the tools as easy (p < .05). Across all tools, 17% of participants believed tools would change care. The main reason for thinking there would be no change was satisfaction with existing care (62%).

CONCLUSIONS

There is variability in how older persons wish to be asked about health outcome priorities. Few find this task difficult, and difficulty was not greater among participants with lower health literacy, education, or health status.

PRACTICE IMPLICATIONS

By offering different tools, healthcare providers can help patients clarify their health outcome priorities.