Sathanapally Harini, Chudasama Yogini V, Zaccardi Francesco, Rizzi Alessandro, Seidu Samuel, Khunti Kamlesh
Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.
Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom.
PLoS One. 2024 Dec 31;19(12):e0301740. doi: 10.1371/journal.pone.0301740. eCollection 2024.
The outcome prioritisation tool (OPT) is a simple tool to ascertain the health outcome priorities of people with MLTC. Use of this tool in people aged under 65 years with MLTC has not previously been investigated. This study aimed to investigate the feasibility of using the OPT in people with MLTC aged 45 years or above, in a multi-ethnic primary-care setting and describe the health outcome priorities of people with MLTC by age, clusters of long-term conditions and demographic factors, and to investigate any differences in prioritisation in light of the COVID-19 pandemic.
This was a multi-centre cross-sectional study using a questionnaire for online self-completion by people aged 45 years or above with MLTC in 19 primary care settings across the East Midlands, UK. Participants were asked to complete the OPT twice, first from their current perspective and second from their recollection of their priorities prior to COVID-19.
The questionnaire was completed by 2,454 people with MLTC. The majority of participants agreed or strongly agreed that the OPT was easy to complete, relevant to their healthcare and will be useful in communicating priorities to their doctor. Summary scores for the whole cohort of participants showed Keeping Alive and Maintaining Independence receiving the highest scores. Statistically significant differences in prioritisation by age, clusters of long-term conditions and employment status were observed, with respondents aged over 65 most likely to prioritise Maintaining independence, and respondents aged under 65 most likely to prioritise Keeping alive. There were no differences before or after COVID-19, or by ethnicity.
The OPT is feasible and acceptable for use to elicit the health outcome priorities of people with MLTC across both middle-aged and older age groups and in a UK setting. Individual factors could influence the priorities of people with MLTC and must be considered by clinicians during consultations.
结果优先排序工具（OPT）是一种用于确定长期护理患者健康结果优先级的简单工具。此前尚未对65岁以下的长期护理患者使用该工具进行过研究。本研究旨在调查在多民族初级保健环境中，45岁及以上的长期护理患者使用OPT的可行性，并按年龄、长期病症集群和人口统计学因素描述长期护理患者的健康结果优先级，同时调查在新冠疫情背景下优先级的任何差异。
这是一项多中心横断面研究，使用问卷让英国东米德兰兹地区19个初级保健机构中45岁及以上的长期护理患者在线自行填写。参与者被要求完成两次OPT，第一次从他们当前的角度，第二次从他们对新冠疫情之前优先级的回忆。
2454名长期护理患者完成了问卷。大多数参与者同意或强烈同意OPT易于完成、与他们的医疗保健相关且将有助于向医生传达优先级。整个参与者队列的综合得分显示，“维持生命”和“保持独立”得分最高。观察到按年龄、长期病症集群和就业状况进行优先级排序存在统计学显著差异，65岁以上的受访者最有可能将“保持独立”列为优先事项，65岁以下的受访者最有可能将“维持生命”列为优先事项。在新冠疫情之前或之后以及按种族划分均无差异。
在英国环境中，OPT对于引出中年和老年长期护理患者的健康结果优先级是可行且可接受的。个体因素可能会影响长期护理患者的优先级，临床医生在会诊期间必须予以考虑。
