Patient Priorities Care

Patient Priorities Care (PPC) is an evidence-based approach to decision making that aligns health care with a person’s own health priorities – the health outcome goals they most desire given the healthcare tasks they are willing and able to do to achieve them. PPC was developed by clinicians, patients, caregivers, health system leaders, and payers. PPC is helpful for everyone, but it is most appropriate for older adults managing multiple chronic conditions, improving care by addressing what matters most to them.

PPC is a Yale research project from the Department of Internal Medicine’s Section of Geriatrics, led by co-creator Mary Tinetti, MD, who is the principal investigator on the research grant.

Interested in incorporating PPC into your practice? Access our implementation toolkit here.

Vu T, Mroz EL, Hernandez-Bigos K, Chow D, Ternent RS, Johnson KB, Tinetti ME, Monin J. Persons living with dementia and multiple chronic conditions identifying health priorities with care partners. J Am Geriatr Soc. 2023 Jan 27. doi: 10.1111/jgs.18257

Rafael Samper-Ternent, Mary Tinetti, Lee A Jennings, Rebeca Wong, Jennifer Arney, Aanand D Naik. Better care for older Hispanics: Identifying priorities and harmonizing care. J Am Geriatr Soc. 2022 Mar 23. doi: 10.1111/jgs.17748. Online ahead of print.

Ouellet JA, Mecca MC, Tinetti ME, Dindo L, Kiefer L, Nguyen AC, Omer ZB, Naik AD, Catic AG. Education outcomes of a multisite, virtual, interprofessional training in patient priorities aligned care. J Am Geriatr Soc. 2021 Nov 6. doi: 10.1111/jgs.17544. Epub ahead of print. PMID: 34741462.

Davenport C, Ouellet J, Tinetti ME. Use of the Patient-Identified Top Health Priority in Care Decision-making for Older Adults With Multiple Chronic Conditions. JAMA Netw Open. 2021;4(10):e2131496. doi:10.1001/jamanetworkopen.2021.31496

Tinetti ME, Costello DM, Naik AD, et al. Outcome Goals and Health Care Preferences of Older Adults With Multiple Chronic Conditions. JAMA Netw Open. 2021;4(3):e211271. doi:10.1001/jamanetworkopen.2021.1271

Gregory M. Ouellet MD, MHS; Eliza Kiwak BA; Darcé M. Costello EdD, MPH, MBA; Ariel R. Green MD, MPH, PhD; Mary Geda BSN, MSN, RN; Aanand D. Naik MD; Mary E. Tinetti MD. Clinician Perspectives on Incorporating Patients’ Values-Based Health Priorities in Decision-Making. J Am Geriatr Soc. 2020. doi.org/10.1111/jgs.16914

Freytag, J., Dindo, L., Catic, A., Johnson, A.L., Bush Amspoker, A., Gravier, A., Dawson, D.B., Tinetti, M.E. and Naik, A.D. (2020), Feasibility of Clinicians Aligning Health Care with Patient Priorities in Geriatrics Ambulatory Care. J Am Geriatr Soc. doi:10.1111/jgs.16662

Tinetti ME, Naik AD, Dindo L, et al. Association of Patient Priorities–Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial. JAMA Intern Med. 2019. doi:10.1001/jamainternmed.2019.4235

Tinetti M, Dindo L, Smith CD, Blaum C, Costello D, Ouellet G, et al. Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PLoS ONE. 2019; 14(6): e0218249. doi.org/10.1371/journal.pone.0218249

Feder SL, Kiwak E, Costello D, Dindo L, Hernandez-Bigos K, Vo L, Geda M, Blaum C, Tinetti ME, Naik AD. Perspectives of Patients in Identifying Their Values-Based Health Priorities. J Am Geriatr Soc. 2019. doi.org/10.1111/jgs.15850

Boyd, C, Smith, D, Masoudi , FA, Blaum CS, Dodson, JA, Green, AR, Kelley, A, Matlock, D, Ouellet, J, Rich MW, Schoenborn, NL, Tinetti, ME. Framework for Decision-making for Older Adults with Multiple Chronic Conditions: Executive Summary of Action Steps for the AGS Guiding Principles on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2019. doi: 10.1111/jgs.15809. [Epub ahead of print]

Tinetti, ME, Green, AR, Ouellet, J, Rich, MW, Boyd, C. Caring for Patients With Multiple Chronic Conditions. Ann Intern Med. 2019. doi: 10.7326/ M18-3269. [Epub ahead of print]

Blaum CS, Rosen J, Naik AD, et al. Feasibility of Implementing Patient Priorities Care for Patients with Multiple Chronic Conditions Journal of the American Geriatrics Society. 2018;66(10):2009-2016. doi.org/10.1111/jgs.15465

Naik AD, Dindo LN, Van Liew JR, et al. Development of a Clinically-Feasible Process for Identifying Patient Health Priorities Journal of the American Geriatrics Society. 2018;66(10):1872-1879. doi.org/10.1111/jgs.15437

PCORI White Paper: Patient Priorities Care Research Agenda: Results of Multi-stakeholder Engagement

Ferris R, Blaum C, Kiwak E, et al. Perspectives of Patients, Clinicians, and Health System Leaders on Changes Needed to Improve the Health Care and Outcomes of Older Adults with Multiple Chronic Conditions 2018;30(5):778-799. doi.org/10.1177/089826431769116

Tinetti ME, Naik AD, Dodson JA. Moving From Disease-Centered to Patient Goals-Directed Care for Patients with Multiple Chronic Conditions JAMA Cardiology. 2016;1(1):9-10. doi:10.1001/jamacardio.2015.0248

Tinetti ME, Esterson J, Ferris R, Posner P, Blaum CS. Patient Priority-Directed Decision Making and Care for Older Adults with Multiple Chronic Conditions Clin Geriatr Med. 2016;32(2):261-275. doi:10.1016/j.cger.2016.01.012