Results of the Acute Care of Older Persons Priority Setting Partnership: A Patient‐Centered Research Agenda at the Intersection of Hospital Medicine and Geriatric Medicine

Background:

Despite evidence of high burden of disease, higher costs, and worse outcomes of care of older adults with acute illness, there is limited understanding of the presentation, diagnostic strategies, and management of these patients. The Patient‐Centered Outcomes Research Institute (PCORI) recommends a framework for identification and prioritization of research areas with a focus on inclusion of input from patients and clinicians.

Methods:

To determine research priorities, we employed a systematic and inclusive process for topic generation modified from the James Lind Alliance involving the systematic engagement of multiple stakeholders, including patients and caregivers. The approach included 5 phases: 1. Convene steering committee; 2. Consult with stakeholders to identify gaps in the scientific knowledge regarding the care of the acutely ill older patient; 3. Collate a list of potential research questions resulting from the solicitation process; 4. Prioritize the most important research questions, and 5. Disseminate results. We report on the results of phases 1‐4.

Results:

We formed a steering committee of hospital‐medicine and geriatrics health services and clinical researchers from the Society of Hospital Medicine research committee. A diverse group of 17 stakeholder organizations was convened by telephone and committed to participate in the project. Using an electronic survey, stakeholder organizations surveyed their memberships to generate 580 individual responses and 1299 unanswered questions for consideration. Two levels of review by steering committee members reduced the list to 75 unanswered questions. Additional consultation of earlier published research agendas and Cochrane reviews were used to add additional questions for consideration. A first round of email voting by stakeholder organizations was followed by a face‐to‐face prioritization meeting employing nominal group technique to reach consensus. A “top 10” list of the highest priority unanswered questions for research was identified and will be presented.

Conclusions:

The input of diverse stakeholders is feasible and generated a balanced list of priority topics for inclusion in a patient‐centered research agenda at the intersection of hospital medicine and geriatric medicine.