What Matters Most: An Example of Implementing Patient Priorities Care.

This is the first in a series of Age-Friendly case studies developed as a function of the John A. Hartford Foundation grant to the American Society of Consultant Pharmacists and the Peter Lamy Center on Drug Therapy and Aging at the University of Maryland School of Pharmacy to Leverage Pharmacists as Age-Friendly 4Ms Champions. This series presents a case for each of the 4Ms: What Matters, Medication, Mentation, and Mobility, and examines how these elements interrelate to optimize care for older patients.This report involves adopting the 4Ms Framework of an Age-Friendly Heath System (What Matters, Medication, Mentation, and Mobility) in combination with the Patient Priorities Care (PPC) approach for a female patient with multiple chronic conditions. PPC supports patients and care teams in aligning health care decisions with what matters most to the patient. While applicable to all patients, it is particularly valuable for older patients with multiple chronic conditions, such as the patient in this case.The authors sought to identify what matters most to the patient, specifically her desires to spend more time with her grandchildren, volunteer in her community, and maintain independence in mobility. They then worked with the care team to determine how best to support those goals.Fatigue was identified as the greatest barrier. The team evaluated potential interventions to reduce the patient's fatigue, considering their risks, benefits, relative likelihood of effect, and feasibility. After engaging in collaborative decision-making with the patient, the team selected an intervention and followed up to assess its impact on the patient's ability to achieve her goals.This case illustrates how the PPC approach can help operationalize patient-centered care by aligning clinical decisions with what matters most to older adults with multiple chronic conditions.