Mariken Stegmann

Table 1. Characteristics of the included studies  Design and aim Setting Participants OPT item ranked as most  important outcome Other outcomes Developmental articles Fried, 2011  (PEC) Qualitative study  Aim: to pilot the OPT  Home dwelling  Connecticut, USA  N=81   Aged 70 and older   Cognitively intact persons with  hypertension and fall risk   Life extension 27%  Maintaining independence 42%  Reducing pain 21%  Reducing other symptoms 10%  Understanding of the instrument was rated  as a 4 or a 5 (out of 5) for 73%  of participants.  Test‐retest reliability fair to poor.  Fried, 2011  (Archives) Qualitative study  Aim: to pilot the OPT  Home dwelling  (senior centres living  facility)  Connecticut, USA  N=357  Aged 65 and older  Life extension 11%  Maintaining independence 76%  Reducing pain 7%  Reducing other symptoms 6%  Percent agreement regarding the most  important and least important outcome  ranged from 85% to 100%.  Articles in literature review Case, 2013 Mixed methods cross‐sectional study  Aim: to compare the OPT with two other  tools  Home dwelling  Connecticut, USA  N= 356   Aged 65 and older  Not applicable  41% preferred the OPT (vs 40% / 19% other  tool).  21% of participants believed use of a tool  would change care.  Van  Summeren  2016 &  Van  Summeren 2017 Mixed methods non‐controlled  intervention study  Aim: to evaluate the OPT during a  polypharmacy conversation between  patient and GP.   Primary care  The Netherlands  N=58 (and their 13 GPs)  Aged 69 and older  Two or more chronic conditions  (one of which had to be  cardiovascular disease), and daily  use of ve or more medications   Life extension 31%  Maintaining independence 35%  Reducing pain 11%  Reducing other symptoms 18%  92% found the OPT understandable  55% could easily prioritise between health  outcomes  After use of the OPT GPs proposed 34  changes of medication, mainly stopping, for  20 patients. At follow‐up, 14 medication  changes were observed for 10 patients.  Ramer,  2018 Quantitative cross‐sectional study  Aim: to examine the associations between  priorities and self‐reported health status  and between priorities and acceptance of  common end‐of‐life scenarios.  Secondary care  New York, USA  N=271   Aged 60 and older  Advanced non–dialysis‐ dependent chronic kidney  disease  Life extension 35%  Maintaining independence 49%  Reducing pain 9%  Reducing other symptoms 6%  Providers’ perceptions about patients’ top  health outcome priorities were correct 35%   Stegmann,  2017  Protocol article of a RCT  Aim: to evaluate the effect of an OPT‐ conversation by the GP (intervention) on  decision self‐efficacy compared to patients  who did not have this OPT‐conversation  (control).  Transmural  The Netherlands  Aged 60 and older  Patients with non‐curable cancer,  who need to decide about  treatment  Not applicable  Not applicable  3 33 Review about the Outcome Prioritisation Tool