Mariken Stegmann

Effects of the use of a conversation in which the OPT was used on clinical care were assessed  in the study by van Summeren. After the OPT‐conversation, 34 changes in medication were  proposed to 20 of the 58 patients, with mainly preventive medication being stopped. 16 Summary The OPT is a promising instrument to guide treatment decisions in older patients. Because  encompassing health outcomes are elicited, the tool can be used in different settings in both  primary and secondary care. Data regarding the use of the instrument and the effect of the  OPT on treatment decisions  are limited.  Practice points ‐ Treatment decisions in older patients can be complex and comprise trade‐offs  between risks and benefits.  ‐ To reach tailor‐made decisions it may be important to elicit patient goals and  preferences in a structured way.  ‐ The OPT is an instrument with four visual analogue scales, each representing a  encompassing treatment goal, and uses a trade‐off principle. It can be used in  different healthcare settings where (complex) treatment‐decisions have to be made.  ‐ One study suggested that there is a low concordance between the goals and  preferences of patients and healthcare providers’ perceptions about this.  Research agenda ‐ To evaluate the effects of the tool on treatment‐decisions in different healthcare  settings.  ‐ To evaluate the opinion of both patients and healthcare providers on the feasibility  and usability of the OPT.  ‐ To evaluate whether patients with a low education and low health literacy are able to  understand this instrument.  ‐ To monitor the prioritisation of outcomes over time, as this may change during  treatment.  ‐ To study whether the tool can be useful for younger patients as well.  ‐ To investigate how patients and healthcare providers translate the generic health  outcomes of the OPT to specific treatment decisions.  Highlights   ‐ The Outcome Prioritisation Tool (OPT) is an instrument with four visual analogue  scales, each representing an encompassing treatment goal, and uses a trade‐off  principle.   ‐ Although the tool is used in different healthcare settings, literature about the  instrument is scarce.  ‐ The studies reporting on the tool showed that OPT‐conversations were feasible for  both older patients and their healthcare providers.  ‐ More research is needed to evaluate the effects of the OPT‐conversations, for  instance on how the tool is used in specific healthcare decisions.  3 35 Review about the Outcome Prioritisation Tool