Management and priorities of older patients with multimorbidity and cancer: developing a patient-centred care pathway

Abstract

This thesis has the aim to identify challenges and to optimize management and care of older patients with multimorbidity and cancer. The first part focuses on identifying challenges in the current way of organising care from perspective of patients, informal caregivers and the healthcare professionals. Furthermore, it advocates for policy makers to aid in changing care in this population. The second part looks at patient priorities and the involvement of the older patient in decision-making. It identifies the importance of quality of life and further investigates the exact meaning of quality of life. Additionally, it tests a method (the OPT-c) to elicit patient priorities for various health outcomes. The third part then specifies how chronic health conditions could be incorporated and monitored in cancer care. It starts with a study on which chronic health conditions are relevant in decision making and care and how to incorporate them. An additional study then identifies 19 core symptoms to monitor in older patients with multimorbidity and cancer. The results of the previously mentioned chapters are combined in part four, which consists of the description of the new patient-centred care pathway for the older patient with multimorbidity including cancer.