Predictors of Unrelieved Symptoms in All of Us Research Program Participants With Chronic Conditions

Complex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic Conditions

“…1 Describing the complex care needs of seriously ill adults with MCCs among those with and without cancer can be instrumental in developing high-quality palliative and end-of-life care with greater precision that improves patient and family-centered outcomes for this vulnerable population. 1,3,4 Nurses are often at the forefront of providing palliative care to seriously ill adults with MCCs across a multitude of health care settings. 4 Nurses play a critical role in caring for medically complex seriously ill adults with MCCs, especially at the end of life.…”

“…7,8 Seriously ill adults with MCCs often have complex care needs associated with high symptom burden, poor quality of life, impaired functional status, and high medication burden that results in polypharmacy. 1,3 Increased health care utilization, another facet of serious illness, can include frequent admissions to the emergency department, multiple hospitalizations, and burdensome care transitions. 9 These key facets of serious illness result in increased clinical complexity and are important predictors of complex care needs at the end of life.…”

“…Furthermore, as serious illness research has largely focused on individuals with cancer, the complex care needs of seriously ill adults with MCCs without cancer have received less attention 1 . Describing the complex care needs of seriously ill adults with MCCs among those with and without cancer can be instrumental in developing high-quality palliative and end-of-life care with greater precision that improves patient and family-centered outcomes for this vulnerable population 1,3,4 . Nurses are often at the forefront of providing palliative care to seriously ill adults with MCCs across a multitude of health care settings 4 .…”

A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions

“…Among U.S. adults with MCCs, arthritis, diabetes mellitus, heart disease, and hypertension are among the most common conditions (Freid et al, 2012; Meraya et al, 2015; Ward & Schiller, 2010). MCCs are often associated with unrelieved, co-occurring symptoms such as fatigue, emotional distress, and pain that can limit daily activities, cause disability, and lead to poor social and occupational functioning (Dreisbach et al, 2022; Jindai et al, 2016). Patients with MCCs commonly have numerous health care providers managing multiple care plans, which often results in care fragmentation—inadequate communication, poor coordination, and lack of teamwork between multiple providers (DuGoff, 2018; Maeng et al, 2012; Savitz & Bayliss, 2021).…”

Friends of the National Library of Medicine Workshop on Precision Health

“…She described the use of the database to conduct research on predictors of unrelieved symptoms in patients in the All of Us Program with chronic conditions from recently published data. 4 Her presentation focused on the identification of symptom phenotypes in patients with cancer, congestive heart failure, chronic obstructive pulmonary disease, and type 2 diabetes and focused on pain, fatigue and anxiety, depression, and irritability. The research teams' findings were foregoing or delaying medical care, and rating mental health as poor or fair increased the odds of belonging to a highly symptomatic phenotype.…”