title: Patient prioritization of comorbid chronic conditions in the Veteran population: Implications for patient-centered care.
abstract: OBJECTIVE
  Patients with comorbid chronic conditions may prioritize some conditions over others; however, our understanding of factors influencing those prioritizations is limited. In this study, we sought to identify and elaborate a range of factors that influence how and why patients with comorbid chronic conditions prioritize their conditions.
  
  
  METHODS
  We conducted semi-structured, one-on-one interviews with 33 patients with comorbidities recruited from a single Veterans Health Administration Medical Center.
  
  
  RESULTS
  The diverse factors influencing condition prioritization reflected three overarching themes: (1) the perceived role of a condition in the body, (2) self-management tasks, and (3) pain. In addition to these themes, participants described the rankings that they believed their healthcare providers would assign to their conditions as an influencing factor, although few reported having shared their priorities or explicitly talking with providers about the importance of their conditions.
  
  
  CONCLUSIONS
  Studies that advance understanding of how and why patients prioritize their various conditions are essential to providing care that is patient-centered, reflecting what matters most to the individual while improving their health. This analysis informs guideline development efforts for the care of patients with comorbid chronic conditions as well as the creation of tools to promote patient-provider communication regarding the importance placed on different conditions.
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Veterans Health Administration, Bedford, MA, USA.
authors.forename: Lorilei M
authors.initials: LM
authors.lastname: Richardson
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Edward Hines Jr. VHA Hospital, Veterans Health Administration, Hines, IL, USA.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Hill
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Edward Hines Jr. VHA Hospital, Veterans Health Administration, Hines, IL, USA; Department of Pediatrics, Northwestern University, Evanston, IL, USA.
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Edward Hines Jr. VHA Hospital, Veterans Health Administration, Hines, IL, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Bauer
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Edward Hines Jr. VHA Hospital, Veterans Health Administration, Hines, IL, USA; Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, USA.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Jesse Brown VHA Medical Center, Veterans Health Administration, Chicago, IL, USA; Division of Academic Internal Medicine, Department of Medicine, University of Illinois Chicago at College of Medicine, Chicago, IL, USA.
authors.forename: Howard S
authors.initials: HS
authors.lastname: Gordon
authors.affiliation: Center of Innovation for Complex Chronic Health Care, Edward Hines Jr. VHA Hospital, Veterans Health Administration, Hines, IL, USA; Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, IL, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Stroupe
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Veterans Health Administration, Bedford, MA, USA; Division of Health Informatics and Implementation Science, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Hogan
keywords: Comorbid conditions; Veterans; patient-centered care; prioritization; self-management