This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Each year, more than 500,000 older adults in the United States think about having major surgery, such as surgery to treat heart disease or cancer, that can cause complications or even death. Although older patients can benefit from these surgeries, they are also more likely to face serious problems. They may also need a long stay in the hospital or a nursing home after. In many cases, patients don’t expect these problems.
Knowing the possible benefits and harms of all of their treatment options can help older patients and their families decide if major surgery is the right choice for them. Doctors often struggle to explain the possible benefits and harms of surgery in a way that makes sense to patients and family members. Patients and family members may find it hard to know what questions to ask. The research team wants to test whether giving patients a set of questions to ask about surgery helps them get the information they need to make the best choice for them.
Who can this research help?
This research may help older adults, family members, and their doctors talk more clearly about treatment options and make treatment decisions that work best for them.
What is the research team doing?
The research team is enrolling 448 adults ages 60 and older in five cities across the United States. Patients have one or more long-term health problems and are thinking about having a major surgery. The team is assigning patients to two groups by chance. In the first group, before patients meet with a surgeon, the research team is sending them a brochure with a list of questions to ask their surgeon and a letter from the surgeon encouraging them to ask questions. In the second group, surgeons are caring for patients as they usually do, giving patients their views on the benefits and risks of the surgery during an appointment.
The research team wants to know if the brochure and letter help patients ask questions and work with their surgeon to make a treatment decision. The team is reviewing recordings of each surgeon-patient discussion. Patients and family members are also filling out a survey after the visit with their surgeon, and 6 and 12 weeks later. The surveys ask patients if they felt that they could ask questions and if their stress levels related to their illness changed. It also asks about their feelings regarding their treatment decision. The team is interviewing some patients who have serious problems after surgery to learn more about their experience making a treatment decision.
Patients, caregivers, and doctors are helping design and carry out the study.