Aims This study aimed to identify the outcomes that are important to frail older patients admitted to hospital with peripheral arterial disease (PAD), informal caregivers and clinicians and to ascertain the attitudes, values and beliefs underpinning prioritisation of these outcomes.
Methods Frail inpatients with PAD aged ≥65 years, informal caregivers, vascular surgeons, nurses, and allied health professionals (AHPs) were purposively sampled from a tertiary Vascular Surgery Department in Brisbane. Focus groups using Nominal Group Technique were conducted with each stakeholder group. The 10 highest ranked outcomes for each group were identified, and qualitative data were analysed thematically.
Results Six patients, four caregivers, four nurses, four AHPs, and six surgeons participated in six focus groups and identified 88 outcomes. Outcomes relating to independence, wellbeing and quality of life were prioritised by all groups. Discharge home and pain relief were highly prioritised by patients, nurses, AHPs and surgeons. Outcomes relating to communication and relationships were important to patients and caregivers. Outcomes unique to caregivers related to knowledge gain and future planning. Seven themes related to the prioritisation of clinical outcomes (including ‘importance of getting home’ and ‘restoring and maintaining independence’) and four themes related to the experience of being, or caring for, a frail patient with PAD (including complexity of making the ‘right’ decisions’, and ‘importance of relationships and communication’).
Conclusions Knowledge about prioritised outcomes may optimise shared decision-making with this vulnerable patient group and may guide the implementation and evaluation of new models of vascular surgery care such as geriatric co-management.