Table 3.

Proposed Topics for Research Agenda for Each Domain

Topic	Research Agenda to Address Challenges
Patient preferences	Generate evidence regarding effects of treatment choices on outcomes other than survival, including functional status and quality of life.
	Develop and test risk calculators and other tools to help clinicians inform patients appropriately by providing individualized outcome data according to each person’s multimorbidity profile.
	Compare methods to convey numerical information on benefits and harms and uncertainty to older adults with multimorbidity and their family or friends.
	Compare feasibility, acceptability, and results of using different methods of preference elicitation.
Interpreting the evidence	Improve trial and study designs to include more older adults with multimorbidity, measure important outcomes, and evaluate time horizon to benefit.
	Compare optimal methods for prioritizing the multiple possible treatment recommendations.
	Develop and test methods to help clinicians apply guidelines appropriately to older adults with multimorbidity.
	Design and test clinical decision support systems for this population.
Prognosis	Develop, refine, externally validate, and test prognostic measures for feasibility and effect on clinical outcomes for this population.
	Determine optimal approaches to communicating prognosis to inform clinical decision-making.
Clinical feasibility	Develop sound and practical measures for describing treatment complexity and burden (pharmacological and nonpharmacological) in older adults with multimorbidity.
	Evaluate use of such tools in clinical practice.
	Determine how overall treatment burden affects adherence and patient-important outcomes.
Optimizing therapies and care plans	Develop evidence and tools to help clinicians recognize indications for discontinuing therapy and identify situations in which therapies should not be initiated at all.
	Evaluate approaches for discontinuing medications, including communication with patients and family and friends.
	Incorporate a discontinuation arm or post discontinuation follow-up in trials.
Overall	Investigate the best methods to implement principles in busy practices.