Patient Involvement in Geriatric Care - Results and Experiences from a Mixed Models Design Study within Project INTEGRATE.

Introduction: Patient involvement is a core component of an integrated care approach. While the benefits and prerequisites of patient involvement have been described in general and additionally for some target populations, little is known about the views and experiences of older people regarding this matter.

Methods: A study with a mixed-methods design was conducted to gain a better understanding about patient involvement in geriatric care. A questionnaire on shared decision-making was administered within a group of older adults in Germany. Additionally, 7 focus groups with health professionals and geriatric patients in Germany and Estonia were held to deepen the insight of the questionnaire and discussing experiences and barriers of patient involvement.

Results: Older people without an actual medical problem expressed a significantly higher desire to participate in shared decisions than those requiring actual medical care. No significant differences could be found for the desire to be informed as part of the care process. No correlation between patients' desire and experiences on shared decision-making could be observed. In the focus groups, patients demanded a comprehensive and understandable information and education process while the health professionals' view was very task-specific. This conflict led to a loss of trust by the patients.

Conclusions: There is a gap between patients' and health professionals' views on patient involvement in older people. The involvement process should therefore be comprehensive and should take into account different levels of health literacy.