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Case 1: Goal of Care and Shared Decision Making for a Patient with Colon Cancer and Possible Metastases

Learning Objectives
1. Set priorities for surgery versus medical management in the treatment of older adults
2. Set clear goals of care for older patients
3. Describe patient-centered care goals versus disease-specific care goals
0.25 Credit CME

An 84-year-old woman is brought to the emergency department (ED) because of a 2-day history of nausea and intractable vomiting. On arrival, the patient appears somnolent but is arousable to verbal stimulation. She has lost more than 20 pounds of weight over the past few months, which she attributes to poor appetite. She has not passed any stool or flatus for more than 3 days. She has a history of hypertension and hypercholesterolemia. Medications include lisinopril (10 mg daily) and hydrochlorothiazide (25 mg daily).

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Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Geriatrics Society and the American Board of Medical Specialties. The American Geriatrics Society is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement: The American Geriatrics Society designates this enduring continuing medical educational activity for a maximum of 0.25 AMA PRA Category 1 Credits™.

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As an ACCME accredited provider of Continuing Medical Education, the American Geriatrics Society must ensure balance, independence, objectivity and scientific rigor in all of our educational activities. We have implemented a process wherein everyone who is in a position to control the content of an education activity has disclosed to us all financial relationships with ineligible company within the prior 24 months. Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. AGS then reviews the disclosure information to determine which financial relationships are relevant and mitigates relevant financial relationships with ineligible companies to prevent commercial bias in the content.

Advisory Panel

The following members of the advisory panel had no relevant financial relationships with ineligible companies to disclose:

  • Ruben Azocar, MD

  • George Drach, MD

  • Sandhya Lagoo-Deenadayalan, MD, PhD

  • Andrew Lee, MD

  • Mike Malone MD

  • Myron Miller, MD

  • Arvind Nana, MD

  • Tom Robinson, MD

  • Victoria Tang MD, MAS

The following members of the advisory panel have reported relevant financial relationships with ineligible companies that have been mitigated through peer review of planning decisions by persons without relevant financial relationships and recusal from any aspect of planning and content related to the financial relationship:

  • Kevin Biese MD, MAT is a paid consultant for Call 9 Telemedicine Medical Advisor and Bristol Meyers Sqibb/Pfizer

  • Daniel Mendelson, MS, MD is a paid consultant for Point Click Care Touchscreen

Writing Panel

The following members of the writing panel had no relevant financial relationships with ineligible companies to disclose:

  • Tomas Griebling, MD

  • Joseph Hejkal, MD

  • Melissa Hornor, MD

  • Jason Johanning, MD

  • Sushila Murthy, MD, MPH

  • Tony Rosen, MD, MPH

  • Kate Schenning, MD, MPH

The following members of the writing panel have reported relevant financial relationships with ineligible companies that have been mitigated through peer review of content by persons without relevant financial relationships:

  • Charles Brown, MD is a paid consultant for and receives grants from Medtronic

  • Badrinath Konety, MD, MBA is a paid consultant for NxThera, and Bristol Myers Squibb, Opko and receives grant funding from Photocure, Genentech, and Genomic Health

Reviewers:

The following reviewers had no relevant financial relationships with ineligible companies to disclose:

  • Shamsuddin Akhtar, MD

  • Patrick Kortebein, MD

  • Joseph LoCicero, MD

Support Statement

This CME activity is supported by a grant from the John A. Hartford Foundation.

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References:
1.
Kelley  AS, Morrison  RS.  Palliative care for the seriously ill.  N Engl J Med. 2015;373(8):747–755. http://www.nejm.org/doi/10.1056/NEJMra1404684Google Scholar
2.
 Palliative Care Fast Fact and Concepts. https://www.mypcnow.org/fast-facts
4.
Smith  AK, Lo  B, Sudore  R.  When previously expressed wishes conflict with best interests.  JAMA Intern Med. 2013;173(13):1241–1245. http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1710099Google Scholar
5.
Kassianos  AP, Ignatowicz  A, Greenfield  G, Majeed  A, Car  J, Pappas  Y.  Partners rather than just providers: a qualitative study on health care professionals' views on implementation of multidisciplinary group meetings in the North West London Integrated Care Pilot.  Int J Integr Care. 2015;15(3):e032https://www.ncbi.nlm.nih.gov/pubmed/26351410Google Scholar
6.
Kruser  JM, Nabozny  MJ, Steffens  NM, Brasel  KJ, Campbell  TC, Gaines  ME, Schwarze  ML.  Best case/worst case: qualitative evaluation of a novel communication tool for difficult in-the-moment surgical decisions.  J Am Geriatr Soc. 2015;63(9):1805–1811. http://onlinelibrary.wiley.com/doi/10.1111/jgs.13615/abstractGoogle Scholar
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