“Growing up, I was an idealistic kid with a desire to help others, even though I was a little naive about everything that goes into being a physician,” says Michael Nanna, MD. “When it came time to choose a career, I knew I would have the opportunity to combine the gratification from helping others with the intellectual stimulation gleaned from medicine, and cardiology in particular.”

Nanna is an interventional cardiologist and clinician investigator at Yale. His clinical work centers on the care of adults with cardiovascular disease, with a focus on the treatment of older adults with coronary artery disease.

One of his research concentrations is on improving processes to approach complex decision-making in older adults living with multiple chronic conditions and cardiovascular disease. Nanna believes Patient Priorities Care (PPC) is a valuable tool for clinicians to standardize their approach for pinpointing their patient’s priorities, preferences, and overall goals of care.

“I think it can be really challenging for clinicians to zero in on the things that matter most to their patients, especially older patients who can have other comorbidities, competing conditions, and tradeoffs of different therapies,” he says. “The more complex the decision at hand, the more important patients’ health priorities become.”

For people with symptomatic heart disease, treatments carry a range of risks and tradeoffs. The potential benefits and outcomes vary as well.

“Understanding what matters most to the patient in front of you can dramatically alter what the ‘optimal’ treatment approach may be,” says Nanna. “There are a multitude of considerations in these patients that PPC helps to streamline to arrive at the best possible decision.”

This is the focus of an ongoing project Nanna is working on, funded by the Yale Claude D. Pepper Older Americans Independence Center, to develop a PPC-based decision tool focused specifically on older adults living with multiple chronic conditions and faced with treatment decisions for their symptomatic coronary artery disease.

“We are really excited at the potential to improve complex decision-making in this vulnerable population,” he says.