Using the 5Ms Framework to Advance Aging-Responsive Care for Heart Failure with Reduced Ejection Fraction

Abigail Latimer,1 Debra K Moser,2 Jia-Rong Wu,2 Kim K Birtcher,3 Malachy J Clancy,4 Jennifer D Portz,5 Joanna Paladino,6,7 Daniel D Matlock,8,9 Christopher E Knoepke10 1College of Social Work, University of Kentucky, Lexington, KY, 40506, USA; 2College of Nursing, University of Tennessee Knoxville, Knoxville, TN, 37996, USA; 3College of Pharmacy, University of Houston, Houston, TX, 77204, USA; 4Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, 19107, USA; 5University of Colorado Anschutz, General Internal Medicine, Aurora, CO, 80045, USA; 6Massachusetts General Hospital, Boston, MA, 02114, USA; 7Harvard Medical School, Boston, MA, 02115, USA; 8Department of Medicine, Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA; 9VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, 80045, USA; 10Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, 80045, USACorrespondence: Abigail Latimer, College of Social Work, University of Kentucky, 619 Patterson Office Tower, #533, Lexington, KY, 40506, USA, Email [email protected]: Complexity of care is the inevitable consequence of an aging population and is particularly true in instances where patients are managing chronic conditions such as heart failure with reduced ejection fraction (HFrEF). HFrEF itself is complex, with an undulating course of illness, increased risk of sudden cardiac death, and myriad accompanying treatment considerations. Generalist management of HFrEF among older patients is further complicated by competing comorbidities, potential for financial toxicity, potential for mental health symptoms, and risk of care with does not align with goals and preferences. The 5Ms (multicomplexity, mind, mobility, medications, and matters most) is a holistic conceptualization of care that has been applied to the care of older adults, including in gastroenterology, ICU care, oncology, and dentistry. In this narrative review, we present 5Ms Model of care for older adults with HFrEF.Keywords: older adult, cardiovascular disease, interprofessional, interdisciplinary, framework