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A complex intervention for multimorbidity in primary care: A feasibility study

AIM: To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics. METHODS: Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic condition...

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Autores principales: Birke, Hanne, Jacobsen, Ramune, Jønsson, Alexandra BR, Guassora, Ann Dorrit Kristiane, Walther, Marie, Saxild, Thomas, Laursen, Jannie T, Vall-Lamora, Maria Helena Dominquez, Frølich, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418232/
https://www.ncbi.nlm.nih.gov/pubmed/32844099
http://dx.doi.org/10.1177/2235042X20935312
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author Birke, Hanne
Jacobsen, Ramune
Jønsson, Alexandra BR
Guassora, Ann Dorrit Kristiane
Walther, Marie
Saxild, Thomas
Laursen, Jannie T
Vall-Lamora, Maria Helena Dominquez
Frølich, Anne
author_facet Birke, Hanne
Jacobsen, Ramune
Jønsson, Alexandra BR
Guassora, Ann Dorrit Kristiane
Walther, Marie
Saxild, Thomas
Laursen, Jannie T
Vall-Lamora, Maria Helena Dominquez
Frølich, Anne
author_sort Birke, Hanne
collection PubMed
description AIM: To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics. METHODS: Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic conditions (diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart conditions), and a hospital contact during the previous year. The CIM included extended consultations and nurse care manager support in general practice and intensified cross-sectorial collaboration. Elements included a structured care plan based on patients’ care goals, coordination of services, and, if appropriate, shifting outpatient clinic visits to general practice, medication review, referral to rehabilitation, and home care. The acceptability dimension of feasibility was assessed with validated questionnaires, observations, and focus groups. RESULTS: Forty-eight patients were included (mean age 72.2 (standard deviation (SD) 9.5, range 52–89); 23 (48%) were men. Thirty-seven patients had two diseases; most commonly COPD and cardiovascular disease (46%), followed by diabetes and cardiovascular disease (23%), and COPD and diabetes (15%). Eleven (23%) patients had all three conditions. Focus group interviews with patients with multimorbidity identified three main themes: (1) lack of care coordination existed across health-care sectors before the CIM, (2) extended consultations provided better care coordination, and (3) patients want to be involved in planning their treatment and care. In focus groups, health-care professionals discussed two main themes: (1) patient-centered care and (2) culture and organizational change. Completion rates for questionnaires were 98% (47/48). CONCLUSIONS: Patients and health-care professionals found the CIM acceptable.
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spelling pubmed-74182322020-08-24 A complex intervention for multimorbidity in primary care: A feasibility study Birke, Hanne Jacobsen, Ramune Jønsson, Alexandra BR Guassora, Ann Dorrit Kristiane Walther, Marie Saxild, Thomas Laursen, Jannie T Vall-Lamora, Maria Helena Dominquez Frølich, Anne J Comorb Article AIM: To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics. METHODS: Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic conditions (diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart conditions), and a hospital contact during the previous year. The CIM included extended consultations and nurse care manager support in general practice and intensified cross-sectorial collaboration. Elements included a structured care plan based on patients’ care goals, coordination of services, and, if appropriate, shifting outpatient clinic visits to general practice, medication review, referral to rehabilitation, and home care. The acceptability dimension of feasibility was assessed with validated questionnaires, observations, and focus groups. RESULTS: Forty-eight patients were included (mean age 72.2 (standard deviation (SD) 9.5, range 52–89); 23 (48%) were men. Thirty-seven patients had two diseases; most commonly COPD and cardiovascular disease (46%), followed by diabetes and cardiovascular disease (23%), and COPD and diabetes (15%). Eleven (23%) patients had all three conditions. Focus group interviews with patients with multimorbidity identified three main themes: (1) lack of care coordination existed across health-care sectors before the CIM, (2) extended consultations provided better care coordination, and (3) patients want to be involved in planning their treatment and care. In focus groups, health-care professionals discussed two main themes: (1) patient-centered care and (2) culture and organizational change. Completion rates for questionnaires were 98% (47/48). CONCLUSIONS: Patients and health-care professionals found the CIM acceptable. SAGE Publications 2020-07-30 /pmc/articles/PMC7418232/ /pubmed/32844099 http://dx.doi.org/10.1177/2235042X20935312 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Birke, Hanne
Jacobsen, Ramune
Jønsson, Alexandra BR
Guassora, Ann Dorrit Kristiane
Walther, Marie
Saxild, Thomas
Laursen, Jannie T
Vall-Lamora, Maria Helena Dominquez
Frølich, Anne
A complex intervention for multimorbidity in primary care: A feasibility study
title A complex intervention for multimorbidity in primary care: A feasibility study
title_full A complex intervention for multimorbidity in primary care: A feasibility study
title_fullStr A complex intervention for multimorbidity in primary care: A feasibility study
title_full_unstemmed A complex intervention for multimorbidity in primary care: A feasibility study
title_short A complex intervention for multimorbidity in primary care: A feasibility study
title_sort complex intervention for multimorbidity in primary care: a feasibility study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418232/
https://www.ncbi.nlm.nih.gov/pubmed/32844099
http://dx.doi.org/10.1177/2235042X20935312
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