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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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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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. |
format | Online Article Text |
id | pubmed-7418232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
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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