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Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study

Multimorbidity, common in the primary care setting, has diverse implications for both the patient and the healthcare system. However, there is no consensus on the definition of multimorbidity globally. Thus, we aimed to conduct a Delphi study to gain consensus on the definition of multimorbidity, th...

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Autores principales: Tyagi, Shilpa, Koh, Victoria, Koh, Gerald Choon-Huat, Low, Lian Leng, Lee, Eng Sing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714819/
https://www.ncbi.nlm.nih.gov/pubmed/36455000
http://dx.doi.org/10.1371/journal.pone.0278559
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author Tyagi, Shilpa
Koh, Victoria
Koh, Gerald Choon-Huat
Low, Lian Leng
Lee, Eng Sing
author_facet Tyagi, Shilpa
Koh, Victoria
Koh, Gerald Choon-Huat
Low, Lian Leng
Lee, Eng Sing
author_sort Tyagi, Shilpa
collection PubMed
description Multimorbidity, common in the primary care setting, has diverse implications for both the patient and the healthcare system. However, there is no consensus on the definition of multimorbidity globally. Thus, we aimed to conduct a Delphi study to gain consensus on the definition of multimorbidity, the list and number of chronic conditions used for defining multimorbidity in the Singapore primary care setting. Our Delphi study comprised three rounds of online voting from purposively sampled family physicians in public and private settings. Delphi round 1 included open-ended questions for idea generation. The subsequent two rounds used questions with pre-selected options. Consensus was achieved based on a pre-defined criteria following an iterative process. The response rates for the three rounds were 61.7% (37/60), 86.5% (32/37) and 93.8% (30/32), respectively. Among 40 panellists who responded, 46.0% were 31–40 years old, 64.9% were male and 73.0% were from the public primary healthcare setting. Based on the findings of rounds 1, 2 and 3, consensus on the definition of a chronic condition, multimorbidity and finalised list of chronic conditions were achieved. For a condition to be chronic, it should last for six months or more, be recurrent or persistent, impact patients across multiple domains and require long-term management. The consensus-derived definition of multimorbidity is the presence of three or more chronic conditions from a finalised list of 23 chronic conditions. We anticipate that our findings will inform multimorbidity conceptualisation at the national level, standardise multimorbidity measurement in primary care and facilitate resource allocation for patients with multimorbidity.
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spelling pubmed-97148192022-12-02 Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study Tyagi, Shilpa Koh, Victoria Koh, Gerald Choon-Huat Low, Lian Leng Lee, Eng Sing PLoS One Research Article Multimorbidity, common in the primary care setting, has diverse implications for both the patient and the healthcare system. However, there is no consensus on the definition of multimorbidity globally. Thus, we aimed to conduct a Delphi study to gain consensus on the definition of multimorbidity, the list and number of chronic conditions used for defining multimorbidity in the Singapore primary care setting. Our Delphi study comprised three rounds of online voting from purposively sampled family physicians in public and private settings. Delphi round 1 included open-ended questions for idea generation. The subsequent two rounds used questions with pre-selected options. Consensus was achieved based on a pre-defined criteria following an iterative process. The response rates for the three rounds were 61.7% (37/60), 86.5% (32/37) and 93.8% (30/32), respectively. Among 40 panellists who responded, 46.0% were 31–40 years old, 64.9% were male and 73.0% were from the public primary healthcare setting. Based on the findings of rounds 1, 2 and 3, consensus on the definition of a chronic condition, multimorbidity and finalised list of chronic conditions were achieved. For a condition to be chronic, it should last for six months or more, be recurrent or persistent, impact patients across multiple domains and require long-term management. The consensus-derived definition of multimorbidity is the presence of three or more chronic conditions from a finalised list of 23 chronic conditions. We anticipate that our findings will inform multimorbidity conceptualisation at the national level, standardise multimorbidity measurement in primary care and facilitate resource allocation for patients with multimorbidity. Public Library of Science 2022-12-01 /pmc/articles/PMC9714819/ /pubmed/36455000 http://dx.doi.org/10.1371/journal.pone.0278559 Text en © 2022 Tyagi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Tyagi, Shilpa
Koh, Victoria
Koh, Gerald Choon-Huat
Low, Lian Leng
Lee, Eng Sing
Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title_full Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title_fullStr Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title_full_unstemmed Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title_short Defining and measuring multimorbidity in primary care in Singapore: Results of an online Delphi study
title_sort defining and measuring multimorbidity in primary care in singapore: results of an online delphi study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714819/
https://www.ncbi.nlm.nih.gov/pubmed/36455000
http://dx.doi.org/10.1371/journal.pone.0278559
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