General practice and patients’ views of the social networks of patients with multimorbidity

Abstract

INTRODUCTION For patients with multimorbidity to live well, they need the support of not only health professionals but family, friends and organisations. These social networks provide support, potentially enabling the formation of a Community of Clinical Practice approach to multimorbidity care. AIM This study aimed to explore general practice knowledge of the social networks of patients with multimorbidity. METHODS Social network maps were completed by both patients and general practice. The social network maps of 22 patients with multimorbidity were compared with corresponding social network maps completed by general practice staff. RESULTS In 60% (13/22) of the patients, general practice staff held a high or moderate knowledge of individual patients’ social networks. Information on social networks was recalled from staff memory and not systematically recorded in patients’ electronic health records. DISCUSSION Social network information is not routinely collected, recorded or used by general practice to understand the support available to patients with multimorbidity. General practice could take an active role in coordinating social network supporters for certain patient groups with complex multimorbidity. For these groups, there is value in systematically recording and regularly updating their social network information for general practice to use as part of a coordinated Community of Clinical Practice.

Exploring the value of social network ‘care maps’ in the provision of long-term conditions care

“…While previous research suggests that patients can easily identify who they were receiving care from, 8,35–37 the research we report here suggests that HPs’ knowledge of the CoCPs of these complex and high service-using patients was more fragmented. They were also less aware of the wider social context of their patients, although this differed between care settings.…”

“…24–27 Social network approaches have been used: to identify types of networks; 26,28 in interventions for improving self-management activities of people with long-term conditions; 29,30 to understand parents’ perspective on the care of children with complex health needs; 31,32 to predict risk in older people; 33 community development at the end of life 34 and to compare the views of network members. 35,36 The present research addresses whether patients’ social network maps can augment the care that HPs provide.…”

“…8,37 Awareness of this support network is an important factor in facilitating person-centred care. 7,36,39 Yet, research into complex long-term conditions care in the community indicates that there is no central repository for the ‘soft data’ (information that is difficult to capture using classification and quantification) 40 that many HPs have about their patients. 8,35–37,39 Such knowledge is generally not recorded in the formal medical record, in part because this kind of information does not fit well with conventional medical records; consequently, it can be lost when HPs leave their jobs.…”

“…7,36,39 Yet, research into complex long-term conditions care in the community indicates that there is no central repository for the ‘soft data’ (information that is difficult to capture using classification and quantification) 40 that many HPs have about their patients. 8,35–37,39 Such knowledge is generally not recorded in the formal medical record, in part because this kind of information does not fit well with conventional medical records; consequently, it can be lost when HPs leave their jobs. 8,37 The ‘care map’ is a tool designed to elicit and represent this previously unrecorded information about who provides care (that makes a difference) and does so from the perspectives of patients.…”

From the Editor: Reading, writing and research impact

“…Szafran's team from Canada show how patients value the team-based care that has been implemented in Canadian primary care clinics for more than a decade 17 and McKinlay's team extend our knowledge about the importance of social networks by testing the knowledge in general practice about patients' social networks by the statements of patients themselves of their own networks. 18 Strobel et al use routinely collected data to examine process of care indicators for indigenous children in Australia. 19 Finally, check out our columnists discussions of saline eyewashes and echinacea might give you some useful practical tips for accessible treatments for common conditions.…”