Multimorbidity in primary care in Portugal (MM-PT): a cross-sectional three-phase observational study protocol

Abstract

IntroductionMultimorbidity is defined as the co-occurrence of more than one chronic disease in one person without assigning an index disease. This rapidly increasing phenomenon markedly influences patients’ overall health, has major implications for effective provision of healthcare services and has a significant economic toll on individuals and society. Since Portugal is a country with a growing ageing population, a better understanding of the role of multimorbidity should be assessed. The aim of this study is to further the knowledge of the epidemiological factors associated with multimorbidity in Portugal, chiefly its prevalence and the health and social implications.Methods and analysisThis study protocol describes a primary care nationwide three-phase study. The first phase is drawn to access the prevalence and patterns of multimorbidity. In the second phase, individual parameters are assessed, such as patients’ health-related quality of life, perceived family support and unmet health needs of patients with multimorbidity. The third and last phase of this study aims to characterise general practitioners’ knowledge, awareness and practices related to multimorbidity management.Ethics and disseminationThe study will be conducted in accordance with the principles expressed in the Declaration of Helsinki. It has full approval from the Ethics Committee of the Faculty of Health Sciences, University of Beira Interior, and the Ethics Committee of the Central Health Region of Portugal. Study results will be published in peer-reviewed journals and presented at national and international conferences.

Relationship between health-related quality of life, perceived family support and unmet health needs in adult patients with multimorbidity attending primary care in Portugal: a multicentre cross-sectional study

“…This study reports on Phase II of a Three-Phase project (MM-PT: Multimorbidity in primary care in PorTugal) aimed at raising awareness on the relevance to deal with multimorbidity in Portugal. Details regarding the full project’s protocol were previously published elsewhere [24]. …”

“…Study size and sampling of the Primary Care Centres have been described elsewhere [24]. Enrolled GPs recruited patients presenting for a primary care appointment at each of the institutions during the period of the study.…”

“…Participation inclusion criteria included being a willing volunteer to participate; being 18 or more years of age; and having a recorded diagnosis of at least two chronic health problems, of which at least one was required to be hypertension, diabetes, asthma or osteoarthritis. These 4 diseases were selected because, on the one hand, they have high prevalence and are frequently associated with low quality of life, and on the other hand, there are national efforts to implement specific recommendations for the diagnosis, treatment and control of these diseases [24]. Exclusion criteria included being acutely unwell or presenting inability to provide independent informed consent.…”

“…Data collection was performed by protocol [24]. It was carried out through a structured face-to-face interview delivered by the investigator or a GP/GP trainee.…”

“…The detailed set of questions used in this study are provided in the previously published protocol [24]. These questions were pilot tested for comprehensibility in 50 adult general practice patients, no changes were necessary.…”