One year follow-up and exploratory analysis of a patient-centered interdisciplinary care intervention for multimorbidity

Abstract

Context Interventions for people with multimorbidity have obtained mixed results. We aimed to document the long-term effect of an intervention for people with multimorbidity. Methods 284 patients (18–80 years) presenting three or more chronic conditions were recruited from seven family medicine groups in the Saguenay-Lac St-Jean region, Quebec, Canada. The patient-centered intervention was based on motivational approach and self-management support. Outcomes were evaluated in a one-year pre-post study design with questionnaires that included the Health Education Questionnaire (heiQ), the Self-Efficacy for Managing Chronic Diseases, the Veteran RAND-12 Health Survey (VR-12), the EuroQoL 5-Domains questionnaire, the Kessler six item Psychological Stress Scale, and measures of smoking habit, physical activity, healthy eating and alcohol consumption. Subgroup analyses by age, number of conditions, sex, and income were also conducted. Results The heiQ domain of emotional wellbeing improved significantly. Improvement was also observed for the VR-12 and the K6. Among the health behaviours, only healthy eating was improved. Subgroup analyses in this exploratory study suggest that younger patients, those with lower number of chronic conditions or higher incomes may respond better in relation to self-management, health status and health behaviours. Conclusion One year after the intervention, participants significantly improved a variety of outcomes. Subgroup analyses suggest that younger patients, those with lower number of chronic conditions or higher incomes may respond better in relation to self-management, health status and health behaviours. This suggests that future interventions should be tailored to patients’ characteristics including age, sex, income and number of conditions.

The History and Applications of the Veterans RAND 12-Item Health Survey (VR-12)

“…Multimorbidity. A motivational approach and self-management support on patients with multiple comorbidities in an ambulatory interdisciplinary care model resulted in modest but significant improvements in PCS and MCS scores at 1 year following the intervention by 2.0 and 1.8, respectively (Fortin et al, 2021).…”

Provider-Perceived Value of Interprofessional Team Meetings as a Core Element of a Lifestyle Medicine Program: A Mixed-Methods Analysis of One Center’s Experience

“…[8][9][10][11][12][13] When compared to single provider or multidisciplinary models, interdisciplinary care has resulted in improved clinical outcomes, especially for patients with conditions such as heart disease and diabetes in which patient engagement and sustained behavior change are essential to disease management. [14][15][16][17][18] Other documented benefits of interdisciplinary team-based care include: enhanced clinician expertise across all relevant treatment domains due to transdisciplinary education among clinicians, improved understanding of patients' needs, consistent messaging from the clinician team to patients, greater patient access to resources which can facilitate sustained behavior change, and improved patient satisfaction with care. 14,[18][19][20][21][22][23][24] Given the complexity and multimorbidity of patients who benefit from lifestyle medicine care, interprofessional team meetings could be a valuable component to standard practice for lifestyle medicine clinicians from various clinical disciplines who collaboratively treat patients in an intensive program approach.…”