Priorities and preferences for care of people with multiple chronic conditions

Abstract

Background To guide the development of high‐quality care for people with multiple chronic conditions, partners of the European Joint Action CHRODIS developed the Integrated Multimorbidity Care Model. To assess its suitability for improving care for people with multimorbidity in the Netherlands, the model was piloted in a primary care setting with both patients and care providers. Aim This paper reports on the patient perspective, and aims to explore the priorities, underlying values and preferences for care of people with multimorbidity. Participants and methods Twenty persons with multimorbidity (selected from general practice registries) participated in a focus group or telephone interview. Subsequently, a questionnaire was completed by 863 persons with multimorbidity registered with 14 general practices. Qualitative data were thematically analysed and quantitative data by means of descriptive statistics. Results Frequently prioritized elements of care were the use of shared electronic health records, regular comprehensive assessments, self‐management support and shared decision making, and care coordination. Preferences for how these elements should be specifically addressed differed according to individual values (eg weighing safety against privacy) and needs (eg ways of coping with multimorbidity). Conclusion The JA‐CHRODIS Integrated Multimorbidity Care Model reflects the priorities and preferences for care of people with multimorbidity in the Netherlands, which supports its relevance to guide the development of person‐centred integrated care for people with multiple chronic conditions in the Netherlands. Patient contribution European patient experts contributed to the development and applicability assessment of the JA‐CHRODIS Integrated Multimorbidity Care Model; Dutch patients participated in focus groups, interviews and a survey.

Balancing standardisation and individualisation in transitional care pathways: a meta-ethnography of the perspectives of older patients, informal caregivers and healthcare professionals

“…Due to the multidimensional nature of multimorbidity, it is of great relevance that the healthcare provided is holistic and that the clinical pathway is not only based on single diagnoses. People with multimorbidity, that is, two or more diagnoses [24], need person-centred care (PCC), a model in which HCPs need to develop a certain skill mix [25]. In Western countries, there is a growing acknowledgement that quality health services should be effective, safe and person-centred, as well as timely, equitable, integrated and efficient [26].…”

Differences in Demographics of Vaccinees, Access to, and Satisfaction with SARS-CoV-2 Vaccination Procedures between German General Practices and Mass Vaccination Centers

“…This effect was absent in participants in vaccination centers. The results might be explained by a generally higher GP consultation rate in patients with chronic conditions and, therefore, a stronger familiarity with their GP and the procedures in the practice [30]. Further, we found in both sites that with increasing age the preference for a SARS-CoV-2 vaccination administered by a GP increased, indicating that older people favored either to be vaccinated in a familiar setting [19] or shorter travel distances [17].…”

Perceptions and experiences of living with and providing care for multimorbidity: A qualitative interview study

“…The perspectives of people with multimorbidity have been documented in earlier work, including the need for a holistic approach to care, continuity of care and establishing trusting relationships with care professionals. 18 , 19 Other sources have identified delays in appointments and referrals experienced by people with multimorbidity, which can be a significant factor influencing care outcomes. 19 Further, studies have found that those with multimorbidity ‘reported better coordination of care when they had more time with their General Practitioner, which ultimately improved individualised care’.…”

“…Multimorbidity presents complex care challenges requiring a comprehensive systems-wide approach to better address both clinical and non-clinical care needs 10 , 17 . This requires strategic and operational change to care systems based on collaborative care models that deliver the holistic and person-centred care necessary to improve care outcomes for this cohort 18 , 36 , 37 .…”