Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS)

Onder, Graziano; Palmer, Katie; Navickas, Rokas; Jurevičienė, Elena; Mammarella, Federica; Strandzheva, Mirela; Mannucci, Piermannuccio; Pecorelli, Sërgio; Marengoni, Alessandra

doi:10.1016/j.ejim.2015.02.020

Cited by 116 publications

(107 citation statements)

References 26 publications

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“…1,2 The prevalence of chronic illness rises with age, 3 so delivery of high-quality care in this growing population group is a priority. 4,5 Care of older people with chronic illness is often complex, 6,7 and to deliver person-centered care in this population, a clear understanding of the person's preferences for care is needed. 8 Person-centered care seeks to provide what is necessary to meet individuals' physical, psychological, social, and spiritual needs by focusing on what is important to them, 5 and care preferences can be defined as what people want from their care.…”

mentioning

confidence: 99%

Influences on Care Preferences of Older People with Advanced Illness: A Systematic Review and Thematic Synthesis

Etkind

Bone

Lovell

et al. 2018

J American Geriatrics Society

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ObjectivesTo determine and explore the influences on care preferences of older people with advanced illness and integrate our results into a model to guide practice and research.DesignSystematic review using Medline, Embase, PsychINFO, Web of Science, and OpenGrey databases from inception to February 2017 and reference and citation list searching. Included articles investigated influences on care preference using qualitative or quantitative methodology. Thematic synthesis of qualitative articles and narrative synthesis of quantitative articles were undertaken.SettingHospital and community care settings.ParticipantsOlder adults with advanced illness, including people with specific illnesses and markers of advanced disease, populations identified as in the last year of life, or individuals receiving palliative care (N = 15,164).MeasurementsThe QualSys criteria were used to assess study quality.ResultsOf 12,142 search results, 57 articles were included. Family and care context, illness, and individual factors interact to influence care preferences. Support from and burden on family and loved ones were prominent influences on care preferences. Mechanisms by which preferences are influenced include the process of trading‐off between competing priorities, making choices based on expected outcome, level of engagement, and individual ability to form and express preferences.ConclusionFamily is particularly important as an influence on care preferences, which are influenced by complex interaction of family, individual, and illness factors. To support preferences, clinicians should consider older people with illnesses and their families together as a unit of care.

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confidence: 99%

Influences on Care Preferences of Older People with Advanced Illness: A Systematic Review and Thematic Synthesis

Etkind

Bone

Lovell

et al. 2018

J American Geriatrics Society

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“…Furthermore, an increasing number of people in Europe (about 50 million) are suffering from multiple chronic conditions or multimorbidity [2,3], of which 60% are people aged 65 years and older [4]. This leads to poor quality of life and high healthcare utilization, reflected in for example elevated numbers of primary care consultations and (ICTs) that could potentially improve self-management, information systems, remote monitoring and independent living solutions [11].…”

Section: Introductionmentioning

confidence: 99%

eHealth in integrated care programs for people with multimorbidity in Europe: Insights from the ICARE4EU project

et al. 2018

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a b s t r a c tIntroduction: Care for people with multimorbidity requires an integrated approach in order to adequately meet their complex needs. In this respect eHealth could be of help. This paper aims to describe the implementation, as well as benefits and barriers of eHealth applications in integrated care programs targeting people with multimorbidity in European countries, including insights on older people 65+. Methods: Within the framework of the ICARE4EU project, in 2014, expert organizations in 24 European countries identified 101 integrated care programs based on selected inclusion criteria. Managers of these programs completed a related on-line questionnaire addressing various aspects including the use of eHealth. In this paper we analyze data from this questionnaire, in addition to qualitative information from six programs which were selected as 'high potential' for their innovative approach and studied in depth through site visits. Results: Out of 101 programs, 85 adopted eHealth applications, of which 42 focused explicitly on older people. In most cases Electronic Health Records (EHRs), registration databases with patients' data and tools for communication between care providers were implemented. Percentages were slightly higher for programs addressing older people. eHealth improves care integration and management processes. Inadequate funding mechanisms, interoperability and technical support represent major barriers. Conclusion: Findings seems to suggest that eHealth could support integrated care for (older) people with multimorbidity.

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“…Also, knowledge of how to successfully implement and improve integrated care is still limited, as is knowledge of how to transfer these experiences to other contexts [28]. Furthermore, improvements to the current way of working in existing initiatives are considered necessary, to make them more person-centred, prevention-oriented, safe and efficient [2427293031]. In addition, more insight into how to measure and evaluate (improvements in) integrated care programmes is needed to be able to capture outcomes and processes adequately and consistently across different programmes and evaluation studies.…”

Section: Introductionmentioning

confidence: 99%

The SUSTAIN Project: A European Study on Improving Integrated Care for Older People Living at Home

Bruin¹,

Stoop²,

Billings³

et al. 2018

International Journal of Integrated Care

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Introduction:Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project.Methods:SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap.Discussion:SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home.

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Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS)

Cited by 116 publications

References 26 publications

Influences on Care Preferences of Older People with Advanced Illness: A Systematic Review and Thematic Synthesis

Influences on Care Preferences of Older People with Advanced Illness: A Systematic Review and Thematic Synthesis

eHealth in integrated care programs for people with multimorbidity in Europe: Insights from the ICARE4EU project

The SUSTAIN Project: A European Study on Improving Integrated Care for Older People Living at Home

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