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The Capital Region of Denmark - a part of Copenhagen University Hospital
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A complex intervention for multimorbidity in primary care: A feasibility study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Perceived value of eHealth among people living with multimorbidity: a qualitative study

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  2. Involving patients with multimorbidity in service planning: perspectives on continuity and care coordination

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  1. Prognostic Value of Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes

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  2. P-wave indices as predictors of atrial fibrillation

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  3. Time trends in the risk of atrial fibrillation and ischaemic stroke in patients with peripheral artery disease between 1997 and 2015

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  4. Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

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Aim: To assess the feasibility of a patient-centered complex intervention for multimorbidity (CIM) based on general practice in collaboration with community health-care centers and outpatient clinics.

Methods: Inclusion criteria were age ≥18 years, diagnoses of two or more of three chronic conditions (diabetes, chronic obstructive pulmonary disease (COPD), and chronic heart conditions), and a hospital contact during the previous year. The CIM included extended consultations and nurse care manager support in general practice and intensified cross-sectorial collaboration. Elements included a structured care plan based on patients' care goals, coordination of services, and, if appropriate, shifting outpatient clinic visits to general practice, medication review, referral to rehabilitation, and home care. The acceptability dimension of feasibility was assessed with validated questionnaires, observations, and focus groups.

Results: Forty-eight patients were included (mean age 72.2 (standard deviation (SD) 9.5, range 52-89); 23 (48%) were men. Thirty-seven patients had two diseases; most commonly COPD and cardiovascular disease (46%), followed by diabetes and cardiovascular disease (23%), and COPD and diabetes (15%). Eleven (23%) patients had all three conditions. Focus group interviews with patients with multimorbidity identified three main themes: (1) lack of care coordination existed across health-care sectors before the CIM, (2) extended consultations provided better care coordination, and (3) patients want to be involved in planning their treatment and care. In focus groups, health-care professionals discussed two main themes: (1) patient-centered care and (2) culture and organizational change. Completion rates for questionnaires were 98% (47/48).

Conclusions: Patients and health-care professionals found the CIM acceptable.

Original languageEnglish
JournalJournal of Comorbidity
Volume10
Pages (from-to)2235042X20935312
ISSN2235-042X
DOIs
Publication statusPublished - 28 Aug 2020

ID: 61662028