Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study

Simpson, G. et al. (2023) Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study. Journal of Multimorbidity and Comorbidity, 13, pp. 1-13. (doi: 10.1177/26335565231194552) (PMID:37692105) (PMCID:PMC10483969)

Abstract

Background: Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions. Methods: A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers. Results: Our findings suggest a care system which is still predominantly single condition focused. ‘Person-centred and holistic care’ and ‘coordinated and joined up care’, were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort. Conclusions: Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.

• Item Type: Articles
• Additional Information: Funding: The Primary Care Research Centre at the University of Southampton is a member of the NIHR School for Primary Care Research and is supported by NIHR Research funds. HDM is a National Institute for Health Research funded Academic Clinical Lecturer and has received NIHR funding for this grant (NIHR202637). This report is independent research funded by the National Institute for Health Research (Artificial Intelligence for Multiple Long Term Conditions (AIM), “The development and validation of population clusters for integrating health and social care: A mixed-methods study on Multiple Long Term Conditions”, "NIHR202637").
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stokes, Dr Jonathan
• Authors: Simpson, G., Stuart, B., Hijryana, M., Akyea, R. K., Stokes, J., Gibson, J., Jones, K., Morrison, L., Santer, M., Boniface, M., Zlatev, Z., Farmer, A., and Dambha-Miller, H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Journal of Multimorbidity and Comorbidity
• Publisher: SAGE Publications
• ISSN: 2633-5565
• ISSN (Online): 2633-5565
• Published Online: 05 September 2023
• Copyright Holders: Copyright © The Author(s) 2023
• First Published: First published in Journal of Multimorbidity and Comorbidity 13:1-13
• Publisher Policy: Reproduced under a Creative Commons license