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J Gen Intern Med. 2007 Dec;22 Suppl 3:419-24.

The challenges of multimorbidity from the patient perspective.

Author information

1
VERDICT/South Texas Veterans Healthcare System, 7400 Merton Minter Blvd, San Antonio, TX, USA. noelp@uthscsa.edu

Abstract

BACKGROUND:

Although multiple co-occurring chronic illnesses within the same individual are increasingly common, few studies have examined the challenges of multimorbidity from the patient perspective.

OBJECTIVE:

The aim of this study is to examine the self-management learning needs and willingness to see non-physician providers of patients with multimorbidity compared to patients with single chronic illnesses.

DESIGN:

This research is designed as a cross-sectional survey.

PARTICIPANTS:

Based upon ICD-9 codes, patients from a single VHA healthcare system were stratified into multimorbidity clusters or groups with a single chronic illness from the corresponding cluster. Nonproportional sampling was used to randomly select 720 patients.

MEASUREMENTS:

Demographic characteristics, functional status, number of contacts with healthcare providers, components of primary care, self-management learning needs, and willingness to see nonphysician providers.

RESULTS:

Four hundred twenty-two patients returned surveys. A higher percentage of multimorbidity patients compared to single morbidity patients were "definitely" willing to learn all 22 self-management skills, of these only 2 were not significant. Compared to patients with single morbidity, a significantly higher percentage of patients with multimorbidity also reported that they were "definitely" willing to see 6 of 11 non-physician healthcare providers.

CONCLUSIONS:

Self-management learning needs of multimorbidity patients are extensive, and their preferences are consistent with team-based primary care. Alternative methods of providing support and chronic illness care may be needed to meet the needs of these complex patients.

PMID:
18026811
PMCID:
PMC2150619
DOI:
10.1007/s11606-007-0308-z
[Indexed for MEDLINE]
Free PMC Article
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