Patient-centered care for multimorbid patients

Background: The Belgian healthcare system is currently organized from a single-disease point of view, which poses a unique challenge for patients suffering from two or more physical and/or mental long-term conditions (multimorbidity) and their healthcare providers.

 

Approach: A scoping review was performed to search for solutions that respond to the ever-changing medical landscape and the complexity of multimorbid care. Patient-centered care programs for multimorbid patients in European and American primary care were investigated and their intervention elements were assessed as to whether they are successful or not. Online databases (PubMed, Cochrane, Embase) were used to identify papers published between January 2000 and August 2023, supplemented by reference tracking and a manual search in grey literature. Studies were included if they assessed the efficacy of a patient-centered intervention in primary care for multimorbid adult patients.

 

Results: From the 7020 identified papers, 39 were selected and included in the review. Interventions took place at three levels (patient, professional and organizational). The efficacy of the included studies was heterogeneous. The different intervention elements had a more frequent positive effect on healthcare experience than on health status and behavior. The only intervention that seemed to score partially positive across all Triple Aim domains was a care coordinator.

 

Implications: This research provides an overview of existing patient-centered interventions for multimorbidity. Findings can assist in the development of a framework for multimorbid patient care. Future studies should recognize the importance of patient experience and formulate and evaluate sufficient outcomes within this domain.