The challenges of multimorbidity from the patient perspective

J Gen Intern Med. 2007 Dec;22 Suppl 3(Suppl 3):419-24. doi: 10.1007/s11606-007-0308-z.

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Chronic Disease / psychology*
  • Chronic Disease / therapy
  • Comorbidity
  • Female
  • Health Behavior
  • Health Personnel / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Primary Health Care* / statistics & numerical data
  • Self Care / psychology
  • United States
  • United States Department of Veterans Affairs
  • Veterans / psychology*