Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach


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There is increasing awareness of the importance of multimorbidity, defined as patients living with two or more chronic health conditions. One in four people in the UK and the USA have multimorbidity, increasing to at least two-thirds of those older than 65 years.1, 2 Multimorbidity is associated with reduced quality of life, impaired functional status, worse physical and mental health, and increased mortality.3 The increasing prevalence of multimorbidity, driven by the ageing population, represents a major challenge to all health-care systems because these patients are heavy users of services. In the USA, people with multimorbidity account for more than two-thirds of total health spending.2

Efforts to improve the care of patients with chronic diseases have focused on developing guidelines to implement standardised care for each disease. However, this approach can have disadvantages for patients with multimorbidity.4 Recommendations based on disease-specific guidelines can be inappropriate for patients with co-existing….. continue reading