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Impact of a comprehensive review template on personalised care in general practice for patients with multiple long-term conditions: a mixed-methods evaluation.

Coope, Caroline; Baker, Dereth; Lippiett, Kate Alice; Moult, Alice; Scott, Lauren J; Chilcott, Simon; Turner, Andrew; Jinks, Clare; Portillo, Mari Carmen; Dziedzic, Krysia; Mann, Cindy; Byng, Richard; Scrimgeour, Grace; Salisbury, Chris; Johnson, Rachel

Authors

Caroline Coope

Dereth Baker

Kate Alice Lippiett

Lauren J Scott

Simon Chilcott

Andrew Turner

Mari Carmen Portillo

Cindy Mann

Richard Byng

Grace Scrimgeour

Chris Salisbury

Rachel Johnson



Abstract

Primary care is in urgent need of more effective and efficient ways of managing the care of people living with multiple long-term conditions (multimorbidity). Personalised care organised around an individual's needs and conditions, taking account of individual context and priorities and supporting self-management, may offer an improved approach. Explore the impact of a computerised template to support personalised care for patients with multiple long-term conditions within the context of routinely applied general practice. A convergent mixed-methods evaluation design. General practices were recruited from three areas of England: Bristol, Southampton and Staffordshire. A computerised template for the review of multiple long-term conditions was made available to all general practices subscribing to a commercial template supplier. Implementation practices were supported to conduct personalised multimorbidity reviews. We used routine clinical data from implementation and control practices, a before-and-after patient questionnaire and qualitative interviews with general practice staff and patients to evaluate the impact of the intervention. Thirty-two general practices were recruited of which half were implementation practices. Using the multimorbidity template has potential to improve quality of care and patient benefit with no increase in consultation numbers. Patients received a more complete assessment of their needs with a clearer focus on the problems that matter most to them. Conducting multimorbidity reviews can increase burden on nursing staff and consideration is required to the organisation of reviews and appropriate training for nursing staff. Use of the multimorbidity template needs to be supported by staff training, adequate practice capacity, support for system reorganisation, and attention to incentives to facilitate its benefits. [Abstract copyright: Copyright © 2025, The Authors.]

Citation

Coope, C., Baker, D., Lippiett, K. A., Moult, A., Scott, L. J., Chilcott, S., Turner, A., Jinks, C., Portillo, M. C., Dziedzic, K., Mann, C., Byng, R., Scrimgeour, G., Salisbury, C., & Johnson, R. (in press). Impact of a comprehensive review template on personalised care in general practice for patients with multiple long-term conditions: a mixed-methods evaluation. British Journal of General Practice Open (BJGP Open), Article BJGPO.2025.0022. https://doi.org/10.3399/BJGPO.2025.0022

Journal Article Type Article
Acceptance Date Feb 12, 2025
Online Publication Date May 28, 2025
Deposit Date Jun 16, 2025
Journal BJGP open
Print ISSN 2398-3795
Electronic ISSN 2398-3795
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Article Number BJGPO.2025.0022
DOI https://doi.org/10.3399/BJGPO.2025.0022
Keywords annual review, multimorbidity, organisation of care
Public URL https://keele-repository.worktribe.com/output/1278830
Publisher URL https://bjgpopen.org/content/early/2025/05/27/BJGPO.2025.0022