Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study

Simpson, Glenn; Stuart, Beth; Hijryana, Marisza; Kwame Akyea, Ralph; Stokes, Jonathan; Gibson, Jon; Jones, Karen; Morrison, Leanne; Santer, Miriam; Boniface, Michael; Zlatev, Zlatko; Farmer, Andrew; Dambha-Miller, Hajira

Abstract

Background
Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions.
Methods
A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers.
Results
Our findings suggest a care system which is still predominantly single condition focused. ‘Person-centred and holistic care’ and ‘coordinated and joined up care’, were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort.
Conclusions
Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.

Citation

Simpson, G., Stuart, B., Hijryana, M., Kwame Akyea, R., Stokes, J., Gibson, J., …Dambha-Miller, H. (2023). Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study. Journal of Multimorbidity and Comorbidity, https://doi.org/10.1177/26335565231194552

• Journal Article Type: Article
• Acceptance Date: Sep 5, 2023
• Online Publication Date: Sep 5, 2023
• Publication Date: 2023-12
• Deposit Date: Jun 14, 2024
• Journal: Journal of Multimorbidity and Comorbidity
• Print ISSN: 2633-5565
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/26335565231194552
• Public URL: https://keele-repository.worktribe.com/output/852127
• PMID: 37692105