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- Title
The challenges of multimorbidity from the patient perspective.
- Authors
Noël, Polly Hitchcock; Parchman, Michael L.; Williams Jr., John W.; Cornell, John E.; Lee Shuko; Zeber, John E.; Kazis, Lewis E.; Lee, Austin F. S.; Pugh, Jacqueline A.; Noël, Polly Hitchcock; Williams, John W Jr; Shuko, Lee
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>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.<bold>Design: </bold>This research is designed as a cross-sectional survey.<bold>Participants: </bold>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.<bold>Measurements: </bold>Demographic characteristics, functional status, number of contacts with healthcare providers, components of primary care, self-management learning needs, and willingness to see nonphysician providers.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
UNITED States; CHRONIC diseases; DISEASES; MEDICAL care; SELF-management (Psychology); PATIENTS; PUBLIC health; CHRONIC disease treatment; CHRONIC diseases &; psychology; RESEARCH; RESEARCH methodology; PATIENT satisfaction; EVALUATION research; MEDICAL cooperation; PRIMARY health care; PSYCHOLOGY of veterans; COMPARATIVE studies; HEALTH behavior; RESEARCH funding; UNITED States. Dept. of Veterans Affairs; HEALTH self-care; COMORBIDITY
- Publication
JGIM: Journal of General Internal Medicine, 2007, Vol 22, p419
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-007-0308-z