Managing Multiple Morbidities in Primary Care
What are multiple morbidities?
According to Fortin procedures (Fortin et al. 2007), Multimorbidity is defined as the co-existence of two or more chronic medical conditions or long-term conditions in an individual and can present numerous challenges in care, especially with the higher number of existing care conditions and is the standard rather than the exception in primary care patients. It becomes more prevalent as the population age. However, Multimorbidity covers the vertical models where most health research and policy is imagined, supported, and performed, and reflected not only the expert’s interests in specifics difficulties and diseases but also the propensity of research to focus on easily defined issues.
Factors Which Might Influence the Perception of Mm for Professionals or the Patient
When we look at the condition of multiple morbidities, we need to examine and discuss inherently the connection between the patient and the disease. However, bio-psychosocial is one of the most critical aspects that occur when a patient is diagnosed with multiple morbidities, some of these important features should be focused upon since they influence the patients’ variation with the condition. The economic factor is one of the most significant features that influence the bio-psychosocial trait. Multiple morbidities come with additional cost that affects the decision of whether the patient can cope with his her condition.
The occurrence of multiple morbidities varies considerably, dependent on the measure applied and the population studied. Factors related to Multimorbidity are age, gender, and socioeconomic features of the population studied. Multimorbidity is not just a disorder of old age. There are particular problems associated with the primary care practitioners working within the health care setting where expert care has become split and the only “generalist experts” are in medicine to take care of the elderly whose services depend on the age. Certain groups of individuals may be particularly susceptible to the defects of the Multimorbidity, which may include certain ethnic groups.
What are the possible implications of multiple morbidity? (..To you as a clinician, to the patient and possibly to the service providers)
Chronic diseases are related to a high rate of mortality and disability, increased polypharmacy, reduced functions level, poor health-related quality of life, and more health care use such as cost, length of hospital stay, increased usage of inpatients and ambulatory care, and the number of physician’s visits. The condition, however, has been associated with adverse health outcomes. The research has shown that there is an increase in disability with increasing levels of chronic diseases. Multimorbidity also increases the difficulties of clinical treatment and patient management and is thus related to higher medical care expenditures due to the need for long-term care. The adverse effect of Multimorbidity on some other health domains is more aggravated by socioeconomic deficiency and poorly organized medical care facilities.
Healthcare systems are mainly established around a single-disease paradigm, and so specialists’ care of the patients is frequently split and duplicative with rising trends towards super-specialism. This can bring multiple difficulties and barriers to universal patient-centred care. The fundamental role of the generalist in the management of patients in healthcare is becoming more evident. In some set-ups, this function can be presented by a general physician in a Nation with a well-developed primary care organization, for example, in the UK.
What challenges do you think you might face in managing clinical situations where multiple morbidities are present and how do you think can you empower yourself to face such situations?
Treatment burden is more familiar with patients with multimorbidity conditions as they manage a progressively chaotic medical routine. They must find their way through numerous fragmented appointments, examinations, and medical regimes. They are also troublesome for the patients, and these can influence adherence (Smith SM & O’Dowd T). You also find that managing multimorbidity is very difficult for patients and practitioners, primarily when influenced by socioeconomic deprivation. It is also financially costly. The longer-term conditions with a patient than the more significant their usage, thus costing the health care. This may include primary care, secondary care, hospital admission, and outpatient visits. Therefore, the solution is slightly disruptive medicine to decrease the workload of containing illness by improved health care and underlining patient choice.
Finally, we are aware that when patients are motivated to be more involved and when their caregiver is less prescriptive, patients have better outcomes. This approach does not take more time but can be more effective since the health care staff is addressing the patient demand first.
In conclusion, patients with Multimorbidity have complex health care requirements. There are so many difficulties experienced in the management of Multimorbidity, demanding a universal strategy to balance the habitually competing priorities of a single illness, target-founded management of several long-term conditions, and the person’s general well-being. Healthcare systems will be required to completely alter their methodologies to meet the complications and the difficulty that Multimorbidity presents.
Fortin M, Hudon C, Lapointe L, Vanasse A. Multimorbidity is common to family practice: Is it commonly researched? Canadian Family Physician 2005; 51: 244–5.
Fortin M, Soubhi H, Hudon C, Bayliss EA, Mvd Akker. Multimorbidity’s many challenges. Brit Med J. 2007; 334 (7602): 1016–7.
Mercer SW, Watt GMC. The inverse care law: Clinical primary care encounters in deprived and affluent areas of Scotland. Ann Fam Med 2007; 5: 503–510.
Smith SM, O’Dowd T. Chronic diseases: what happens when they come in multiples? Brit J Gen Pract 2007; 57 (537): 268–70.
Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. 2007Interventions to improve outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database of Systematic Reviews: Protocols 2007 Issue 2 John Wiley & Sons, Ltd Chichester UK DOI: 101002/14651858CD006560.
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