Abstract
Background:The complex needs of patients with multiple chronic diseases call for integrated care (IC). This scoping review examines several published Asian IC programmes and their relevant components and elements in managing multimorbidity patients.Method:A scoping review was conducted by searching electronic databases encompassing Medline, Embase, Scopus, and Web of Science. Three key concepts – 1) integrated care, 2) multimorbidity, and 3) Asian countries – were used to define searching strategies. Studies were included if an IC programme in Asia for multimorbidity was described or evaluated. Data extraction for IC components and elements was carried out by adopting the SELFIE framework.Results:This review yielded 1,112 articles, of which 156 remained after the title and abstract screening and 27 studies after the full-text screening – with 23 IC programmes identified from seven Asian countries. The top 5 mentioned IC components were service delivery (n = 23), workforce (n = 23), leadership and governance (n = 23), monitoring (n = 15), and environment (n = 14); whist financing (n = 9) was least mentioned. Compared to EU/US countries, technology and medical products (Asia: 40%, EU/US: 43%-100%) and multidisciplinary teams (Asia: 26%, EU/US: 50%–81%) were reported less in Asia. Most programmes involved more micro-level elements that coordinate services at the individual level (n = 20) than meso- and macro-level elements, and programmes generally incorporated horizontal and vertical integration (n = 14).Conclusion:In the IC programmes for patients with multimorbidity in Asia, service delivery, leadership, and workforce were most frequently mentioned, while the financing component was least mentioned. There appears to be considerable scope for development.HighlightsFirst scoping review to synthesise the key components and elements of integrated care programmes for multimorbidity in Asia.All programmes emphasized ‘distinctive service delivery’, ‘leadership’, and ‘workforce’ components.‘Financing’ component was least mentioned in identified integrated care programmes.
Highlights
Multimorbidity refers to the co-occurrence of more than one chronic health condition in the same individual [1]
This review yielded 1,112 articles, of which 156 remained after the title and abstract screening and 27 studies after the full-text screening – with 23 integrated care (IC) programmes identified from seven Asian countries
The complex needs of patients with multiple chronic diseases call for integrated care [12], which brings a broad range of professionals together to coordinate services
Summary
Multimorbidity refers to the co-occurrence of more than one chronic health condition in the same individual [1]. If physicians follow single disease-based clinical guidelines [5, 6], it will result in duplication of unnecessary services for patients with multiple problems [7, 8]. This phenomenon is still commonly seen in many healthcare systems, where current clinical management approaches are mostly guideline-driven [6] and focused on patients having a single disease [9–11]. The complex needs of patients with multiple chronic diseases call for integrated care [12], which brings a broad range of professionals together to coordinate services. The complex needs of patients with multiple chronic diseases call for integrated care (IC) This scoping review examines several published Asian IC programmes and their relevant components and elements in managing multimorbidity patients
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