Questionnaire survey of geriatricians and primary care physicians' approaches to treating older patients with multimorbidity.

Abstract

Geriatricians and primary care physicians in Japan are expected to provide care to older patients with multimorbidity. A questionnaire survey was carried out to understand the current approaches to older patients with multimorbidity. A total of 3300 participants, including 1650 geriatric specialists (G) and 1650 primary care specialists (PC) were enrolled. A 4-point Likert scale was used to score the following items: diseases that cause difficulty in treatment (diseases), patient backgrounds that cause difficulty in treatment (backgrounds), important clinical factors and important clinical strategies. Statistical comparisons were made between the groups. In the Likert scale, higher scores show a greater degree of difficulty. We obtained responses from 439 and 397 specialists in the G and PC, respectively (response rates 26.6 and 24.1%). The overall scores for "diseases" and "backgrounds" were significantly higher in the G than those in the PC (P < 0.001 and P = 0.018). The top 10 items in the "backgrounds" and in the "important clinical strategies" were all matched between the groups. The overall score of the "important clinical factors" was not statistically different between the groups; however, "low nutrition," "bedridden activities of daily living," "living alone" and "frailty" were found only in the top 10 items of the G, and "financial problems" was found in those of the PC. Geriatricians and primary care physicians have many similarities and differences in their approaches to multimorbidity management. Therefore, there is an urgent need to establish a system in which they can share a common understanding to manage older patients with multimorbidity. Geriatr Gerontol Int 2023; 23: 628-638.