Abstract
Multimorbidity’s high prevalence and negative impact has made it a subject of worldwide interest. The main aim of this study was to access the Portuguese knowledge, awareness, and practices of general practitioners (GPs) regarding multimorbidity and its management, in order to aid in the development of interventions for improving outcomes in multimorbid patients in primary care. A web-based qualitative descriptive study was carried out in the first trimester of 2016 with primary care physicians working in two districts of the Centre region of Portugal. Open-ended questions were analysed via inductive thematic content analysis. GPs pointed out several difficulties and challenges while managing multimorbidity. Extrinsic factors were associated with the healthcare system logistics’ management (consultation time, organization of care teams, clinical information) and society (media pressure, social/family support). Intrinsic factors related to the GP, patient, and physician-patient relationship were also stated. The most significant conclusion to emerge from this study is that although GPs perceived difficulties and challenges towards multimorbidity, they also have the tools to deal with them: the fundamental characteristics of family medicine. Also, the complex care required by multimorbid patients needs adequate consultation time, multidisciplinary teamwork, and more education/training.
Highlights
In recent years, there has been a worldwide increasing interest in multimorbidity [1], and this is understandable because of its high prevalence [2] and negative consequences, as multimorbidity is responsible for 63% of all deaths worldwide [3]
An estimated 50 million people in the European Union suffer from multimorbidity [8], making it the most common chronic condition [5]
“Managing multimorbidity is hard work for general practitioners (GPs) because we focus on the health of the whole person
Summary
There has been a worldwide increasing interest in multimorbidity [1], and this is understandable because of its high prevalence [2] and negative consequences, as multimorbidity is responsible for 63% of all deaths worldwide [3]. An estimated 50 million people in the European Union suffer from multimorbidity [8], making it the most common chronic condition [5]. In America, the number of people with chronic conditions is projected to increase steadily for the 30 years [9]. In a recent study in Portugal the prevalence of multimorbidity in primary care was above 70% in adult patients [10]. Multimorbid patients have a higher number of primary care consultations and health-related costs [11]. This has significant implications for the healthcare system and patients’ quality of life [12,13]
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