Processes of care desired by elderly patients with multimorbidities
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BACKGROUND: Most recommended care for chronic diseases is based on the research of single conditions. There is limited information on 'best' processes of care for persons with multiple morbidities. Our objective was to explore processes of care desired by elderly patients who have multimorbidities that may present competing demands for patients and providers. METHODS: Qualitative investigation using one-on-one interviews of 26 community-dwelling HMO members aged 65-84 (50% male) who had, at a minimum, the combined conditions of diabetes, depression and osteoarthritis. Participants were chosen from a stratified random sample to have a range of 4-16 chronic medical conditions. RESULTS: Participants' desired processes of care included: the need for convenient access to providers (telephone, internet or in person), clear communication of individualized care plans, support from a single coordinator of care who could help prioritize their competing demands and continuity of relationships. They also desired providers who would listen to and acknowledge their needs, appreciate that these' needs were unique and fluctuating and have a caring attitude. CONCLUSIONS: These respondents describe an ideal process of care that is patient centered and individualized and that supports their unique constellations of problems, shifting priorities and multidimensional decision making. Individual and ongoing care coordination managed by a primary contact person may meet some of these needs. Achieving these goals will require developing efficient methods of assessing patient care needs and flexible care management support systems that can respond to patients' needs for different levels of support at different times.
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Undesirable physical and emotional symptoms and impaired physical functioning can directly prevent patients from carrying out normal daily activities, including tasks required to appropriately and successfully self-manage.
“As such, undesirable physical and emotional symptoms and impaired physical functioning can directly prevent patients from carrying out normal daily activities, including tasks required to appropriately and successfully self-manage [139–141].”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [141]
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- Authors
- Bayliss, E. A., Edwards, A. E., Steiner, J. F., & Main, D. S.
- Affiliations
- Kaiser Permanente (US)
- University of Colorado Denver (US)
- Venue
- Family Practice
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-08-01
- Volume
- 25
- Issue
- 4
- Pages
- 287-293
- ISSN
- 0263-2136 (ISSN-L)
- 1460-2229
- PMC
- PMC2504745
- OpenAlex
- W2098122214
- Cited by
- 328
- References
- 28
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 9 · 2023: 12 · 2022: 14 · 2021: 22 · 2020: 20 · 2019: 31 · 2018: 22 · 2017: 24 · 2016: 23 · 2015: 21 · 2014: 23 · 2013: 24 · 2012: 27
- FWCI
- 9.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Family Practice (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institutes of Health (5r21ag027064-02)
- Agency for Healthcare Research and Quality (K08HS015476)
- National Institute on Aging (5 R21 AG027064)
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Health Sciences › Health Professions › General Health Professions › Health, Nursing, Elderly Care
- Keywords
- multimorbidity, elderly patients, process of care, patient-centered care, care coordination, care coordinators, chronic disease management, diabetes mellitus, depression, osteoarthritis, continuity of care, individualized care plans, community-dwelling older adults
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Chronic Disease, Depression, Diabetes Mellitus, Female, Geriatrics, Health Services Accessibility, Health Services for the Aged, Health Services Needs and Demand, Humans, Male, Osteoarthritis, Self Care, Comorbidity, Patient Satisfaction, Patient-Centered Care
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