The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research
Open accessAbstract
Objective: To synthesise the existing published literature on the perceptions of general practitioners (GPs) or their equivalent on the clinical management of multimorbidity and determine targets for future research that aims to improve clinical care in multimorbidity. Design: Systematic review and metaethnographic synthesis of primary studies that used qualitative methods to explore GPs’ experiences of clinical management of multimorbidity or multiple chronic diseases. Data sources: EMBASE, MEDLINE, CINAHL, PsycInfo, Academic Search Complete, SocIndex, Social Science Full Text and digital theses/online libraries (database inception to September 2012) to identify literature using qualitative methods (focus groups or interviews). Review methods: The 7-step metaethnographic approach described by Noblit and Hare, which involves cross-interpretation between studies while preserving the context of the primary data. Results: Of 1805 articles identified, 37 were reviewed in detail and 10 were included, using a total of 275 GPs in 7 different countries. Four areas of difficulty specific to the management of multimorbidity emerged from these papers: disorganisation and fragmentation of healthcare; the inadequacy of guidelines and evidence-based medicine; challenges in delivering patient-centred care; and barriers to shared decision-making. A ‘line of argument’ was drawn which described GPs’ sense of isolation in decision-making for multimorbid patients. Conclusions: This systematic review shows that the problem areas for GPs in the management of multimorbidity may be classified into four domains. There will be no ‘one size fits all’ intervention for multimorbidity but these domains may be useful targets to guide the development of interventions that will assist and improve the provision of care to multimorbid patients.
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Cites
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995
Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60240-2 · Cited by 6,972
Shared decision making: A model for clinical practice
Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., et al. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2077-6 · Cited by 4,405 · cited 1×
“Evaluating existing models of shared decision-making, such as the choice talk/option talk/ decision talk model described by Elwyn et al 45 , in clinical encounters with multimorbid patients may be a useful place to start this process.”
Charles, C., Gafni, A., & Whelan, T. (1997) · Social Science & Medicine · doi:10.1016/s0277-9536(96)00221-3 · Cited by 4,137
Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ
Tong, A., Flemming, K., McInnes, E., Oliver, S., & Craig, J. (2012) · BMC Medical Research Methodology · doi:10.1186/1471-2288-12-181 · Cited by 3,569
Aging with multimorbidity: A systematic review of the literature
Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., Meinow, B., & Fratiglioni, L. (2011) · Ageing Research Reviews · doi:10.1016/j.arr.2011.03.003 · Cited by 3,092
Noblit, G., & Hare, R. (1988) · doi:10.4135/9781412985000 · Cited by 2,723
Boyd, C. M., Darer, J., Boult, C., Fried, L. P., Boult, L., & Wu, A. W. (2005) · JAMA · doi:10.1001/jama.294.6.716 · Cited by 2,581
Continuity of care: a multidisciplinary review
Haggerty, J. L., Reid, R. J., Freeman, G. K., Starfield, B. H., Adair, C. E., & McKendry, R. (2003) · BMJ · doi:10.1136/bmj.327.7425.1219 · Cited by 2,374
Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly
Wolff, J. L., Starfield, B., & Anderson, G. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.20.2269 · Cited by 2,233
Cited by
Skou, S. T., Mair, F. S., Fortin, M., Guthrie, B., Nunes, B. P., Miranda, J. J., Boyd, C. M., Pati, S., Mtenga, S., & Smith, S. M. (2022) · Nature Reviews Disease Primers · doi:10.1038/s41572-022-00376-4 · Cited by 1,362
Evidence on multimorbidity from definition to intervention: An overview of systematic reviews
Xu, X., Mishra, G. D., & Jones, M. (2017) · Ageing Research Reviews · doi:10.1016/j.arr.2017.05.003 · Cited by 397
Challenges of managing people with multimorbidity in today’s healthcare systems
Moffat, K., & Mercer, S. W. (2015) · BMC Family Practice · doi:10.1186/s12875-015-0344-4 · Cited by 349
Muth, C., Blom, J. W., Smith, S. M., Johnell, K., Gonzalez‐Gonzalez, A. I., Nguyen, T. S., Brueckle, M. ‐., Cesari, M., Tinetti, M. E., & Valderas, J. M. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12842 · Cited by 339
St Sauver, J. L., Boyd, C. M., Grossardt, B. R., Bobo, W. V., Finney Rutten, L. J., Roger, V. L., Ebbert, J. O., Therneau, T. M., Yawn, B. P., & Rocca, W. A. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006413 · Cited by 257
Metadata
- Authors
- Sinnott, C., Mc Hugh, S., Browne, J., & Bradley, C.
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2013-09
- Volume
- 3
- Issue
- 9
- Pages
- e003610
- ISSN
- 2044-6055 (ISSN-L)
- OpenAlex
- W2162687296
- Cited by
- 398
- References
- 46
- FWCI
- 2.91
- Type
- journal article
- Language
- en
- Open access
- gold
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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