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By Martin Fortin, Elizabeth A. Bayliss, Susan M. Smith, Stewart W. Mercer, Mogens Vestergaard, Chris Salisbury

Under the sponsorship of the Agency for Healthcare Research and Quality Multiple Chronic Conditions (AHRQ MCC) Research Network, a panel of six members of the International Research Community on Multimorbidity (CIRMo) presented a webinar on interventions for patients with multimorbidity: “An International Perspective on Designing Interventions for Multimorbidity in Primary Care”. The webinar included three parts:

Context and background for interventions: Dr. Chris Salisbury, University of Bristol, UK, discussed the eligibility criteria in intervention studies for multimorbidity (Who should we include in studies of interventions for multimorbidity?). Dr. Elizabeth A. Bayliss, Kaiser Permanente Colorado, University of Colorado School of Medicine, USA, who acted as the moderator of the webinar, presented “Outcomes for Multimorbidity Interventions” followed by Dr. Susan M. Smith, HRB Centre for Primary Care Research, RCSI Medical School, Dublin, Ireland, who presented a brief summary of a systematic review: “Interventions for improving outcomes in patients with multimorbidity in primary care and community settings”.

Reports on specific research and operational interventions: Senior investigators described three intervention initiatives in three different contexts. Dr. Stewart W. Mercer from the Institute of Health & Wellbeing, University of Glasgow, Scotland, presented “Preliminary findings of an exploratory cluster RCT of a primary care-based complex intervention for multimorbid patients living in deprived areas”. Dr. Martin Fortin, Université de Sherbrooke, Québec, Canada, presented results of an ongoing pragmatic randomized controlled trial: “PR1MaC: Evaluating the integration of chronic disease prevention and management services into primary healthcare” and Dr. Mogens Vestergaard, Aarhus University, Denmark, described a very interesting Danish experience in managing patients with multimorbidity: “The multimorbidity clinic at silkeborg hospital”.

Questions & answers period: At the end of the presentation was a very interesting period of interactions between participants of the webinar and the panel of researchers.

The Webinar was coordinated by James R. Fraser and hosted by Jared Lyle from the AHRQ MCC Research Network.

You can access the webinar presentations and recording through the AHRQ MCC Research Network website:

https://ahrqplexnet.sharepointspace.com/Grantee%20Site%20Pages/Meetings%20and%20Webinars.aspx

Look for the last item under “Webinars & Workshops” entitled “An International Perspective on Designing Interventions for Multimorbidity in Primary Care.”

By Martin Fortin

As part of the 2012 Annual Meeting of the North American Primary Care Research Group (NAPCRG), participants from different disciplines and fields of expertise had the opportunity to take part in the “International collaborative research initiative to design interventions for patients with multimorbidity in primary health care” to discuss and share ideas and perspectives with each other.

This forum was initiated and organized by six researchers: Martin Fortin, MD, MSc; Elizabeth A. Bayliss, MD, MSPH; Stewart Mercer, MBChB, PhD; Susan Smith, MD, MSc; Jane Gunn, MBBS, FRACGP, PhD, DRANZCOG; Mogens Vestergaard, MD, PhD. The forum aimed to use a group process to identify a set of attributes relevant to interventions in multimorbidity, to share findings and to identify potentially important future directions for improving generalist patient-centered care of persons with multimorbidity in primary care settings.

Participants came from different organizations across the USA, Canada, Australia, Denmark, Ireland and the UK which fostered discussions enlightened by different perspectives and experiences. The forum’s organizers gave very short presentations on a number of topics (list presented below*) before handing the floor over to participants for very enthusiastic small group and plenary discussions.

The organizers would like to thank and congratulate each one of the participants for so generously sharing their wide-ranging perspectives and to inform them that the lead group is planning to write a paper based on the forum’s discussions and the work leading up to it.

*Presentation list (summary):
-Concepts and definitions for multimorbidity interventions (M Fortin)
-Systematic review of interventions to improve outcomes for patients with multimorbidity in primary care and community settings (S Smith)
-Outcomes for multimorbidity interventions (E Bayliss)
-Preliminary findings of an exploratory cluster RCT of a primary care-based complex intervention for multimorbid patients living in areas of high deprivation in Scotland: The CARe Plus Study (S Mercer)
-Co-designing an intervention for improving care for those with severe and enduring mental health problems (J Gunn)
-Integration of chronic disease prevention and management services into primary health care: The PR1MaC Study (M Fortin)
-Interventions for multimorbid patients in Denmark (M Vestergaard)

From left to right:
Chris Salisbury, Stewart Mercer, Susan Smith, Mogens Vestergaard,
Martin Fortin, Jane Gunn, Elizabeth A. Bayliss and Sally Wyke.