By Carol Sinnott
Our research group has recently published a systematic review of the existing published literature on the perceptions of general practitioners (GPs) or their equivalent on the clinical management of multimorbidity [1].
Article focus:
• Patients with multiple morbidities present unique challenges to healthcare providers. An awareness of these challenges is needed to direct research efforts and intervention design in this field.
• Qualitative studies have explored GPs perceptions of the management of multimorbid patients, but to date these studies have not been systematically reviewed or synthesized.
Key messages:
• This systematic review shows that the problem areas for GPs in the management of multimorbidity may be classified into four domains: disorganization and fragmentation of health care; the inadequacy of guidelines and evidence based medicine; challenges in delivering patient centred care; and barriers to shared decision making.
• These domains may be useful targets to guide the development of interventions that will assist and improve the provision of care to multimorbid patients.
Strengths and limitations:
• The meta-ethnographic approach used in this review gave a broader understanding of the challenges of multimorbidity than any single study, while still preserving the context of included studies.
• We focused on the GPs’ perspective on multimorbidity – an understanding of the challenges experience by patients is also required to inform the development of effective interventions.
The complete article can be accessed at:
http://bmjopen.bmj.com/cgi/content/full/bmjopen-2013-003610
[1] Sinnott C, Mc Hugh S, Browne J, Bradley C. GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research. BMJ Open. 2013;3(9):e003610.