By Marjan van den Akker
An international group of scientists working around the themes of multimorbidity and polypharmacy have recently published a paper in BMC Medicine [1] on the management of patients with multimorbidity in primary care consultations. The article aims to support decision making in primary care consultations, through a set of guiding principles. These principles are named after the Greek mythological figure Ariadne, who helped the Greek hero Theseus escape from the labyrinth.
The sharing of realistic treatment goals by physicians and patients is at the core of the Ariadne principles. These result from i) a thorough interaction assessment of the patient’s conditions, treatments, constitution, and context; ii) the prioritization of health problems that take into account the patient’s preferences – his or her most and least desired outcomes; and iii) individualized management realizes the best options of care in diagnostics, treatment, and prevention to achieve the goals. Goal attainment is followed-up in accordance with a re-assessment in planned visits. The occurrence of new or changed conditions, such as an increase in severity, or a changed context may trigger the (re-)start of the process.
1-Muth C, van den Akker M, Blom JW, Mallen CD, Rochon J, Schellevis FG, Becker A, Beyer M, Gensichen J, Kirchner H, Perera R, Prados-Torres A, Scherer M, Thiem U, van den Bussche H, Glasziou PP. The Ariadne principles: how to handle multimorbidity in primary care consultations. BMC Med 2014; 12:223.